A story (after Candide)

Once upon a time a 50-year-old man went to his GP with a sore knee and, while there, had his blood pressure checked. The doctor, being a fervent and justified believer in opportunistic health promotion, was pleased that he had discovered the fact that this patient was suffering from the dreaded disease of hypertension. This was the best type of medicine, and damned be those who could not see just how important incidentalomas might be. He explained fully about the illness to the man and, after the statutory three blood pressure readings were all raised, the man gave his informed consent to take some bendroflumethiazide. The man fully understood the seriousness of hypertension and made the attainment of normotension his top priority. He was delighted with the service provided by this best of all possible health services and he had every faith in Dr Pangloss (and his illustrious line of forebears). All would be well but, as he had a disease, he would now have to take extra care of himself. The fact that he already was well, and had had no symptoms except for a bruised knee did not strike this man as odd. Some 3 weeks later it was not his knee, but his big toe, that was sore. The doctor diagnosed gout and treated it with an anti-inflammatory agent, …