I DON’T KNOW

The one thing my patients never wanted to hear me say was, “I don’t know.”  While saying, “I don’t know” was the appropriate and honest thing to say, it often meant the patient was going to leave my practice in search of the answer, a move that might get them into worse trouble than they were already in.  So, why bring this up now?

I just listened to a podcast by a professor at Stanford who reviewed his findings on Covid-19 and his thoughts about where the American medical system, government and the press went wrong.  Instead of saying, “we don’t know but we are actively seeking answers,” we broadcast our current knowledge as if it was the gospel.  

In time, our knowledge grew and each time we learned more, we published a new gospel.  The more versions of the gospel of Covid that existed, the more defenders of the gospel joined the conversation and the conversation eventually turned into a war of words and science. Currently, there are so many versions of the gospel that no one knows what to believe.

Do we wear mask or don’t we?  Do we keep our distance from others or don’t we?  Is it safe to send our kids to school or isn’t it?  Do we put your local mom and pop businesses out of business to protect the community or don’t we?  The list goes on and on and, as of right now, we still really don’t know.

What we do know is that the flip flopping of the world’s specialists, governments and journalists have created a mess.  That mess could have been avoided by simply stating, “we don’t know but we are actively seeking answers.”  Unfortunately, not having a reputable source of information has driven many to the internet for answers and the internet is full of mistruths and lies.

So, what do we know?  What we know is that it will take another 6-12 months to assess the world’s data and develop a true picture of what we are dealing with.  I don’t know enough to tell you what you should do.  However, I can tell you what I think.  I think we should err on the safe side whenever possible.

Wearing a mask is not going to harm you unless you have advanced lung disease.  Keeping others at a distance is not going to harm you unless you are prone to depression and social isolation is going to lead to a worsening of your depression and possible suicide.  Whether to send your kid back to school or not is highly dependent on your child’s personality and your family dynamics.  I can’t tell you whether you should get vaccinated as I don’t have any information on the Covid-19 vaccine. 

The one thing I know for sure is I want a doc who is not afraid to say, “I don’t know.”  Knowing what I didn’t know and admitting it was one of my best attributes as a physician. Often, to help my patient understand why knowing what I didn’t know was important, I would draw a triangle and divide it into thirds.  The tip of the triangle represented what I know.  The mid-section represented what I knew that I didn’t know.  The base, and largest area of the triangle represented what I didn’t know that I didn’t know.

Recognizing that a large part of the world’s knowledge falls in the base of the knowledge triangle is humbling.  It also is very helpful as it means that you can never stop studying and looking for answers.  It also provides hope that, being persistent in your quest for answers, will be rewarded.

When your doc says, “I don’t know,” thank him/her and then ask him/her what to do next.  When pressed for an answer, I would refer my patient to a specialist or even to Mayo Clinic.  Unfortunately, if I didn’t know the answer, my specialist/Mayo were highly unlikely to have the answer.

Confused?  It’s not uncommon to be confused when there is no obvious answer.  Again, err on the side of caution until you know more.

Here’s your music and a joke.

One day Grandpa was watching Junior playing with an earthwormGrandpa said, “Junior, I will give you $10 if you can put that worm back down in its hole.”

The kids thinks and thinks, then runs into the house and returns with a can of hair spray. He sprays the worn all over and as it gets stiff he stuffs it down into the hole. Grandpa gives the boy $10.

The next day Grandpa comes out to where Junior is playing and gives the boy $20. The boy looked up in confusion and asked, “What’s this for?”

Grandpa smiles and says, “That’s from Grandma!”

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