This blog is devoted to remembrances and essays on general topics, including literature and writing. It has evolved over time, and some older posts on this site might reflect a different perspective and purpose.

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Tuesday, June 14, 2011

The Good Doctor and the Good Mechanic


                  A few years after we bought Linda’s Volvo station wagon, the engine died noiselessly one day when she stopped at an intersection. It wouldn’t start again and had to be towed to the dealer. Where it promptly started up perfectly on the first try.
                  They put it in the service bay, hooked it up to the latest computer equipment and ran every diagnostic test they could think of. The verdict: The computer doesn’t show anything wrong, so there’s nothing to fix.
                  Several days later it died at an intersection again and had to be towed to the dealer again. Where it promptly started up perfectly on the first try.
                  They put it in the service bay, hooked it up to the latest computer equipment and ran every diagnostic test they could think of. The verdict: The computer doesn’t show anything wrong, so there’s nothing to fix.
                  By this time we were beyond frustration. Not only had we paid a few hundred dollars for two diagnoses that took us nowhere, but we were also getting snarky messages from triple-A about how we should take better care of our cars so they don’t have to be towed all the time.
                  Then we took the Volvo in to our regular German auto mechanic for a routine oil change and mentioned the problem of the stalling and starting. He had no computerized equipment for diagnosing a Volvo, but he had something better — a feel for cars and a functioning brain.
                  “You know,” he said, “I had a Volvo station wagon in with a problem like that a couple of years ago, and it turned out to be a defective thingumy-jingumy.” (Sorry, but that’s as far as my specific recall of automotive detail goes.) “I can’t promise you that’s what it is, but if you want, we could try replacing it and see if that takes care of the problem.”
                  Based on years of good experience with him, we took his suggestion and replaced the thingumy-jingumy. The problem went away.
                  Which reminds me of the time, a few years ago, when I went in for a physical and one of the blood-test results came back slightly elevated. It was the last physical with a doctor I’d had for years, who was retiring. The old doc looked at the results and philosophically opined that given my medical history and general health level it was nothing to worry about yet and that his counsel would be to watch and wait.
                  A year later I went in for a physical with the new, and much younger, doctor assigned to me by the HMO. The same tests came back at the same, slightly elevated level. The young doctor took it very, very seriously and put me through more tests and an ultrasound to try to get to the bottom of it, but the tests didn’t provide any clues.
                  Then we switched health plans, and I had to get a new doctor. I wondered what this one would say about the elevated test levels, but I never found out. When the blood tests came back this time, the previously elevated levels had dropped to normal without any action on my part or that of the medical establishment. The old doctor was vindicated.
                  And the moral of the story is: Good diagnosis is often as much about experience, intuition and artistry as it is about science and technology. That’s true for physicians and auto mechanics alike. They’re both in the same business, really — trying to keep a complex and perishable piece of machinery running as well as possible for as long as possible.