Looking for zebras

J0178731_2 There’s a phrase in the medical profession (I either read it in a novel or heard it on a TV show, and it stuck in my mind): “when you hear hoofbeats, don’t look for zebras”  That is, most of the time, in medicine, symptoms are caused by the most common illness, not the rare one.

Except in our family. For a while, we were living in zebra territory. And since then, I’m always looking for zebras.

There was my daughter’s Saturday morning stomachache. A really bad stomachache. I took her to the doctor at around 11 a.m. even though my husband, who knows I definitely have a tendency to jump to extreme conclusions, reassured me there was no way she had appendicitis. The doctor agreed with him—stomach virus coming on, she’d probably get diarrhea or some such soon, call, of course, if it gets worse. I took her home. It got worse. An hour later I put her back in the car and went back to the doctor, calling for the appointment

en route. I knew, in my heart, that this was not a stomach virus. The doctor still was betting on the stomach virus, but, to humor me, sent me over to Stanford Hospital for an ultrasound, which involved several hours of waiting in a crowded emergency room. By 7 pm my daughter was on the operating table, by 9 pm she was waking up, minus a badly infected appendix.

Then it was my turn. I had  awful pains down my arm, couldn’t move my arm, couldn’t sleep at night. The odds-on diagnosis—a muscle spasm, pinching nerves. The zebra finally diagnosed several sleepless, immobile weeks later—a ruptured disk.

There were other zebras that stampeded through our family—the “pulled muscle” that was a cracked spine, the “twisted wrist” that didn’t heal for weeks because it was actually broken, the scratchy throat that was the beginning of whooping cough (we caught that zebra when it was still a baby, fortunately).

And now my pediatrician and I have an understanding; if we hear hoofbeats, we look for zebras. She tells me the obvious diagnosis of any symptom as well as the longshot, and takes the longshot seriously until it is definitively ruled out. We’ve caught a few more zebras that way, though not so many lately; could be we’ve finally left zebra territory.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s