think horses, not zebras
a common rule of thumb and a poem to challenge it
there’s this saying that when you hear hooves think horses, not zebras because horses are more common
but the thing is, slapping this phrase when you’re seeing stripes with your eyeballs, standing right outside a zebra enclosure in the zoo.
Tagging Rebecca Stevens A. | MaggieLaFae | Anthony Jackson | Avi Kotzer | Thalia Dunn | Zach Neuman | Keegan Roembke | Somsubhra Banerjee if you’re up to it and anyone else interested in today’s prompt: when common rules of thumbs can be wrong too.
Hi I’m Lucy Dan 蛋小姐 (she/her/她) and this rule of thumb is generally to encourage students in health professions to think about prevalence rates and to consider more prevalent disorders as explanations for the symptoms you see, rather than some rare footnote in some textbook somewhere.
It’s a great rule of thumb to start off with, until you find additional information that contradicts and suggests you should consider something narrower, rarer, instead of invalidating folks for their experiences and telling them that something is “unlikely”. It becomes such an invalidating conversation “unlikely” and be told 922 times that it’s unlikely when you are very much, somehow, part of that unlikelihood. Unfortunately, the way that statistics work, unlikely does not mean impossible.
Also concerning is how those prevalence rates are derived. If the textbook describes a disorder mostly found in one gender and then clinicians keep identifying this order based on those characteristics, across generations you continue to develop a larger sample of descriptions of how something might present for one group of people, ignoring how differently symptoms can present in someone else.
One classic example is that women are more likely to suffer a heart attack without the classic chest pains that are depicted in TV shows, and are described as “atypical” symptoms:
In fact, women are more likely than men to suffer a heart attack without chest pains up until the age of 65. The study also showed younger female heart attack patients (under 45), who did not experience chest pain, were 20 percent more likely to die than male heart attack patients their same age. Source.
This is a super long rant to say — rules of thumb help us save time like a shortcut that helps narrow complex information quickly. However, like any shortcut, it has flaws when that initial time-saving assumption is debunked. And we need to consider that too.
Hop down the rabbit hole? 🐰🕳
^ by Brajendra Kumar