Reviews Personal views

Uncertainty—from different perspectives

BMJ 2001; 323 doi: (Published 25 August 2001) Cite this as: BMJ 2001;323:460
  1. Tom Cuddihy Bearsden
  1. Glasgow

    Until recently, I was pretty confident that I was good at dealing with uncertainty. After all, I thought, it goes with the territory in medicine and particularly in general practice. Every day I have to make decisions and live with the outcomes in uncertain clinical situations. The common scenarios in general practice all involve weighing up probabilities and accepting varying degrees of uncertainty. When faced with the child with a fever and not much in the way of physical signs, the doctor takes a quick decision to treat the fever as a simple viral infection while trying to anticipate the less likely—but more worrying—possibilities.

    This was uncertainty of an entirely different order. This was me!

    With experience you learn that the unlikely does sometimes happen. Young men with healthy lifestyles and no risk factors do have heart attacks, and lifelong smokers can be healthy at 100. Inevitably, there are occasions when you get caught out and then you either live with your misdiagnosis and learn from it, or you collapse …

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