it's never lupus
One of the great things about my job is how much, on a good day, it resembles an episode of House. But, you know, with less blood and screaming because we have computers for patients.
The amusing thing is how often the principles in TV show medicine apply. Dr. House can tell us a few things it's good to remember:
Oh, and don't forget that sometimes, multiple individually harmless conditions can have a crippling interaction.
The amusing thing is how often the principles in TV show medicine apply. Dr. House can tell us a few things it's good to remember:
- "Everybody lies."
Never trust reports, only observations. People think they know what the problem is, and they'll tell you what they expect to see if the problem was what they thought it was.
- "Never trust doctors."
This is a corollary of the above; people will come to you asking to work on a problem they've diagnosed. If they had diagnosed it correctly, would they be talking to you? No. No, they would have fixed it already.
- "The simplest explanation is almost always somebody screwed up."
And how.
- "We treat it. If she gets better we know that we're right."
Fixing a hypothetical problem is the most reliable way to verify it was the real problem...
- "Saying there appears to be some clotting is like saying there's a traffic jam ahead. Is it a ten-car pile up, or just a really slow bus in the center lane? And if it is a bus, is that bus thrombotic or embolic? I think I pushed the metaphor too far."
Not every problem matters, or has anything to do with symptoms. Also, it's really easy to push car analogies too far.
Oh, and don't forget that sometimes, multiple individually harmless conditions can have a crippling interaction.