As a modern culture, we tend to put our faith wholeheartedly in doctors. They're the experts, and more often than not we take their advice without question. But what we don't take into account is that many of these doctors either don't have a clue or actively withhold information that could be putting your life in jeopardy. And if you think that sounds sensationalist, take a look at these facts—facts that doctors know about but which they conveniently forget to mention as you sign the bill.
处于现代文明中的我们总是倾向于毫无保留地信任医生。他们是权威般的存在，我们通常会毫无异议地采纳他们的意见。但没被我们纳入考虑的是，很多医生要么对一些可能会威胁我们生命的重要信息毫无头绪，要么就竭力隐瞒这些信息。如果你觉得我说的这些话有点耸人听闻，那就看看下面的这些事实——这是医生都知道但却在你签单时忘了提的一些事实。
10.Cancer Isn't Always Cancer
10.癌症并不总是癌症
The worst possible outcome of a trip to the doctor is a diagnosis of the Big C. We're so terrified of it that even the word is taboo in some places, and the medical community lives by one maxim: early diagnosis. The earlier you find the cancer, the more easily you can treat it. But such enthusiasm can easily lead to false positives, and treating something that isn't there can be dangerous.
一个医生可能犯过的最大错误就是对癌症的误诊。癌症总是令人恐惧的，有些地方甚至忌讳提到这个词，而医疗团队却以一个信条赖以为生：早期诊断。癌症发现得越早，治疗起来就越容易。但这样的热忱却极易导致假阳性错误（false positives），而且对根本不存在的疾病加以治疗是极危险的。
We're not just making that up. Mammograms are famous for misdiagnosing breast cancer, since every little anomaly in the breast can look like a tumor. The most common misdiagnosis is with DCIS, or Ductal Carcinoma In Situ. Despite the "carcinoma" in there, DCIS isn't really cancerous ; only rarely does it turn into cancer, and practically everyone with DCIS survives, no matter what kind of treatment they get.But when doctors quote cancer statistics, they usually lump in DCIS, which now accounts for about 30 percent of breast cancer "cases" in the US. And when faced with that option, most people choose to undergo "needless and sometimes disfiguring and harmful treatments" to get rid of something that, statistically, will do less harm than the treatments themselves.
那并不是我们瞎编的。乳房X光检查就容易误诊出乳腺癌，因为乳房的任何一点小异常就可能会被视为肿瘤。最常见的要数对乳腺导管原位癌（DCIS）的误诊。尽管有"恶性肿瘤"的存在，乳腺导管原位癌也不会真正癌变；只有在极少的情况下，它才会病变成癌症，而且不管这些患有乳腺导管原位癌的人接受的是什么样的治疗，他们几乎都活了下来。但当医生统计癌症事例时，他们通常会将乳腺导管原位癌纳入其中，目前美国就有30%的乳腺癌"病例"。此外，当被诊断出患有此病，多数人都会选择"不必要甚至有害健康的治疗"，而据相关统计数据显示，这种治疗对人体造成的伤害远大于"癌症"本身。
9.一些疫苗接种失败
In 2012, the US saw the worst outbreak of whooping cough since 1955. And that's strange, considering that we've been vaccinating against it for over 50 years. Whooping cough is caused by two types of bacteria, Bordatella pertussis and Bortatella parapertussis, but the vaccine—the DTaP—is only designed to fight the first one, B. Pertussis. Which doesn't seem too bad. Getting rid of half the problem is better than doing nothing, right?
2012年，美国出现自1955年以来最严重的百日咳疫情。考虑到我们已经使用百日咳疫苗长达50年，因此这次百日咳疫情的爆发相当奇怪。百日咳有两种病原菌，即百日咳博多氏杆菌和副百日咳博多氏杆菌，但百日咳疫苗——DTaP 疫苗——却只针对百日咳博多氏杆菌这一种病原菌。这似乎也并不坏。能对抗一种病原菌总比什么都不做要好，是这样吗？
Not quite. In all these years of exclusively pounding away at one of the causes, the second type of bacteria has been flourishing, to the point that receiving the vaccine causes B. parapertussis lung infections to grow 40 times as large as they would normally. And recently, the vaccine has also been less effective on the things it's actually supposed to treat. In 2011, the CDC nearly doubled their recommendations for the vaccine, saying you need three initial shots of DTaP followed by three additional shots if you expect it to work. That's because vaccines can actually strengthen viruses. They can't rewire the human genome (and you can dismiss links to autism as alarmist nonsense) but vaccines can stimulate mutations in the viruses they fight. China found that out in the worst possible way when their Hepatitis B vaccines caused the virus to begin mutating twice as fast as it normally would. We've been seeing the same thing happen with the flu virus—vaccines basically just fuel the virus's instinct to survive.
这样的看法不完全正确。这些年来，我们总是专门致力于对抗其中一种病菌，而另一种病菌则伺机活跃起来，以致接种疫苗会促使副百日咳博多氏杆菌的肺部感染率上升到正常情况下的40倍。并且最近，此种疫苗的效果远没有所预想的那般好。2011年，美国疾病控制中心（CDC）建议接种两倍剂量的百日咳疫苗，他们声称如果想要接种的疫苗奏效的话，那么起初注射过三次疫苗的人还要再注射三次。那是因为这些疫苗实际上会强化体内病菌。它们虽然并不能重建人类基因组（你也许对疫苗可能导致孤独症的看法嗤之以鼻，认为其是危言耸听的胡扯），但却能刺激病菌突变。中国以一种糟糕的方式明白了这点，他们发现他们的乙肝疫苗会促使病菌以正常情况下的两倍速度发生突变。我们在流感病毒上也见过同样的情形——疫苗基本上是为病菌的繁衍提供燃料的。
8.Prescription Drugs Can Cause Diabetes
8.处方药会导致糖尿病
Type 2 diabetes is caused when your body either doesn't make enough insulin or can't effectively use all the insulin it makes. The result is a buildup of glucose, or sugar, in the bloodstream, which starts damaging nerves and blood vessels over time. About 2.3 million Americans have type 2 diabetes, and the numbers rise every year.
2型糖尿病是由患者体内所产生的胰岛素相对缺乏，或是由体内胰岛素不能得到有效分泌所导致的。这样就会造成血流中葡萄糖或是糖分的增多，随着时间的推移，这些增加的糖分将会破坏神经和血管。在美国，约有230万2型糖尿病患者，并且这个数字还在逐年上升。
It turns out that some of the most commonly prescribed drugs, like antidepressants, might be causing it. In 2011, there were 46.7 million prescriptions given out to treat depression in the UK alone. When researchers at the University of Southampton looked at the numbers, they found that people who took two of the most common types of antidepressants, SSRIs and tricyclic antidepressants, were twice as likely to develop diabetes. And sure, those findings were released in 2013, but we've known about the link since 2008 and yet millions more are prescribed on a monthly basis.And it gets worse—some of the most common drugs used to treat ADHD in children can triple the risk of type 2 diabetes. More often than not, that's a lifelong condition, and kids don't even get the choice to refuse.
有结果表明，不少常见的处方药，比如抗抑郁药物，就有可能会导致糖尿病。2011年，仅英国这一个国家就给出了4670万张治疗抑郁症的药方。基于这串数字，南安普敦大学的研究者发现，服用了选择性血清再吸收抑制剂（SSRIs）和三环抗抑郁药（tricyclic）这两种较普遍的抗抑郁处方药的人患上糖尿病的可能性是没有服用这两种药物的人的两倍。当然，那些发现在2013年才被公布出来，但从2008年开始，我们就已经知道处方药与糖尿病之间的关联，可数百万乃至更多的人仍会每月定期地服用处方药。更糟糕的是——一些被用于治疗少儿多动症（ADHD）的常见处方药会使服用者患上糖尿病的几率增加三倍。而且那又多半是不可根治的终身病症，可孩子对此却连拒绝的选择都没有。
7.Some Medications Increase Cancer Risk
7.一些药物会增大致癌几率
Now that we've assuaged some of your worries about cancer, let's go ahead and kick everything back up again.
既然我们在之前纾缓了你对癌症的担忧，那现在就让我继续讲下去，让所有忧虑都回复原位吧。
Blood pressure medications can almost triple your risk of aggressive breast cancer. In the US alone, about 58.6 million people take medication for high blood pressure, so you'd think the cancer link would be more well-known. The study that discovered this relationship looked at 1,763 women with breast cancer. Those who used a particular type of blood pressure medicine—calcium channel blockers—were 2.5 times more likely to develop cancer. The risk is greater in elderly women over the age of 55, and it likely happens because calcium channel blockers prevent cells from dying. If cells can't complete their normal life cycle, they go rogue and become cancerous.But even that wouldn't be a problem if the medication weren't so grossly over-prescribed. In a review of one hospital, 150 out of 161 doctors prescribed calcium channel blockers to their patients. But how many of those doctors told their patients about the risks? Only eight. That's a potentially deadly lapse in duty.
降压药几乎会使罹患侵袭性乳腺癌的风险增加三倍。单在美国，就约有5860万人服用降压药，因此你可能会以为降压药与癌症的关联应该更为人所熟知。发现降压药与癌症之间关联的研究小组调查了1763个患有乳腺癌的女性。研究表明，那些服用一种特别降压药——钙通道阻滞剂（calcium channel blockers）的女性患上乳腺癌的几率是普通人的2.5倍。55岁以上的老年妇女患上乳腺癌的风险更大，因为钙通道阻滞剂会阻止细胞死亡。而如果细胞不能完成它们正常的生命周期循环，那么这些细胞的活动就会失控，并最终发生癌变。但如果处方药的剂量并非过大的话，那还算不上一个什么大问题。在对一家医院的审查中，我们发现161名医生中就有150名医生为他们的病人开的处方药中含有钙通道阻滞剂。但又有多少医生告诉他们的病人关于此药的风险？仅仅只有八人。那是他们工作中的潜在致命失误。
6.Aspirin Can Cause Internal Bleeding
6.阿司匹林会导致内出血
One of the more common pieces of advice from doctors is that you should take a low dose of aspirin every day. The idea is that it serves as a maintenance treatment to prevent blood clots, which can cause heart attacks and strokes. But what they don't tell you is the small fact that doing so can trigger massive internal bleeding.
我们经常从医生那里得到的建议就是，每天服用一小剂阿司匹林。因为这种维持治疗能够预防血栓的形成，而血栓则会导致心脏病发作和中风。但医生不会告诉你的是，这样做同样也会引起严重的内出血。
Researchers found that, out of 10,000 people, a daily dose of aspirin prevented 46 people from dying over the course of 10 years. But they also found that 49 people out of the same 10,000 experienced major internal bleeding, and another 117 started bleeding in their gastrointestinal tract. So there may be some benefits, but there may be an even higher chance that something will go horribly wrong. On top of that, aspirin doesn't actually work for everyone. Some people have aspirin-resistant platelets, which negates any positive effect you might get from the aspirin. But since we have no way to test for that, doctors never know if they're recommending a dud treatment or not.
研究者发现，每天定期服用一剂阿司匹林的10000人中，有46人能在10年内相安无事。但同时他们也发现，这10000人中有49人患有胃出血，另外还有117人的胃肠道有出血征兆。因此我们不可否认阿司匹林的好处，但同时它也许会使情况变得非常糟糕。除此之外，阿司匹林并不适用于每个人。阿司匹林的抗血小板作用存在个体性差异，一些患者存在阿司匹林抵抗（aspirin resistance），这便使阿司匹林的所有积极效果全被否定。但由于我们没办法对那进行测试，因此就连医生自己也不知道他们正在为患者推荐的治疗药物是否有用。
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