I concur on the absolute utility of an open and questioning mind aided by the power of such tools as Google. I too have it at my fingertips and use it daily ( an excellent example for the disbelievers I come across: type in "arthritis, urethritis" into Google and see that the first 5 pages or so of hits are articles on Reiters syndrome). But isnt Heitzso's point also about Disease Surveillance ? David Derauf ----- Original Message ----- From: "Daniel L. Johnson, MD" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Monday, November 25, 2002 1:15 PM Subject: Diagnosis of unusual illness
> Heitzso wrote: > > > > my mother (real life) contracted Guillain Barre > > Syndrome from a flu shot recently and just got out of the hospital > > (she's able to walk, but barely). Yesterday I heard of another GB > > case from this year's flu shots. But when my mother first went to > > an emergency room she was turned away. It wasn't until she lost the > > ability to walk that she was correctly diagnosed and treatment started. > > I wonder whether access to large federated data stores of recent > > symtoms and diagnosis would have caught her GB on the first ER visit? > > The sad reality is that "large federated data stores" have existed for years; > they are called "medical textbooks" and they are amazingly easy and fast for the > expert user -- but that we humans sometimes fail to experience that little click > of cognitive dissonance that says, "Whoa! Case of premature 'closure' of > diagnostic thinking here! Dig deeper on this case!" > > The "large federated data store" that is currently most useful to me when I hear > the little "click of cognitive dissonance" is -- hold your breath -- > google.com. If I enter proper medical jargon, I get only medical hits, and > sometimes very, very helpful ones. But I have a Linux cptr hooked to a T-1 line > in every exam room with a browser up and running. And the textbooks are 30 feet > away, so they get consulted second. Third, I call up a smart colleague and see > if he can break the mental ice. > > But... it all starts with the recognition that here's something strange: we docs > all fall victim at one point or another to the truth that "common diseases > commonly occur" and after a few years of looking for and not finding medical > zebras, the urgency of continuing to look does abate, just as for the sentry who > stands guard for years against a enemy who never shows. > > So it's not more data we need, it's a more perfect human; and silicon ain't > gonna help. I'm sorry that your mom fell afoul of human frailty. > > Dan Johnson md >
