COULD?

Due to my impending surgery on my left hand, I will be re-publishing some of my past articles as typing is painful.  Today’s article was first published in May, 2012.

“Could” is a word I would do without if I had my way!  Unfortunately, my patients love it! 

“Doc, could my headache be from stress?”

“Doc, could my husband be suffering from depression?”

“Doc, could my son have ADD?”

“Doc, could …?”  is a question I hear multiple times a day.  The funny thing is the answer is always the same.  Realistically, anything “could” be true.  So every time a patient asks the question, “could,” the answer is yes. 

“Yes, your headache could be from stress.”

“Yes, your husband could be suffering from depression.”

“Yes, your son could have ADD.”

Unfortunately, the “could” question often misleads my patients.  While the answer to a problem could be stress, depression, or ADD, often those are unlikely sources of the problem at hand.  Explaining why they could, but are unlikely, is time consuming and stressful for the patient and the doctor.  I particularly hate when a parent ask the “could” question in front of their child.  It is not uncommon to see fear immediately consume the patient’s face.

The question my patients should be asking is, “Doc, what is the probability that stress, depression, or ADD is the problem?”  Differential diagnoses are based on probabilities.  A differential diagnosis is a list of the probable causes for an illness ranked from most likely to least likely or most dangerous to least dangerous.

Knowing what my patients’ concerns are is critical.  Cyberchondria is real and the internet stirs up trouble on a regular basis.  Learning to avoid the word “could,” and using “probable” instead, helps allay a lot of fears!

Could this article help you find the answer to what’s bothering you?  I hope so!

Here’s today’s joke:

Joe wanted to buy a motorbike

but he doesn’t have much luck until one day, he comes across a Honda road bike with a ‘for sale’ sign on it.

The bike seems even better than a new one, although it is 10 years old. It is shiny and in absolute mint condition.

He immediately buys it, and asks the seller how he kept it in such great condition for 10 years.

‘Well, it’s quite simple, really,’ says the seller, ‘whenever the bike is outside and it’s gonna rain, rub Vaseline on the chrome. It protects it from the rain.’

And he hands Joe a jar of Vaseline.

That night, his girlfriend, Sandra, invites him over to meet her parents. Naturally, they take the bike there.

But just before they enter the house, Sandra stops him and says, ‘I have to tell you something about my family before we go in.’

‘When we eat dinner, we don’t talk. In fact, the first person who says anything during dinner has to do the dishes.’

‘No problem,’ he says. And in they go.

Joe is shocked. Right in the middle of the living room is a huge stack of dirty dishes.

In the kitchen is another huge stack of dishes. Piled up on the stairs, in the corridor, everywhere he looks, dirty dishes.

They sit down to dinner and, sure enough, no one says a word.

As dinner progresses, Joe decides to take advantage of the situation.

So he leans over and kisses Sandra.

No one says a word.

So he reaches over and fondles her breasts.

Still, nobody says a word. So he stands up, grabs her, rips her clothes off, throws her on the table, and shags her right there, in front of her parents.

His girlfriend is a little flustered, her dad is obviously livid, and her mother horrified when he sits back down, but no one says a word.

He looks at her mother..

‘She’s got a great body,’ he thinks.

So he grabs the mother, bends her over the dinner table, pulls down her knickers, and screws her every way possible right there on the dinner table. After she has a big orgasm, he sits down again.

Now his girlfriend is furious and her dad is boiling, the Mother is pleasantly beaming.

But still, Total silence.

All of a sudden there is a loud clap of thunder, and it starts to rain.

Joe remembers his bike, so he pulls the jar of Vaseline from his pocket…

Suddenly the father shouted….

‘OK I’ll do the fucking dishes!

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