Once you know something, it’s impossible to un-know it. This can be problematic for everyone, but it’s especially bad for doctors, who have knowledge of a vast number of conditions that can potentially kill people. About 10 years ago, as a family practice intern working through my emergency room rotation, I developed a lingering heaviness and cramping in my right calf.
Had this happened to me B.M.S. (Before Med School), my thoughts might have run this way:
Owowowowow! A charley horse. Okay, I’ve got to stretch it out…I’ll take an Aleve when I get home. It’ll pass.
Instead, my internal dialogue went something like this:
Owowowowow! A charley horse. Okay, I’ve got to stretch it out…Huh.That’s odd. I didn’t do anything unusually physical lately. Okay, differential diagnosis. Could be a muscle strain or a Baker’s cyst. Or it could be a DVT (blood clot).
OMIGODOMIGODOMIGOD A DVT!!! STOP STRETCHING!!! DON’T MOVE!!!
If you dislodge that clot and it goes to your lung, it’s curtains! In fact, I think I’m feeling short of breath now. Omigod it’s too late! Or am I just imagining it?…
…Wait, let’s think this through rationally. I’m not on hormones. I’m not laid up after surgery. Did I take a long plane or car ride recently? Well…there was that two-hour drive last month OMIGODOMIGODOMIGOD A TWO-HOUR DRIVE LAST MONTH!!!
…Whoa, easy there. That was too long ago for it to be just showing up now, right? Right. Okay. So far I don’t have any of the worrisome risk factors for a DVT. Whew, what a relief. Wait, I thought there was something else though. What’s the last risk factor again? Oh, yeah, cancer OMIGODOMIGODOMIGOD CANCER!!!….
…And so on and so on.
This is why doctors are well-advised not to treat themselves (or their family members). Our training has taught us to examine all possibilities as well as calculate all probabilities, and by now, we simply know too much.
You might say we have a leg up on the competition.
Pun completely intended.
