Dr James Le Fanu: 10 January
There is a common medical belief that events tend to come in threes, so a casualty o fficer who admits two heart attack patients in the same evening, will anticipate a third. The surgeon for whom two operations have gone badly will be apprehensive that the next one will as well. And physicians comment on how patients with rare illnesses also tend to come in threes.
There is unlikely to be any sound statistical base for this piece of folklore that only reflects the well-known tendency for people to be struck by, and therefore remember, such coincidences. The ‘Rule of Three’ has, however, an interesting parallel in the more general belief that personal misfortune also comes in threes – or more comfortingly that three misfortunes in a row signals the end of a run of bad luck.
The number three has both lucky and unlucky connotations – unlike 13, which is universally held to be ominous. It can be lifegiving, as with the Holy Trinity and the mystery of birth – where from the relationship of two people a third emerges. But in the Russian Orthodox church it is also strongly linked to death; the way of a departing spirit being illuminated by three candles lit from a single taper. A better-known example derives from trench warfare during the First World War when lighting three cigarettes from the same match made the holder a target for enemy marksmen.
Richard Blacher, professor of psychiatry in Boston, US, has found the morale of patients to be seriously depressed by the implications of this ‘Rule of Three’, even though they may recognise their fears to be irrational. Those who have had two heart attacks tend to believe a third will be fatal, while a person is much more likely to believe he will not survive an operation if he has recently lost two relatives. It is in the nature of this type of superstition that no amount of reassurance is of value. Professor Blacher argues rather that doctors should try to seek out such hidden fears and exorcise them with some form of ‘counter-magic’.
In a particularly telling case, he describes the case of a 50-year-old woman unable to sleep because of her fear she would die in the night after her cardiologist had told her she has suffered two cardiac arrests in the intensive care unit following complicated heart surgery. Professor Blacher responded that during the operation itself her heart had also to be stopped, which meant in fact that she had had three cardiac arrests. His patient commented: ‘That makes me feel a lot better. If it stopped three times it must be very strong to keep coming back.’ She called him a few days later to report she was sleeping soundly.
This week’s medical query comes courtesy of a gentleman from Bath who recalls how, as a boy, growing up in the 1950s and 1960s he was forever getting boils and styes. ‘My last boil, which I remember well because of its painfulness, I had on my forehead in 1960.’
He notes, however, that none of his children or his grandchildren seem to be prone to them and he wonders what might be the reason for this welcome decline. He speculates that it might be due to an improved diet as in the past they would only ever eat salads in season and subsisted on root crops in the winter months.
This decline in the frequency of boils is well recognised, being usually attributed to the increased frequency of bathing and showering, as boils are spread within a family by person-toperson transmission of the skin bacterium staphylococcus aureus. It is perhaps relevant here that 60 years ago a quarter of households did not have sole use of a bathroom. It is also possible that the prescription of antibiotics for other reasons might have had the inadvertent e ect of preventing boils from developing.
Email drjames@lady.co.uk
There is unlikely to be any sound statistical base for this piece of folklore that only reflects the well-known tendency for people to be struck by, and therefore remember, such coincidences. The ‘Rule of Three’ has, however, an interesting parallel in the more general belief that personal misfortune also comes in threes – or more comfortingly that three misfortunes in a row signals the end of a run of bad luck.
The number three has both lucky and unlucky connotations – unlike 13, which is universally held to be ominous. It can be lifegiving, as with the Holy Trinity and the mystery of birth – where from the relationship of two people a third emerges. But in the Russian Orthodox church it is also strongly linked to death; the way of a departing spirit being illuminated by three candles lit from a single taper. A better-known example derives from trench warfare during the First World War when lighting three cigarettes from the same match made the holder a target for enemy marksmen.
Richard Blacher, professor of psychiatry in Boston, US, has found the morale of patients to be seriously depressed by the implications of this ‘Rule of Three’, even though they may recognise their fears to be irrational. Those who have had two heart attacks tend to believe a third will be fatal, while a person is much more likely to believe he will not survive an operation if he has recently lost two relatives. It is in the nature of this type of superstition that no amount of reassurance is of value. Professor Blacher argues rather that doctors should try to seek out such hidden fears and exorcise them with some form of ‘counter-magic’.
In a particularly telling case, he describes the case of a 50-year-old woman unable to sleep because of her fear she would die in the night after her cardiologist had told her she has suffered two cardiac arrests in the intensive care unit following complicated heart surgery. Professor Blacher responded that during the operation itself her heart had also to be stopped, which meant in fact that she had had three cardiac arrests. His patient commented: ‘That makes me feel a lot better. If it stopped three times it must be very strong to keep coming back.’ She called him a few days later to report she was sleeping soundly.
This week’s medical query comes courtesy of a gentleman from Bath who recalls how, as a boy, growing up in the 1950s and 1960s he was forever getting boils and styes. ‘My last boil, which I remember well because of its painfulness, I had on my forehead in 1960.’
He notes, however, that none of his children or his grandchildren seem to be prone to them and he wonders what might be the reason for this welcome decline. He speculates that it might be due to an improved diet as in the past they would only ever eat salads in season and subsisted on root crops in the winter months.
This decline in the frequency of boils is well recognised, being usually attributed to the increased frequency of bathing and showering, as boils are spread within a family by person-toperson transmission of the skin bacterium staphylococcus aureus. It is perhaps relevant here that 60 years ago a quarter of households did not have sole use of a bathroom. It is also possible that the prescription of antibiotics for other reasons might have had the inadvertent e ect of preventing boils from developing.
Email drjames@lady.co.uk