Skepticism…at Work!?

Big news on the skeptical samurai front…

The Skeptical Samurai has finished school (well…at least for the time being)!

I have finished up my final clinical rotation and submitted my final paper. 

I have also started a new job!  I have a position as a Nurse Practitioner at one of the local emergency departments. 

It is an extremely challenging yet rewarding position.  Part of that daily “reward” is the opportunity to work on my proverbial “skeptical chops”…

Let me be more specific…

As my position is in the emergency department, I see a constant influx of new individuals each and every day.  It is my responsibility to assess and diagnosis each patient that I see.  After completing the process of assessment and diagnosis (which can take minutes to hours) it then becomes my responsibility to determine the disposition of each patient (“disposition” is fancy healthcare speak for determining if the patient will be discharged, observed further, referred, admitted, etc).  A vital part of the above process is completing a detailed health history with each patient.  Typically, this includes establishing the patient’s “chief complaint” (just what it sounds like) and the “history of the present illness” (the patient’s interpretation of the events associated with the chief complaint).

And this brings me to the topic of this blog post…

Correlation does not always imply causation!  In other words, just because two events are somehow related does not mean that one event caused the other!

Each day I find myself completely blow away by some individuals “ability” to link certain events together.

The majority of the time when a patient tells me about the events precipitating their visit to the emergency department, it all makes sense.  For example:

“I have a lot of pain in my right knee.  I was out playing soccer, attempted to kick the ball, my body went one way and my knee went the other.  I felt a popping sensation, I fell to the ground, had immediate pain in my right knee, I could not put weight on it then, and I cannot put weight on it now.  So I think that I may have injured my knee”

Pretty straight forward right!?  Makes sense, the patient sustained an obvious physical trauma, experienced associated pain, and that leads him to deduce that he has most likely injured his knee. However there are some patients that simply defy any and all logic or reason, for example: 

“I have had an itchy rectum for the last 6 months.  I woke up this morning and now my left eye also hurts.  Do you think that the two could be related” (I wish that I was making this one up, but this was an actual conversation that I had with a patient!).

Humans are hardwired to recognize patterns.  There are a variety of different theories as to why we are hard wired in this manner, but the long and short of it is that our brains seem to be primed to recognize patterns.  Unfortunately, this innate ability can sometimes lead us astray.  More specifically, it can lead us to seen patterns and causation where there are none.  As a result, an individual’s ability to think in a critical manner can be negatively affected, which can, I would argue, result in an individual making decisions that they may otherwise not have made.        

So what should you take from all of this?

As stated above, we are hard wired to recognize patterns.  However, we may recognize patterns where there are none.  In order words, we are attempting to bring order to a seemingly otherwise chaotic situation.  As being capable of critical thought, we must go beyond this innate drive to simply recognize patterns, and analyze a given situation to see if correlation does in fact imply causation, or if we are simply attempting to see a pattern where there is none.


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