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The human face of improbabilities

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.d7353 (Published 08 June 2012) Cite this as: BMJ 2012;344:d7353
  1. Josh Baru, Cook County Hospital, Chicago Illinois, USA
  1. joshua_baru{at}rush.edu

I was recently an attending physician on the general medicine inpatient service for two weeks. During that fortnight I admitted 56 patients, among whom I diagnosed four cases of tuberculosis—pulmonary reactivation, disseminated, peritoneal, and spinal osteomyelitis. Three of them were immigrants (from Mexico and Ecuador), and the other was a native of Chicago. None of them had HIV, and none had other risk factors for tuberculosis.

“What are the odds?” I wondered, so I grabbed an envelope lying on my desk and started scribbling on the back. There were 12 000 cases …

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