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CommentaryPreventive MedicinePrimary Care

You Never Want to Be an Interesting Case. Be Medically Boring.

Our bodies are truly complex. The way we are made, how we develop, the effects of the environment and the passage of time—all impact who we are, how we function, whether we are healthy, and how long we survive.

With the immense progress of medical science in the past two decades especially, we know vastly more than we ever did and are beginning to unravel many of the mysteries of our bodies. We can explain more and improve more, by far, than we could even when we thought we knew a lot back, say, in 1979 when I began practice. It has been a great time to be alive and to be a physician.

Then I see TV shows like CSI or House where everyone is medically “interesting,” and I get very uneasy, because I love medical boredom. Despite the immense intellectual interest of human biology, you as a person and patient never want to be interesting. You want to be medically boring. We don’t want excitement and uncertainty. The best interaction you can aspire to with me runs like this:

“How are you?”
“Anything new?”
“Taking your medicines?”
“Yep. How are my tests?”
“All normal.”
“Did you find anything worrisome when you examined me?”
“Nope. See you in six months.”

This is medical boredom at its best because it means you are healthy. And that is clearly why I work so hard with everyone on preventive care and counseling on intelligent self-care so that perhaps I won’t have to work that hard with you in uncontrolled and dangerous situations.

Consider that alternative, that you are medically interesting. Aha. Now you may not feel well and your tests may be off or, perhaps, you have normal tests but still feel wretched. But what you have and what to do about it is not obvious. After all, that’s what makes it medically interesting. To the doctor, that is.

For you, it will not be so much fun. And sometimes, even with the smartest collection of colleagues and up-to-the minute imaging and other tests (perhaps as good as on CSI and House) we still don’t get the right answer. So you may not get better and could even get worse.

So, please, aspire to be medically boring. It’s better for all real people and their doctors. Leave the medically interesting to the TV shows.

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