Science!

I was in the medical ICU for my elective, and I really learned a lot there.  One neat fact I learned was a scientifically-sound, sure-fire way to tell someone's prognosis...

cartoon bronch

We had a patient who was showing symptoms of a very, very rare lung disease.  The prognosis for this disease is actually much better than any of the other diseases in the differential, meaning we were all hoping this rare disease was what the patient had not only so we could say we've seen it, but because the alternatives if it's NOT what he had were really not so great for the patient.

While the pulmonary fellow was convinced this rare disease was what the patient had, the attending did not really agree.  He gave two reasons for his reservations: one, what we saw in the bronchoscope was not actually suggestive of this rare disease, and two, the patient was a nice guy.


....What?

nice guys finish last

The attending called this "the nice guy prognosis," meaning that the nicer you are, the worse your prognosis is.  He said this with complete seriousness and confidence, as if he had just told us that beta-blockers lowered blood pressure or smoking can make asthma worse.

Sooo, lesson learned.  I'm going to start being meaner.  For my health.