April 2007
There may be more sources of health information today than there were even ten years ago, but that doesn't mean all of them are good. Inaccurate information continues to spread - whether passed from parent to child or from website to website. Often the misinformation is harmless, but there are times when it leads to problems. When I was 16 years old, I broke a bone in my foot and, rather than seeing a doctor or getting an x-ray, I continued walking on it for days. I had been told "if you can bend it, it's not broken." Wrong. Although I ended up healing well, walking around on a fractured bone is not recommended! Doing so could have prevented the bone from healing, increased the duration of pain or even led to my needing surgery.
Medical myths, like urban legends, remain even in the information age. In fact, as more and more sources of health information become available, medical myths might become more common rather than less so. Myths, after all, are replicated half-truths - told and retold to each new generation.
It's a classic: the pneumonia myth
Did your parents ever tell you not to go outside without a coat because you'll catch pneumonia? Or, did they tell you not to sit by an open window because the draft might make you "catch your death of cold"? I had certainly heard those warnings enough times to believe them. Until I entered medical school, I never thought much about whether they were actually true-and they're not!
There may be good reasons to bundle up before heading out, or for closing the window on a cold 
day, but they have nothing to do with avoiding a cold. Most colds are caused by viruses, and most cases of pneumonia are caused by bacteria. Brief exposure to cold, damp air does not make you more vulnerable to these infections. Cold air definitely can set off coughing or wheezing in people with asthma, or with a tendency toward asthma. But cold air doesn't give you a cold or pneumonia.
This myth goes way back. And it's probably responsible for the widespread belief about how our 9th president died. William Henry Harrison died in 1841, just 30 days into his presidency after giving a particularly long inaugural speech in cold and windy weather. He was not wearing an overcoat.
Why Do Some Medical Myths Persist?
People tend to trust information they learn from those they admire or those they are close to, such as their parents or a respected teacher. Alternatively, what is now a myth may well have once been "fact"-something that even the scientists and doctors of the time believed. For example, it was only about 150 years ago that doctors discovered bacteria, and only about 100 years ago that viruses were discovered. Before we knew that these and other germs were the causes of many infectious diseases, there was no reason to question the idea that being cold could make a person sick. Since cold, damp air is common during cold and flu season, and since there was no better explanation at the time, it seemed logical to blame the weather for colds and pneumonia.
Myths may seem to serve a purpose. No parent wants their kids to freeze in the winter because they refuse to wear their coats outside. Telling your children they'll get pneumonia unless they put on their coats may be an effective way to get the kids to bundle up-especially when they are very young-but sooner or later they'll catch on. They'll notice that when they don't wear a coat, the worst that happens is they feel uncomfortable. My own view is that parents should figure out how to get their kids to do what's best for them without resorting to spreading inaccurate medical information. But, that's just my view.
How Do You Separate Truth From Fiction?
Sometimes even doctors spread myths-usually because the truth hasn't yet been discovered. Such health "information" is more common than you may think, and it is not always easy to identify something that is generally accepted but wrong. How do you determine whether what appears to be expert information is correct? Keeping an open mind, asking questions and sticking with reliable sources, such as your physician, your pharmacist or websites affiliated with academic medical centers, are good starting points for deciding what information to trust and what to discard. Don't just believe something because "everyone knows that."
Are there things that you know or suspect may be medical myths? Let me know about them! I may feature them on this blog at a later date.
Robert H. Shmerling, M.D. is an Associate Physician at Beth Israel Deaconess Medical Center. He is also a Senior Medical Editor for Harvard Health Publications.
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Comments: 22
He checked me all over, listened to my heart, my lungs, etc. and could not find a cause for it. He put me on a general antibiotic and told me that if the fever had not reduced by the next morning to come back immediately. I was back in his office when it opened in the morning.
My doctor checked me over from head to toe again. I could tell he was upset. He just could not figure out what was going on with me.
He finally decided he was going to start doing different tests on me, starting with a chest x-ray to start ruling things out.
I was sent to the nearest hospital to have the x-rays done and was told to stay there until the x-rays had been read. He put a rush order on them to have them read immediately.
After the x-ray was taken, I waited patiently for the results.
A technician came out and told me that they had finished reading the x-rays and that they were calling the doctor with the result right then. Next thing I know I was being told that my doctor was on the phone for me and needed to speak to me.
I had a very sever cause of pneumonia. My left lung was almost full. He apologized and apologized for not being able to diagnose it the day before. He also asked me to come back to his office right away.
I got back to his office and he took me into an examining room and listened to my lung for about 15 minutes. He was stumped. He could not hear a thing. He asked me to lie down, then sit up, then stand and he just kept listening to my lung – nothing.
He apologized to me a few more times and then gave me a shot and a prescription for penicillin. The last thing I remember him saying was that you are always supposed to be able to hear the fluid in the lungs for pneumonia. He also stated that he was not going to make that mistake again and that he was going to remember that you can not always hear the fluid in the lungs when pneumonia is present.
We are all made different!
Are there any significant ill-effects from brief exposure to the elements for a healthy person (other than the risk of unanticipated longer exposure)?
Thanks for the article.
Question on this.
It would seem that cold viruses and bacteria are often present on and in our bodies and that when we are healthy and strong that our bodies natural defense mechanisms can fight them and help us maintain our health. But that when we are weakened due to poor nutrition, lack of sleep or whatever that our body's defense mechanisms may also be weakened and that we are then more susceptible to illness (such as colds). I know that my husband used to have terrible allergies and he would having sneezing fits that went on for hours - and as a result he was often sick with colds and fevers during allergy season.
So isn't it possible that prolonged exposure to cold wind and rain can weaken us somehow and make us more likely to catch a cold or other illness?
Also, When I was a child I often had ear-aches and my mother would insist that if it was a windy day I wear this ugly scarf over my head. I hated this and used to take it off once i left the house. About 2 weeks ago I went for a walk and it was quite windy and cool (early Spring) and when I got home I noticed that one of my ears was aching - as if I had an inner ear infection! The pain went away within a few hours but it made me wonder about the whole scarf thing.
Thanks for the welcome! I'm looking forward to being a part of the Gather community. Your question is a good one and makes 2 important points: brief exposure is very different from prolonged exposure, and it pays to be prepare for the unexpected. Brief exposure to cold, damp, windy or hot weather is rarely a major health hazard (although there are some exceptions to this which I'll mention below). But that same environment can be dangerous if the exposure is stretched out to many hours or an overnight. For example, when someone gets lost in the woods in cold weather without adequate shelter, body temperature may fall, frostbite can affect the fingers, toes, ears and nose, and it can truly be life-threatening.
There are examples of people suffering ill-effects from brief environmental exposure. People with lupus (systemic lupus erythematosus, or SLE) are often quite sensitive to the sun and after just a few minutes of direct sun exposure, they may develop a fever, rash, and become quite ill. That's why sun avoidance, sun screen and protective clothing are recommended for people with SLE. People with significant lung disease can run into trouble fairly quickly when the weather is hot and humid, especially if air pollution levels are high.
I think these exceptions prove the rule, though – for all the nagging parents do to get their kids to bundle up, brief exposure to wind, rain, cold or heat are not likely to cause significant health problems.
I agree! Kids should just put on the jacket and avoid the nagging in the first place. And you make a good point about the timing: if you get a cold after not wearing a coat, it's almost surely a coincidence. But you'll never convince the parent who did the nagging. When one event (getting a cold) follows another (getting "chilled" outside), it may be tempting to assume they are related and that the first caused the second. And that will inevitably lead to the dreaded "I told you so."
As for walking pneumonia, you are right again. It's a non-medical term that just means the person was not admitted to the hospital.
That's a great suggestion. I had not heard about this until a news story a year or two ago that surveyed a large group of people and found this belief to be rather popular. I may have to write about that in a future installment!
Thanks for your comment – the main point I'm making is that brief exposure to the elements is generally harmless. Surely, prolonged exposure could cause problems and I suppose it is possible that some people with severe environmental allergies might develop infections as a result of congestion and blocked airways. But there's a big difference between allergies and infections (even if some symptoms, such as sneezing, overlap). Since both are common, it seems likely to me that bad allergies and colds may occur together just by coincidence. It's hard to know for sure, of course, but my sense is that the vast majority of people with seasonal allergies have no more or less infections than those without allergies.
And yes, I think the scarf was completely unnecessary!
Lisa, the way this was explained to me by a doctor, is that it requires two things, a swelling of the brain, and an actual concussion. Either one by itself will not cause the danger, but the two combined "can" and usually with young children.
I like the point about the cold, as a kid we often played in the snow, and cold weather, and it actually helps the immune system, as the Inuets have known for centuries.
Again good article.
This myth caused a problem for me when I had a bicycle accident (bicycle vs. car) in 1994. Although there was no evidence of any injury other than soft tissue injuries (and I was wearing a helmet), they wanted to admit me to the hospital for the night.
The emergency room personnel (at a well-known teaching hospital) insisted that it wasn't safe to go home with a potential head injury, as I might fall asleep and never wake up again. They wanted someone to keep me awake all night. I had a huge argument with them over this matter and left against medical advice. Of course, I went straight to sleep that night (without fear) because I've always thought that the above-mentioned "theory" was a fallacy. I believe it is now a well-established fact that one need not stay awake all night after a concussion.
I wasn't talking about swelling of the brain, which is a serious medical condition. I was talking about an uncomplicated concussion which is defined (on Medline) as: a brain injury that may result in a bad headache or unconsciousness. Concussions do not include injuries where there is bleeding under the skull or into the brain (that is a complication of the injury).
If someone has received a blow to the head, they should be watched closely for signs of possible brain damage such as repeated vomiting, unequal pupils, confused mental state, varying levels of consciousness, or seizure-like activity. If any of these signs are present, then they should call their health care provider.
Swelling of the brain can be caused by a significant head injury and may result in brain herniation whereby pressure inside the skull (intracranial pressure) increases and displaces brain tissues. A brain herniation can cause a massive stroke. This results from poor blood supply to certain areas of the brain and compression of vital structures that regulate breathing and circulation, and can rapidly lead to brain death. That is very different from a concussion.
For many years people were advised to stay awake after a blow to the head (to monitor for changes). I have it on very good authority (from several sources including a clinical researcher in neurology) that the above-mentioned is a myth and that you don't have to keep people awake if they suffer a concussion. I was told that you should call your provider, if after a head injury, a person can't wake up. This situation is usually proceeded by altered levels of consciousness (drowsy or hard to arouse). By the way, in my case, I was wearing a helmet which was intact, never lost consciousness, and had no signs of a head injury.
In any event, the topic of head injuries, myths versus realities, might be a good one.
Yes I know about the points you are talking about, especially having as many accidents and injuries as I have had. But when I was hit by a trailor while trying to get a kitten out of the way (my fault I thought the driver saw me signal him to stop). I had serious head aches from the incident, band when I asked my dotor about the sleeping issue from head injuries he explained it to me that it took both to be a danger and mostly to children, not just one or the other, the rest was myth.
I had swelling of the brain from the accident, and the pain and other issues went away after a few days.
Good myth suggestion! I have noticed something in movies and television dramas along these lines. A person gets injured. A friend or loved one props them up and tells them to "stay with me, keep talking to me, don't give up…" as if any of this will prevent deterioration. I think you are right that many people mistakenly believe that keeping a person awake has a therapeutic effect.
But, I'd say in the emergency room when you were advised to stay awake, it was more of a miscommunication than a myth. While I cannot speak for your doctors, I doubt they were thinking that keeping you awake would prevent you from slipping into a coma. It's more along the lines you describe about monitoring: it's harder to tell if a person is in a coma when they are asleep! And if there's no one else at home to check on you, how will anyone know if you are unconscious and unarousable (rather than just sleeping)? So, for whatever reason, the doctors seeing you must have been worried about a significant head injury; keeping you awake in a supervised setting was deemed appropriate to be sure you were doing alright. Another option is letting you sleep but awakening you often to be sure you are arousable; again, that's impossible if you are at home alone.
Of course, people with minor injuries are sent home all the time without this intensity of monitoring. Much depends on the level of concern – your own concern was low but, for reasons that may not have been shared with you, the doctors you saw seemed to be more worried.
you would turn blind!!
Is this true?
A book could be written on this topic : Myths. Especially myths propagated by the good docs themselves. Any day in future you want to write a book, sir, I shall be your ghost-writer. I have been watching docs play havoc with the mental stability of the hypchondriacs, the superstitious, the over-cautious, the born-to-be-afraid of things that go thump in the dark, the brainy ones devoting more time to worry than plain living, the superrich, the ones with too much time on their hands.... after all the Romans had a mighty powerful tool in the maxim : Mens sana incorpore sano.
A healthy mind in a healthy body.
Vice versa, can be true too. For mind rules the body. It rules the universe.
I hear the rumbles of an article there...
thanks a lot, doc.
Keep posting. You get a ten for this masterpiece.
Cheerz!