Hickam’s dictum is a counterargument to the use of Occam’s razor in the medical profession. While Occam’s razor suggests that the simplest explanation is the most likely, implying in medicine that diagnostician should assume a single cause for multiple symptoms, one form of Hickam’s dictum states: “A man can have as many diseases as he damn well pleases”
This definitely applies to me as I go for more testing but it also applies to so many rare patients.
The rare community of patients often refer to themselves as ‘zebras’. This is because when doctors are learning they are told to look for the most obvious reason “when you hear hoofbeats think horses” but rare patients aren’t horses; we require more thought, testing and thinking outside the box which is why it can take so long to diagnose a rare disease patient. It may be frustrating for the doctor but it’s even more frustrating for the patient.
An organisation has been created producing a quarterly magazine discussing rare conditions. Rare Revolution Magazine brings together all the rare conditions allowing patients to talk and support each other. Whilst each rare disease does not affect many people, collectively rare diseases affect 1 in 17 so having several “rare” people in your life is actually quite common.
So always think of us “Zebras” and bear in mind the most obvious answer is not always correct.
How Rare? 