I thought the story about Lewis Blackman was very eye-opening to me as a first year resident. The idea of premature closure and anchoring to a diagnosis that seems likely and easy is scary but real. It is simple to make a quick assumption, but it is necessary to ask what the worst case scenario in a particular case is, when symptoms are not responding to your initial assumption. When the case is then passed from one resident to the next, we lose the continuity of the case and the line of thinking, if we do not communicate well and hand the patient off properly to the next physician in line. When we look back on a case like this, it is easy to see where the breakdowns happened and quickly point out the mistakes made. It is also apparent that this scenario would be easy to repeat if we do not focus on being mindful in the way we practice, by asking what are we missing. We also need to completely and effectively communicate the case to the next resident or attending covering.
