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Unless the rest of you are all saints, and I'm the only sinner here, then I suspect we've all got personal diagnostic blind spots. These are clinical situations in which we're weak, and which we make repeated errors. With luck, supportive colleagues – who thankfully do not have identical weaknesses – and with a focus on spotting the shortcoming, we can turn this into a strength. The better doctors I work with transform this into a shared learning experience; a registrar I did clinics with turned his anxiety about managing headaches into a powerful and lasting teaching session. Personally, I'm very bad at diagnosing atypical appendicitis, in ways that I cannot bring myself to write here. However, I don't believe I've missed a case in some time because of this heightened awareness. (Note to clinical colleagues: This would be a bad time to come forward and tell me about a couple of dozen cases…).
The teenage girl losing weight is probably, if not a diagnostic blind spot, then an area replete with error, and in which I struggle because of my internal biases which take me to an answer – sometimes the wrong one – a bit too quickly. With this priming, I suspect that you may read this month's Problem Solving in …