Occupational Hazard

Every occupation has its hazards. Miners are prone to anthracosis or "black lung," divers to the bends and tennis players to bursitis. According to Dr. Frank Gross of the U.S. Public Health Service, who describes his findings in the New England Journal of Medicine, many physicians suffer from a condition to be known henceforth as the Emperor's Clothes Syndrome (ECS).

First described by Hans Christian Andersen in 1837, ECS can affect anyone who practices medicine. But Gross reports that the disability is more common among interns, residents and assistant department chiefs than it is among new medical students and professors. The symptoms are easily recognized. In a typical case, the chief of a hospital service will examine a patient and announce that he hears, for instance, a heart murmur. None of the interns or residents accompanying him can detect it until the senior resident--who has much influence over the trainees' futures--announces: "I hear it." Then the disease spreads rapidly. One after another, the members of the chief's party will report that they too hear the murmur, often adding comments like "It's very soft," or "It's intermittent."

The effects of ECS can be severe, and include not only permanent loss of diagnostic ability in the physician but "perpetual wrong disease labeling" in his patient. Fortunately, ECS is completely preventable. Gross's recommended prophylaxis: skepticism. Physicians should rely on their own observations, not on those of their colleagues. Nor should they hesitate to be like the child in the Andersen story and admit that the Emperor is naked. Such an attitude, says Gross, leads to hyperimmunity.

This file is automatically generated by a robot program, so reader's discretion is required.