• Misdiagnosing is easier than you think

    Sarah Kliff notes a poll this morning:

    Wolters Kluwer poll out this morning finds that not only are most consumers turning to the Internet to answer medical questions, but that they also put strong faith in their own diagnosis. Among college educated Americans, 63 percent say they have “never” misdiagnosed themselves. Add in those who have say they’ve “rarely” made a wrong call and the number jumps up to 84 percent.

    As much as I complain about physicians, they are often necessary. Good ones, even more so. And in support of this, I will provide a personal and completely humiliating anecdote.

    In the summer of 2006, my daughter (and third child) was born. Just two weeks later, my 2 1/2 year old son jumped off this in the backyard:

    It’s just a tiny bit off the ground! But my wife, who was extremely sleep-deprived, claimed that my son had hurt himself. Rolling my eyes, I went outside to check him out. He was limping a little, but was otherwise getting along fine. I asked him if he was hurt, and he said no. Case closed.

    Later that night, my wife nagged me about it again. I had already diagnosed him as fine, but as we had a two week old in the house, I wanted to be accomodating. I took  his leg and really moved it around. He laughed. I couldn’t reproduce pain. I said he was fine.

    Of course, he was still limping the next day. And the day after that. And my wife wouldn’t leave it alone. She said he had to go to the doctor.

    Now a sane man would have just agreed and taken him in. But I was also sleep deprived. Moreover, I had already diagnosed him. So I was done. I told her she could take him in if she wanted.

    In the 100 degree heat, my wife, our 4 1/2 year old, our newborn baby, and our limping 2 1/2 year old went to the doctor. I declared that this was a waste of time. I declared that this was a waste of money. But off they went.

    Hours later, my wife called to tell me they had sent Noah off for x-rays. I could hear my daughter wailing in the background. I could hear my oldest nagging her. And then I made one of the stupidest decisions of my life. I started to lecture her.

    I told my her that she should have refused the x-rays. I told her that they were a waste. I told her that she should never have taken him in for the visit. I told her (I kid you not) that she was the reason that health care spending was so high in the United States.

    I’m sure you can predict what came next:

    In my defense, it was a small fracture, and I bet he would have been fine without the cast. But, as you can imagine, I am no longer allowed to make diagnoses in the house. If the kids appear sick, they’re going to the doctor. I’ll never say anything about that again.

    The lesson you should take home from this is that we are likely terrible at diagnosing those close to us, especially ourselves. There are physicians for a reason. If you’re concerned about your health you should at least call one, if not go see one.


    • A similar thing happened to me recently but I put up less fight and my son is 17 AND my son turned out to have a sprain as I had diagnosed.

    • I think that physicians are notorious for neglecting the health of their families (shoes, cobblers, etc.).
      I know that I have been banned from making any diagnosis in our family. (It doesn’t help that I have the attitude that most illness is either self-limited and/or untreatable.)
      If anyone in my family has a medical question, they know to go and see a “real” doctor.

    • I’m not a physician but my wife was an EMT. I always felt like I was saying we should take the kids to the doctor a lot more than she ever did so one night 2-3 years ago, I figured I’d buck the trend.

      Our son had swallowed what we thought was a quarter (it turned out to be a Red Robin (Yum!) token which was a hair bigger). He wasn’t in major discomfort, he was coughing periodically but he seemed fine. My wife wanted me to take him to the E-room (happened after office hours). I told her he was fine, it probably just irritated his esophagus on the way to his stomach.

      Fast forward a couple hours and he’s still coughing in his sleep. I finally agree to take him to the E-room. You can figure out the rest. X-rays showed it stuck right above his stomach. Cue the ambulance to Hershey Children’s Hospital (we didn’t know the closest hospital didn’t have a Peds unit). Admit him to a room, wait for the schedule to open up so they can retrieve the token. Disappointed they didn’t let us keep it.

      My excuse for this is heredity. My mother let my brother walk around with a broken arm for 2 days before taking him to the doctor.

    • That picture is adorable. The cast (and your son!) is so cute.