Superstition in Medicine: What do YOU Believe?
Nothing can make a medical staff gasp quicker than the famous “it sure is quiet in here tonight” line… Medical students are known for their crazy pre-exam rituals… Surgeons have the lucky skull-cap…. ER docs swear by the full moon… Certain residents are known as “black clouds” on the service…. And Friday the 13th isn’t good for anyone!!
Why do we in medicine, trained by science with lifelong learning as our backbones, have so many superstitions?
It’s an idea that is an old as medicine itself. The idea that the unexplained coincidences in the randomness of medicine can be explained by supernatural ideas. At the dawn of the 20th century we were as equally interested in superstition.
In 1906, in JAMA itself, the idea of superstition was contemplated, starting with a reminder of the origins of the word itself:
“It comes from the Latin word superstes—a survivor. Superstitions then are survivals from a previous set of beliefs or opinions in any department of thinking which still continue to have their influence over men’s actions though they have lost their basis or supposed basis in truth… “
And when considering the advancement of medicine at the time, even then the treatment of Typhoid fever was engulfed in superstition…
“There are superstitions, however, in departments of medicine that have been much more successfully studied. Notwithstanding the fact that it is now generally recognized that typhoid fever is a generalized infectious disease with a local manifestation, usually though by no means always or necessarily in the intestine, there are still many who believe that the medication for typhoid fever should always be directed to the administration of antiseptics which will hamper the growth of the typhoid bacilli in the intestinal ulcers.”
Another doctor of the time, M.G. Seeling, also spoke of uncertainty of medicine and the almost supernatural side of superstitions before the St. Louis Medical Science Club in 1905.
“Superstition does not embrace merely the innumerable instances of the ludicrous in medicine, resting on a false basis of deduction, nor does it consist merely in a large store of folk-lore, with its numerous mystic side lights on the art of medicine. The term is a broader, a more comprehensive one.”
“Medicine, never let us forget, is not an exact science, an its very inexactness which is the spring and fountain head of false theorizing, leading to superstition. “
Here we are, 110+ years later, and still medicine continues to be engulfed with superstitious beliefs. Many are like those described in the above JAMA article. Simple vestiges of prior beliefs now slowly dissipating with each generation of passing physicians. And yet some are still more akin to the supernatural side, and still very alive today.
My own experience is equally torn between the conflicting habits of luck and unnerved devotion to scientific common sense. I’ve always been the type to “knock on wood” to avoid jinxing one’s proclamations of the future – a longstanding family tradition. As a new medical student, I did particularly well on an exam after a large pre-exam dinner of Chinese take-out. From then on out, the night before the big exam was always Asian cuisine – a pattern that continued for years.
I also noticed during my residency that certain residents always had the bad calls. Their calls were “train wreck” cases that the number seemed to exceed what could be explained by coincidence. Myself, the opposite – a “white cloud” of sorts – who frequently spent the overnights doing boring cases, if not soundly sleeping. While I’ve yet to administer anesthesia for the full ruptured AAA case during residency, another famed “black cloud” resident tells stories of bringing two into the OR back t0 back in a single night. His calls are always filled with multiple gunshot traumas, OR codes, and random chance medical disasters. Mine are rarely as exciting. Coincidence?
Yet while many hated the “Q-word,” I’ve always laughed at the notion that we can predict or alter what is coming ahead. When some asks me how a day is going, I’m not shy to say if it’s slow. I may give a quick tap to a nearby wooden object, but I don’t expect a trauma to come to the OR immediately after nor the laboring patient to suddenly require an emergent cesarean delivery… just because I said it was quiet covering the respective services.
While I may still “knock on wood” from time to time, I probably take my beliefs most closely from the popular book/movie on fate No Country for Old Men. Two particular quotes from that classic have always stuck with me, particularly when applied to medicine and superstitions.
“You never know what worse luck your bad luck has saved you from.”
“This country’s hard on people, you can’t stop what’s coming, it ain’t all waiting on you. That’s vanity.”
Medicine is hard on people, especially during training. Tough cases come randomly, and often in random bunches. Bad things happen if you are around long enough, and good things too! But don’t think your important enough for the universe to change its course just because you were careful enough to avoid calling the day quiet or light – that’s just vanity!
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