Most of you guys probably know this, but in the second year of medical school the curriculum takes a much more clinical turn. For every physiological fact we learn, we learn 3 things that can go awry with the body Xenu has blessed us with. This newly acquired knowledge has given us great diagnosing power. And with great power comes great responsibility… responsibility David and I have not exercised well.
It’s a common saying that when you hear hoof beats, think horses, not zebras. The main point is to steer diagnosticians towards the most probable diagnosis, however mundane, rather than the flashiest. To that I say “no thanks.” After all, House didn’t become a network hit by diagnosing tennis elbow and the common cold. In order to keep my diagnosing mind sharp, I’m always diagnosing my friends, classmates, strangers, the hobo that lives outside Julia’s window, etc etc. Unfortunately our batting average in this zebra clubbing contest is sitting at a paltry .166, well below the Mendoza line. Anyways, to better illustrate my point, I've created a little table of all the misdiagnoses we've made so far.
Can I think of this instead?
What we observed
Our differential diagnosis
What it really was / most likely is
1. Bloodshot eyes
1. Cicatrical pemphigoid
Riding the Pineapple Express
1. Hutchinson-Gilford Progeria Syndrome
John S. (apparently he's just really old)
1. Dozing off in class
1. High blood pressure
Too much beef stew
1. Lack of verbal impulse control
1. Asian guy with a cough
Both SARS and Bird Flu