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Steve Hosea burned into my mind that the most important part of the medical history isn’t the medical history. It’s the social history.” Charity had taken away other lessons from Dr. Hosea. The simplest explanation is usually the best. If the patient turns up with two separate symptoms—say, a fever and a rash—the cause is more likely than not a single underlying disease. If there is the faintest possibility of a catastrophic disease, you should treat it as being a lot more likely than it seems. If your differential diagnosis leads to a list of ten possibilities, for instance, and the tenth and least likely thing on the list is Ebola, you should treat the patient as if she has Ebola, because the consequences of not doing so can be calamitous. When something doesn’t quite seem right about your diagnosis, respect the feeling, even if you can’t quite put your finger on why the diagnosis might be wrong. A lot of people had died because doctors had allowed their minds to come to rest before they should. A doctor needed to be a detective for the patient: that was Dr. Hosea’s big message.
The Premonition
Michael Lewis
The player of the inner game comes to value the art of relaxed concentration above all other skills; he discovers a true basis for self-confidence; and he learns that the secret to winning any game lies in not trying too hard.
The Inner Game of Tennis
W. Timothy Gallwey
The short answer is that evolution doesn’t really care if we live that long. Natural selection has endowed us with genes that work beautifully to help us develop, reproduce, and then raise our offspring, and perhaps help raise our offspring’s offspring. Thus, most of us can coast into our fifth decade in relatively good shape. After that, however, things start to go sideways. The evolutionary reason for this is that after the age of reproduction, natural selection loses much of its force. Genes that prove unfavorable or even harmful in midlife and beyond are not weeded out because they have already been passed on.
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