In hospitals, doctors encounter this scenario almost daily: When informing a patient they have a serious illness, the patient reacts with shock, terror, disbelief, and even suspicion that the doctor made a mistake.
"How could that be? I've always been in great health!"——This is a common refrain from many patients who feel perfectly fine.
Most people habitually rely on their "self-perception" to judge their health status, but this approach is highly one-sided.
While "self-perception" can indeed reveal symptoms and signs of many diseases, serving as an important indicator for evaluating health, it is crucial to recognize that it is merely one subjective indicator among many.
On one hand, individuals vary greatly in their tolerance for the impact or discomfort caused by illness. Some are particularly sensitive to pain, lamenting even minor ailments and perceiving them as serious problems. Others, despite exhibiting noticeable symptoms, overlook them due to carelessness or indifference.
On the other hand, many diseases—including those posing serious threats to human health—may present no obvious subjective symptoms during their early or even mid-stages. Though the condition progresses gradually, the patient remains entirely unaware. At this point, the patient still feels "well" or "normal," only becoming aware of physical discomfort once the disease has advanced to a late stage, often causing significant damage to organ function. By then, it is frequently too late, and the optimal window for treatment has been lost.
The Hidden "Health" of Coronary Heart Disease Patients
A Scene: Tian Juan said, "I truly regret it. Mom just left us so suddenly. We celebrated her 70th birthday at home last month. Back then, she was in good health, full of energy, and showed no signs of anything unusual."Mom worked tirelessly her whole life, raising us siblings with great effort. Even after we all started our own families, she continued helping care for her grandchildren. We siblings had already made plans to take her to Beijing for this year's National Day holiday—it was the place she longed to visit most. But life is unpredictable. Just a week ago, we received the news of her passing.
My younger brother at home told me that morning, Mom rose early as usual to prepare breakfast for everyone. After he finished eating and was getting ready for work, she suddenly complained of discomfort in her chest area, feeling dizzy and nauseous. She then collapsed and lost consciousness. The family immediately called an ambulance to take her to the hospital, but despite efforts to save her, Mom passed away that same day.
The doctor informed us that Mom had died from a massive myocardial infarction.She had never mentioned any health issues before. Though we suggested taking her for routine checkups, she insisted she felt perfectly fine, had no illnesses or pains, and that going to the hospital would be a waste of money. She simply refused to go. If we had insisted on regular checkups, perhaps this tragedy could have been avoided. But what good is regret now? It's too late for that.
Doctor's Commentary: Cardiovascular diseases have become the leading cause of death worldwide. Hypertension and coronary heart disease are among the most well-known conditions. Despite this, according to World Health Organization surveys, only about half of those with hypertension have been diagnosed. In other words, roughly half of hypertensive patients remain undetected. Among those diagnosed, nearly half were discovered incidentally during routine physical examinations.The reason lies in the fact that during the early to mid-stages of hypertension, a significant portion of patients exhibit no obvious symptoms. Feeling "well enough," they assume good health and neglect to seek examination, thereby delaying diagnosis. A smaller number of patients are only discovered to have hypertension after suffering a cerebral hemorrhage.
Similarly, among coronary heart disease patients, at least one-quarter of cases are asymptomatic.In these cases, the coronary arteries responsible for supplying blood to the heart have already undergone significant pathological changes, but patients have not yet exhibited clinical manifestations of myocardial ischemia. This occurs because myocardial blood supply is only affected when the narrowing caused by coronary artery lesions exceeds more than half of the original vessel lumen cross-section. Only then do clinical symptoms of myocardial ischemia appear, such as the well-known angina pectoris and myocardial infarction.However, when individuals with latent coronary heart disease encounter adverse stimuli like excessive exertion, intense excitement, extreme stress, or severe cold, the sudden increase in cardiac workload can trigger insufficient blood supply against the existing cardiovascular pathology. This may precipitate acute myocardial infarction or even sudden cardiac death. Tian Juan's mother's death exemplifies such sudden fatality in a latent coronary heart disease patient.
A "Cured" Hepatitis B Patient Suddenly Vomits Blood
A Case Study: More than a decade ago, Bi Fan had contracted hepatitis B, which was treated and declared "cured." Since then, he felt perfectly healthy, experiencing no unusual symptoms—not even common colds or fevers. Unexpectedly, a few days ago, he suddenly vomited a large amount of fresh blood and was rushed to the hospital for treatment.Examination revealed Bi Fan had advanced cirrhosis, leading to bleeding from ruptured varices in the lower esophagus. He was stunned: "How could this happen? How could I get this disease? I always felt perfectly healthy!"
Doctor's Commentary: Liver cirrhosis is a common disease in China and one of the leading causes of death. It is closely linked to hepatitis B virus infection. The onset is insidious, with slow progression and mild symptoms. The latent period from hepatitis B infection to cirrhosis development can span several years or even decades.During the compensated phase, symptoms are mild and nonspecific. Clinical manifestations often emerge only when the disease progresses to the decompensated phase, by which point liver damage is irreversible. Some cirrhosis cases remain asymptomatic throughout, detected only during physical examinations, exploratory surgeries for other conditions, or postmortem autopsies.
A Man Like an "Iron Ox," Yet His Kidneys Have Withered
A Snapshot: Hu Niu, just over 40 years old, is slightly lean. While not exactly "as strong as an ox," he has rarely fallen ill over the years.Occasionally catching a cold, he'd self-medicate with over-the-counter remedies and bounce back. Not only did he feel robust, but colleagues dubbed him an "iron ox." Two weeks ago, he suddenly suffered excruciating headaches at work, followed by vomiting. Colleagues rushed him to the infirmary. Doctors diagnosed high blood pressure, prescribed medication, and advised him to seek comprehensive testing at a major hospital.The results revealed Hu Niu had chronic nephritis, already in its late stages. Both kidneys had shrunk significantly, severely impairing renal function. Struggling to accept this, Hu Niu expressed doubt: "I always felt perfectly healthy, and I've never had nephritis before!"
Doctor's Commentary: Chronic nephritis is a common condition. Among such patients, only a small minority have a history of acute nephritis.Most chronic nephritis patients initially feel perfectly healthy, with the disease developing insidiously. This slow, stealthy onset often means symptoms only manifest clinically after several years of progression. By then, achieving a complete cure becomes extremely difficult.
Patients should remain vigilant and not fall victim to the illusion of "feeling fine."
Numerous common health threats are fueled by this "feeling fine" mindset. Conditions like various cancers, diabetes, and membranous nephropathy often present with minimal initial symptoms, allowing patients to be deceived by their "feeling fine." Some fortunate individuals may be diagnosed incidentally during routine health screenings; otherwise, detection might not occur until the disease has progressed significantly.
Reality shows us that relying solely on "feeling fine" is insufficient to judge one's health status. So how can we detect serious, asymptomatic diseases early while still feeling perfectly healthy?
First, regular health checkups and disease screenings are crucial. This applies not only to middle-aged and elderly individuals but also to young people. Only through consistent monitoring can diseases be detected early and effectively addressed.For instance, many early-stage lung cancer patients and hypertension sufferers were discovered incidentally during routine health screenings. Similarly, the widespread adoption of gynecological screenings has significantly reduced cervical cancer rates by enabling early detection and treatment of precancerous cervical lesions.