Medicine: The Machine Is Fallible

Now that the electrocardiograph has become a standard fixture in consulting rooms, doctors and patients often feel that a checkup is incomplete without its routine ceremonial—daubing with salty goo, taping on electrodes, and letting the machine make wavy lines on squared paper. Confidence in this useful machine has gone too far, says Dr. Francis F. Rosenbaum of Milwaukee. Sometimes it sounds a false alarm, sometimes its "all's well" gives a false sense of security.

By itself, says Dr. Rosenbaum, the electrocardiograph cannot tell the heart's whole story. If the graph shows a minor deviation from normal, the doctor usually mutters something about "strain" and orders the patient to give up some of his favorite activities. This exaggerated caution causes many patients "serious psychologic and economic suffering."

False security, leading to overexertion, can be far more tragic. A man may have made a good recovery from one heart attack, so that his electrocardiogram looks almost normal. But at the very moment of the reading, a clot may be forming in a coronary artery which will kill him next day.

Dr. Rosenbaum does not recommend junking the electrocardiograph. He insists that its evidence be accepted as only part of the story—along with laboratory tests and thorough physical examination.