“I love the treasure hunts,” an 8-year-old relative confided to my brother, “because we get Legos as prizes!”

“What?!” I replied in dismay.

My brother was reporting on a discussion he had had with the child about an upcoming weeklong trip that six of my young relatives would be making to visit my husband and me.

“Who told him that?” I asked.

“Didn’t they get Legos the last time they were there?” my brother asked.

“Yes,” I said, mildly outraged, “but that was completely different!  That was February, the weather was bad, one of the kids was sick, we didn’t have much time to plan, and I needed something to give them that would keep them all busy for a long time!  This visit is in August; we’re going to the Grand Canyon; and while we’re in Prescott, we’ll also go hiking, swimming, and boating.  There really isn’t going to be any time to play with the big, complicated Lego sets like the ones they got in February.  This is a completely different event!”

I added as an afterthought, “Besides, we had three or four treasure hunts during that visit. Only one of them had Legos as prizes. The rest had completely trivial little toys, because they loved following the clues so much that they asked for extra treasure hunts that I hadn’t planned on, so the prizes were just little, leftover toys we had lying around from earlier visits.  Why does he assume that Legos are the standard prize?!”

I could almost hear my brother shrug over the phone line.

“I don’t know,” he replied, “but he does!”

I suddenly realized that how I felt in that conversation was probably similar to how doctors feel when patients come in assuming that they have a particular condition because their symptoms seem similar to those of a friend, or they assume that their condition will call for a certain treatment because that’s what somebody they know got, or it’s what they got the last time they had these symptoms.

The ability to make important distinctions is a critical one.  It’s a problem when a doctor doesn’t make distinctions and assumes that you have a certain condition even though some of your major symptoms don’t fit that diagnosis, or offers the same treatment to everyone when it’s only a good fit for a subset of the patients. 

But it’s also a problem when patients fail to make distinctions and doctors have to run after them, metaphorically waving their arms and calling out, “Wait! Wait!  Slow down!  That’s the wrong road!”

As I will have to do with my young relative.