Don't become a doctor #11 - perfection

I was in an elevator one day, and I couldn't help but overhear two neurologists talking (elevator conversations are bad! Even when it's an elevator full of doctors! Don't make me call the HIPAA police!). The only part I caught was one saying, "The PCP really dropped the ball. It was textbook HSV encephalitis."

Just as an aside, herpes simplex virus (either the cold sore or the genital herpes variety) can rarely INFECT YOUR BRAIN, and if you manage to live through that, you'll usually suffer some major neurologic damage.

I was completely stunned at the boldness of the neurologist's statement. But I'm sure that this PCP doesn't need a couple neurologists beating him up. Probably doing a good enough job himself. I know I would.

In medical school, one of my professors told me something wise. "Ifinding, I'll bet you think you should be right 100% of the time, because when you're wrong, people suffer, and maybe die. But guess what? You'll never be right 100% of the time. No one can be. We're human. In fact, you only need to be right 60% of the time. That's what the USMLE says (182 out of 300 on Step 1). I think that the most admirable goal would be 90%. If you can be right 90% of the time, then you'll probably be the best doctor you know. And when you fuck up, then you can say to yourself that you're allowed to be wrong one in ten times."

That's a really easy concept when you're a student, and the only thing at risk are your grades. It's a lot harder when you're trying to decide if it's pericarditis on EKG or an MI. And after a while, you learn painfully that you will be wrong sometimes, and the best you can do is plan for the worst.

So if you can't deal with being wrong sometimes, then stay away from medicine. I long for the days when being wrong meant losing points on my boards. Now when I am wrong, people get hurt, and people die. There aren't many things in medicine that feel worse, but the truth of the matter is that it is unavoidable. No one is 100%. No one.