Clinical perception and simple laboratory tests: do not mistake the finger pointing at the moon

Sometime in the past, in an urban emergency department (ED) of a large general hospital located somewhere around the globe, a patient entered the emergency room and asked to be seen by a doctor. He was a Caucasian male, aged around 62, smoker, with a history of type 2 diabetes, but not complaining for any particular symptom. He was simply “feeling bad”, thinking that he should be seen by a doctor. When the nurse completed the triage, and the patient was finally visited, he referred that same sensation of “feeling bad” to the emergency physician. As routine practice, the doctor ordered some first-line laboratory tests [a basic clinical chemistry profile, a complete blood cell count (CBC) and a cardiac troponin test] along with an electrocardiogram (ECG), to have a general picture of the health status. The test results, which were all available ~30 min afterward, revealed only two abnormalities.