Do Doctors Really Think This Way?

(Originally published in the December 2016 Sparrow Hospital Medical Staff Newsletter)

In the last two months we have had a series of unfortunate events in our household. First, our home furnace stopped working - blowing only cold air. After multiple resets it continued to only blow cold air. Next, the basement dehumidifier started making excessive noise requiring it to be shut off. Then, the garage door started to malfunction and would not close correctly. And finally, the water heater started leaking and I, because I just had to pay for the furnace repair, elected to wait to replace it. 

Ultimately though, I was forced to shut it off when the leaking became worse which meant my son refused to go to school that day without a shower. 

I panicked when I received a call from the plumber who told me they could replace the water heater that morning as long as there was someone who could let them in. Both my wife and I were working and would not be able to get home. I then remembered that my son was there - the only fortunate part of this story.

Why did all this happen? I was told I was in a “replacement cycle” and because many of these machines were new at the same time, they were all failing at the same time. I know better though. It is because of the Himalayan salt lamps my wife bought. Mined in the Punjab region of Pakistan, the large salt crystal is combined with an incandescent bulb (remember those) to create a lamp that is supposed to produce negative ions that filter the air and provide innumerable health benefits. For us, however, they initiated the above string of disasters.

In the 2007 book How Doctors Think, Jerome Groopman, M.D., describes the availability heuristic and how it applies to Physicians. In a clinical situation, a diagnosis may be made because the Physician often sees similar cases in his/her practice. The Physician will misattribute a general symptom as specific to a certain disease based on the frequency the disease is seen in the practice.  More simply, it is mistaking a simple association for cause and effect.  Dr. Groopman’s thesis is that by better understanding how we think, we can learn to think better and make more accurate diagnoses. 

If I look more carefully at the facts and probabilities, it is not that unlikely that we would notice the furnace wasn’t working when we first turned it on in the fall, that the dehumidifier had been making noise for a year, that the water heater was way past its expected life, and that the garage door has lasted since 1988. I still like my hypothesis, however, and may also blame the Spartan Football’s 2016 record on our salt lamps.