Alex Burns is a GP in Cornwall, UK. He sees patients and supervises trainee doctors and medical students. A PhD student at the University of Exeter, his research explores how clinicians make diagnostic decisions amid uncertainty.
Lines written by a doctor, after an elderly man presents with a positive PSA test, trying to decide what to do next.
He’s had his test, all private done
Time to discuss its wisdom? gone
He’s come with wife and anxious son
Certainty though? I think there’s none
Diagnosis, the reasoning is Bayes, but it’s done in all sorts of ways.
What this test means, I think I know,
It has made me uncertain though
Free of doubt? It just isn’t so—
False positives often show.
Diagnosis, the process is Bayes, but sometimes it’s caution that sways
More tests, perhaps, would bring me peace:
If normal, then my doubts might cease.
Yet each new test may just increase
False leads that never bring release.
Diagnosis, the process is Bayes, but choices blur in anxious haze
For harms may lurk just up ahead,
Risks of treatment left unsaid.
Anxiety has to surgery sped,
To impotence and loss it’s led.
Diagnosis, the process is Bayes, but fear distorts what reason weighs
This choice: is it mine to make?
There is another’s health at stake.
And trust I could so quickly break,
And family’s fears I must not forsake.
Diagnosis, the thinking is Bayes—perhaps I’ll just do as the guideline says…
Featured photo by Brett Jordan on Unsplash.
