Monday, July 26, 2021

Horses, Zebras, and Unicorns

I got a lab result back today on a test that I had no idea what it was about.  As near as I can tell, my APRN was making sure I didn't have some strange condition, so the blood had to be sent to Salt Lake City and took a while to get back.  Whatever it was, I don't have it. It seems a waste of money. How many people, even wealthy ones, would get that test if they were paying for it themselves?

Doctors used to love to say that thing about horses and zebras. Do they still?  I had too many guys who said "When I was at Harvard Medical School, we were taught that if we heard hoofbeats, we should look for horses, not zebras."  Oh, like they didn't know that trick at Tufts, doctor? I liked the simpler "common things being common" better.  You are more likely to have a strange presentation of something common than have a strange condition. A friend had longstanding puzzling and very frustrating symptoms. One of the causes was migraines, but because her presentation was odd, neither she nor the previous treating physicians had thought of that.

So yes, horses before zebras.  I always thought it would improve the saying to go one step further and say "And never look for unicorns."  There are conditions that people believe in, but do not exist. Some alt-medicine is recommending useless treatments, but a lot of it is treating nonexistent conditions.  This is usually of the "When all you have is a hammer, everything looks like a nail" type.

1 comment:

Jonathan said...

"Horses before zebras" makes sense. Along with it they should teach that, occasionally, it really is a zebra. Not all physicians understand this.