Tuesday, July 9, 2019

Dangerous Stories

Stories can be inspiring and entertaining and help us understand the world around us. But if simply accepted uncritically, anecdotes can also mislead is in major ways. Medical information is not exempt from this type of misdirection.

One reason stories can mislead us is they may simply be false from the outset. Some of the more outlandish stories I have heard from patients are “The HPV vaccine makes you walk backwards” and “The flu shot contains microchips so the government can track you.” These are obviously false on so many levels that they are almost comical. But they are also real concerns that people have based on false information being spread on social media and elsewhere.

Another way that stories can mislead us that our recollection of events is notoriously inaccurate. I once saw a new patient for the first time and the father told me they had left his previous doctor because he had given them an MMR vaccine and caused his child to have autism. Fortunately, I had the records from his previous physician to review and it was obvious that the child had developmental problems long before receiving the MMR vaccine and that there was a different explanation for his difficulties. I don’t think the father lied to me. I think he believed the story he told me. It just didn’t match up with the evidence. But without having the other information available, one could have been easily misled by the story.

It is common for folks to have memories that diverge significantly from the written record. This has happened to me as a patient as well as I have misremembered things about my own medical history. And I have had patients tell me detailed stories about myself in certain situations, only to discover when I checked the record of the event that I wasn’t even there.

A final way that stories can mislead is that we tend to connect dots that aren’t necessarily connected. Many years ago I had an infant patient who did not show up for his check-up where he would have received multiple vaccines. Tragically, the night after his missed appointment, he died. Now imagine he had showed up, we had given him vaccines, and then he died later that same day. I think it is inevitable that someone would have reached the “obvious” conclusion that his vaccines killed him, even though we know that wasn’t the case.

Anecdotes can be the first step in uncovering important information. But accepting a story without digging into it and collecting data in a way that is as objective as possible can lead us astray and cause us to make decisions which have dangerous consequences down the road.