Friday, January 23, 2009

Forgetting Occam's Razor

As I've confessed before, one of my recreational vices is the TV show House. It's entertaining enough & Hugh Laurie is really good in the title role and it just relaxes me a bit. I always thought it was harmless, but now I'm wondering.

There is a saying in medicine which has become quite well known thanks to medical shows: If you hear hoof beats, think horses not zebras. In other words, consider the most common cause for a symptom before marching off to explore some rare disease which could cause it. The thing about House is that it doesn't just feature zebras, but giant carnivorous purple-and-orange Martian zebras. Plots either revolve around very unusual diseases or more commonly not so unusual diseases with totally bizarre presentation.

Some nasty GI bug, or perhaps a gang of them, latched onto me last week and while I was much better this week I couldn't quite seem to kick it. So I was off to my internist yesterday in hopes of getting an antibiotic scrip. TNG was along for the ride, also in the process of shaking off a bug. He at least brought some reading material (the apropos, in a macabre fashion, The Hostile Hospital), but I had not. So I was scanning through the waiting room magazines & lo and behold: a copy of New England Journal of Medicine (and recent too!).

I don't regularly read NEJM for the simple reason that most of the articles aren't really in my field: they rarely publish molecular medicine studies, though when they do show up they tend to be huge splashes. So I started skimming the ToC for something interesting & spotted an intriguing headline.
Hypogonadism Due to Pituicytoma in an Identical Twin
But as I read the short article I became increasingly puzzled as I read it repeatedly: how exactly was the Pituicytoma in one twin causing the hypogonadism in the other twin?

Then it hit me: only a House fan would have parsed that title that way. There was nothing that bizarre going on. One twin: healthy. The other twin: not-healthy. Duh!

1 comment:

allPower said...

I don't think this is due to you forgetting about Ockham's razor or being an house-fan but rather the fault of the authors choosing a misleading order of words: "Hypogonadism in (One) Identical Twin Due to Pituicytoma" may have been clearer... Good story though ;-)