As a first year medical student, I was always taught to not “chase the zebras.” As we were trained to think of broad differential diagnoses, we were also taught to not get locked down on a rare disease. However, today during the Lewis Blackman video, one piece of advice they gave was to always ask yourself, “what’s the worst it could be?” It is part of what it means to have mindfulness – the ability to reevaluate your prior diagnosis and double-check or second-guess yourself. I agree that asking what the worst possible outcome for the patient might be will more likely ensure higher quality care for the patient, but what if the worst possible outcome is the zebra? Am I supposed to be a physician that always assumes the patient has the super rare disease, or to go with the most likely disease? As I reflect today, I am asking myself how I can refine my critical thinking abilities to always assume the worst, while still keeping in mind the most likely clinical diagnosis and not get carried away with the zebras.
