What is a tree, or disease, by any other name?
My last fellow, in retinal diseases, came up to me one day and asked me about a diagnosis. She was so excited. It was her second day on the service, and the first day with me staffing her in clinic. She couldn't wait to present me with a detailed, and clear description of the pathology at hand, "there is this punched out lesion involving the outer segments of the retina and choriocapillaris, with pigmented edges, free of infiltrates.I just don't know what it is?" Well, what would you do? Would you give her the answer? "Look, I am going to tell you what it is, but before I do, I want you to be present with this moment, and really enjoy it for what it is." It's that moment, of wonder, before you've labelled something, that you really see it for what it is. Once you give it a name, which is helpful for talking about it, and in medicine billing for seeing it, you never see it the same way again. You just glance over it. ...