Like poker, medicine has certain rules — patterns of clinical symptoms and lab findings each correlating with a specific spectrum of prognoses that vary in likelihood, the differential diagnosis. Physicians are like seasoned card players, trained to maintain composure and incorporate numerous variables into logical, calculated decisions at what seems like a “dealer’s table” of outcomes. Sometimes, we hedge our bets that the patient will self-resolve, so we elect not to treat; other times, we act conservatively with a battery of tests and pre-emptive therapy.
I tilted the overhead lamp and reached for a fresh blade. My gown was stained from hours of work on the woman’s arm; I continued to scrape, dab and blot. This, however, was not surgery. I was finishing my final project for a college figure painting class.