22 February 2009
The story begins like this.
" 'O.K., I’m glad it’s not lupus,' the middle-aged man said with a sad, rueful smile. He turned to look at the medical student who brought him the news of yet one more disease that it turned out he didn’t have.' "
From NYT Magazine article:
"It’s a truism in medicine that difficult diagnoses are most likely to be made by the most or least experienced doctors. The most senior have a wide set of experiences to draw on. Whatever the diagnosis, there is a good chance that they have seen it. The novice doesn’t count on experience for guidance. His head is still stuffed with all the possibilities he read about in school — the rare diseases just as common in his experience as the more usual ones. The fact that the doctors caring for this patient had no experience with this disease but were well aware of the potentially fatal consequences of treatment made a difficult diagnosis even more so. In this setting, making a diagnosis is not simply an act of reason; it is a leap of faith."