Dec 15, 2009
MY NOW OLD PROFESSOR MIKE SCHAER ACCUMULATED A SERIES OF SAYINGS WHICH SUM UP THE DESIRED APPROACH TO TREATMENT OF ILLNESS IN ANIMALS. IN TOTAL, THEY DESCRIBE AN APPROACH WHICH BOTH PURSUES A DIAGNOSIS AND TREATS SIGNS OF ILLNESS SIMULTANEOUSLY. IT IS THE RECOGNITION OF THE NEED TO DO BOTH, IN THE ABSENCE OF COMPLETE INFORMATION, THAT IS THE ESSENCE OF ETHICAL PRACTICE. IT IS ALSO A WAY OF THINKING WHICH DISTINGUISHES THE ACCOMPLISHED CLINICIAN FROM ALL OTHERS. WE DO OUR PATIENTS NO SERVICE WHEN WE RUSH TO THE FIRST IMPULSE OF POSSIBLE DIAGNOSIS, NOR WHEN WE DELAY OFFERING RELIEF WHILE WE PURSUE A CONFIRMED ONE. FOOD FOR THOUGHT FOR ALL TO CONSIDER AND WHY MEDICINE IS OFTEN CONSIDERED AN ART AS MUCH AS A SCIENCE. INDEED, IT IS AN ART THAT REQUIRES EXTENSIVE TRAINING, EXTENSIVE EXPERIENCE AND A SCIENTIFIC THOUGHT PROCESS TO PERFORM WELL. SUCH A MIND NEVER THINKS OF POSSIBLE TREATMENTS FOR SIGNS AND SYMPTOMS, WITHOUT PURSUING THE DIAGNOSIS WHICH UNDERLIES THEM. STILL, WE ALL SEE THAT OCCUR QUITE A BIT. INDEED WE OFTEN SEE 'TREATMENTS IN SEARCH OF A DIAGNOSIS" WHICH MIGHT REQUIRE THEM.
SUCH AN APPROACH RUNS COUNTER TO THE HEART OF MEDICINE, WHICH IS SCIENCE.
"Uncle Mikey's" Maxims
1. Treat for the treatable.
2. Assumptions lead to trouble; therefore don't assume.
3. Always interpret clinical information within the context of the patient's presentation.
4. Avoid tunnel vision.
5. Treat your patient, not just its disease.
6. Avoid overmedicating.
7. Be honest with yourself.
8. Don't postpone today's urgencies until tomorrow.
9. Think that common things occur commonly.
10. Look closely at your patient; it will usually tell you what's wrong.
11. Never let your patient die without the benefit of the silver bullet.
12. When you hear hoofbeats, look for horses, but don't forget about the zebras.
13. Never sell the basics short-they are still the best buy in town.
14. If you don't think it, you won't find it.
15. Never let a biological specimen go to waste.
16. Disaster lurks whenever a patient's problem is "routine."
17. If it's not getting worse, give it a chance to get better.
18. Don't stray too far from the patient -- the diagnosis will appear eventually.
19. Don't give your patient a disease it doesn't deserve to have.
20. Don't let technology make you "decerebrate."
21. The necropsy is the clinician's trial by jury.
22. The wisdom of experience should never be ignored.
Michael Schaer, DVM