My brother said something brilliant yesterday and I want to share it with you. “Nothing is so uncertain as a sure thing.” Think about it for a minute. How many times have you been sure about something, only to be proven wrong, later?

This morning I realized that my training and practice of medicine was, in many aspects, tied to this statement.  As a physician, being sure of yourself can be a dangerous thing.  Being sure that your patient has a stomach virus causes you to miss the underlying appendicitis.  Being sure the resident’s assessment is accurate causes you to miss the one thing the patient forgot to tell the resident:  that thing being the piece of information necessary to make the proper diagnosis.

When I used to make rounds at the local hospital, patients would complain that everyone asked them the same questions over and over again.  “Doc, don’t you read the chart?  The cardiologist just asked me those questions.” One of the worst mistakes I made was during my second year of residency.  The patient came to the floor at 3 a.m.  I had been on shift for 32 hours and after examining the patient, I copied the cardiologist’s interpretation of the EKG into my note and moved on to my next patient.  I knew the cardiologist was one of the best and he had seen the patient in the ER; so copying his findings was no big deal, right?  Wrong!  Had I read the EKG myself, I would have found his error. ”Nothing is so unsure as a sure thing.”

Fortunately, the patient did fine and the erroneous reading of the EKG had no effect on her outcome. It did have a tremendous effect on my outcome.  It taught me the importance of doing my own history and evaluation no matter how many other physicians had evaluated the patient before me.

The moral of the story is simple.  When you are sick and seeing multiple healthcare providers, don’t complain if they ask you the same questions over and over again.  Complain if they don’t.  And remember, no matter how certain your doc is, he/she may be wrong.  There are no sure things in practice of medicine!

By the way, you can help your docs be more efficient by keeping a detailed personal history and medication list up to date and bringing it with you at each visit.

Tomorrow, I’ll address: “The whole problem with the world is that fools and fanatics are always so certain of themselves, and wiser people so full of doubts.” – Bertrand Russell

Here’s your joke for the day:  The owner of a sex shop hires a new clerk.

After the owner taught him the basics of running the store, he has to run an errand.

‘Could you run the store on your own for a couple of hours, Jeremy?’ he asks.

‘Sure thing, boss!’ Jeremy replied, ‘don’t you worry, I’ve got this.’

So the boss leaves for his errands, leaving young Jeremy in charge of the store.

Some time later, a woman walks in. She’s in search of a mechanized equivalent of the male boomstick of glory. Jeremy shows her the so-called model ‘Hercules’; huge, veiny and with a firm grip. The woman is very intrigued and leaves the store thrilled to bits.

Several other women pass by as well and Jeremy proves himself to be a keen salesman of battery-powered penises. All women leave the store satisfied with their purchase.

Then an elderly lady walks in the store in search of some private pleasure. Jeremy shows her the top of the stock, but the lady seems dearly unimpressed. Then, a spectacular model catches her eye. ‘What about that red one?’ she asks. ‘Oh, I see, my lady is a connoisseur!’ Jeremy replies. He shows her the model and with a light step and a big grin, the lady leaves the store.

Later that afternoon, the boss returns and asks how business has been.

Beaming with pride, Jeremy replies: ‘It was great! I sold quite a lot!’

‘Oh really?’ the boss asks, impressed, ‘what models did you sell?’

‘Well sir, 1 model Hercules, 1 model King Kong, 2 LongSchlong21’s and the fire-extinguiser.’

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