William Aird, Professor of Medicine at Harvard Medical School, shared a post on LinkedIn:
“The Short Case
In Canadian medical training, the short case was a rite of passage. You were brought to the bedside, given a task, and expected to think out loud, under observation, in real time.
‘Dr. Aird, please examine this patient with an MCV of 140.’
Two decisions arise immediately.
- Do you list every possible cause, or weight them?
- Do you organize the examination by diagnosis, or move head-to-toe?
Start with the differential.
The differential is not just a list. It is a weighted list. An MCV of 140 does not distribute probability evenly. Some diagnoses move forward. Others recede. Then comes the examination.
How do you translate that differential into action?
You could proceed diagnosis by diagnosis. Or you can reorganize it by anatomy. Each region of the body becomes a testing ground for multiple hypotheses at once. You are not moving from disease to disease. You are moving through the body, testing them in parallel.
Naming possibilities is memory. Updating them in real time is reasoning.
I explore this further in a new essay on The Blood Project.”
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