Ninety-Nine Lessons in Critical Thinking

SECTION I DOCTOR- PATIENT INTERACTIONS 1. The World Is Too Complex To Perceive Directly 2. The Key Factor Which Determines What We Perceive Is Our Attention and How It Is Focused 3. Which Is Older, Stories or Books? 4. Be Fierce, Nurture an Intense and Ferocious Aggressiveness in the Pursuit of Your Learning and the Benefit of Your Patients 5. "Listen to Your Patient, He Is Telling You the Diagnosis" 6. Be a Good Observer 7. Consider the Patient's Experience 8. Learn from Your Patients 9. Intellectualization Limits Your Compassion 10. Key Elements of the Patient Visit: The Interview and Deep Listening 11. Words Influence Thought 12. The Physical Exam 13. Touch Is Important 14. Be Prepared for the Unexpected SECTION II DIAGNOSIS AND EVALUATION 15. The Fundamental Three- Step Approach to Diagnosis 16. A Mnemonic for Etiologies, VITAMINS ABCD 17. Investigations 18. Don't Be Afraid To Say You Don't Know 19. Information Toxicity 20. Treat the Patient, Not the Test 21. It's Good To Be Knowledgeable, but It Is Necessary to Also Be Attentive to the Patient 22. Consider Toxic Exposures 23. Family History Is an Important Part of the Interview 24. Rare Presentations of Common Events Are More Common Than Common Presentations of Rare Events 25. Symptoms and Signs Have Important Significance: The Absence of Symptoms and Signs Is Not Always as Important as Their Presence 26. Salutogenesis: The Production and Maintenance of Health SECTION III MANAGEMENT 27. Get to Know the Patient and Show Interest (the Patient Is a Person) 28. Learn from Clinical Experience (but Not Too Much) 29. Use the Placebo Response to Your Patient's Benefit 30. Tell the Truth Whenever Possible 31. Cognitive Function Is Relevant for All Areas of Medicine 32. You Are Primarily Responsible for Caring for the Patient, Not the Family 33. Denial of Illness and Disability Can Be Shared by the Patient, the Family, and the Doctor 34. Consider the Context of Care 35. Challenges to the Ability to Provide Humane Healthcare 36. Do Not Confuse Etiology with Pathophysiology 37. Communicate with the Patient 38. Be Attentive to Medications and Medication Errors SECTION IV CRITICAL THINKING 39. Think Deeply (Think Beyond the Obvious) 40. How Often Do Rare Events Occur? 41. Do Not Depend on Logic Alone 42. Although Intuition Cannot Replace Evidence, It Can Be Valuable 43. Should You Think Out of the Box? 44. All Models Are Wrong 45. Biomarkers Are Not the Disease Itself 46. Absence of Evidence Is Not Evidence of Absence 47. Being Wrong (at Times) Is OK 48. Much of What We Know Is Wrong (So Don't Believe Everything You Read) 49. Smart People Make Mistakes 50. Fishing Expeditions May Be Productive 51. Manifestations of Bias 52. Experimenter Bias 53. Bias of the Lost Actors 54. Being Smart Is Not Enough 55. Don't Be Afraid of Your Imagination 56. Do Not Assume That Your Ideas Are Not Novel and Important Just Because They Appear To Be Obvious 57. Consider the Evolutionary Aspects of Disease SECTION V PERSONAL AND CAREER DEVELOPMENT 58. Live in "Day-Tight Compartments" 59. Learn How To Learn and Enhance Your Learning Capacity 60. Find Out Where You Find Meaning 61. Search for Your Passion and Follow It (Gnaw Your Own Bone) 62. Learn to Critically Read the Literature 63. We Are All Neurologists 64. Neurology and Cardiology (Etc.) Don't Exist 65. Do Not Respect Boundaries, Be a Trespasser 66. Be Grateful 67. Look Beyond the Easiest Options and Pursue the Best Resources Possible 68. Focus, but Not Too Much 69. Be Persistent and Tenacious 70. Do Not Be Intimidated by Accomplished Persons in Medicine and Science 71. Accept the Help of Others 72. Pay Attention to Your Own Health and Learn How To Deal with Stress 73. Learn from the History of Medicine and Science 74. Recognize Your Intellectual Ancestors 75. You Are an Educator- That's One of Your Most Important Responsibilities 76. Learn To Be a Salesperson 77. Learn How To Learn from Bad Example 78. Remember Pierre Curie, Carl Wernicke, and Others SECTION VI DISCOVERY 79. What Is Science? 80. No Single Theory Ever Agrees with All the Facts 81. There Is Only One Kind of Science, and That Is the Study of Everything with All Possible Methods 82. It's Good To Be First, but It Is Not Necessary 83. You Don't Need To Be Brilliant To Be a Researcher 84. Appreciate a Diversity of Approaches 85. Why Think When You Can Experiment? 86. Judge Every Project by Asking "What Difference Will It Make To Know the Answer?" 87. What Is Important in Research 88. Do Not Be Obsessed with Technology and Methods 89. Pay Attention to Study Design, Data Analysis, and Statistics 90. Be Aware of (Beware of ) Statistics and Data Torturing 91. Pay Attention to the Assumptions of Diagnostic Testing and Research Evaluations 92. It Is Possible To Be Productive from a Distance 93. You Can Make Contributions as a Clinician Without a Laboratory SECTION VII ETHICS 94. Never Whisper in the Presence of Wrong 95. You Are Responsible for Your Actions; You Cannot Let Others Take Responsibility for You 96. The Need To Believe in the Guilty Victim 97. Compassion Is Part of Our Fundamental Nature 98. The Myth of Progress 99. Don't Be Ageist