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What is a Zebra?

By | August 8, 2020 | General Sports Medicine | Tagged: , , , , , , , , , | 1 Comments

When going through medical school training, we learn about horses and zebras. Horses are the more common things that we tend to see, the common diagnoses, while the zebras are the very uncommon ones. The saying goes, “if you hear hooves coming, think horses, not zebras.” That said, the zebras are still out there, and many people are walking around with a zebra that a physician or other healthcare professional has not been able to identify. Maybe they treat it as a horse, and maybe it does respond similar to a horse, but it does not fully behave like a horse, it acts differently, it looks different, it’s a zebra.
As we learn things medically we acquire declarative knowledge, and then we can convert it into procedural knowledge as we apply the information we have learned into practice. This is where many of us are at the mercy of our education. We have to have humility that we don’t know everything in medicine, and we need to know what we don’t know. Sometimes something sees us, but we don’t see it, and very often these are the zebras.
I personally read daily about medicine, read about cases, typical and atypical presentations, learn what normal looks like so I can understand when I see something abnormal that presents to me. I’ve been very good at identifying many of the zebras that other people have not been able to find.
In addition to identifying it, how do you treat a zebra? Some people come in with a diagnosis and were told they just have to deal with it, they just have to deal with being a zebra for the rest of their life. They may offer them a treatment, but you can’t simply paint over the stripes of a zebra and expect it to behave like a horse for the rest of its life, it’s still a zebra.
By learning from numerous mentors and continuing to learn on a daily basis, I’ve been able to find treatments to be able to help people with common and uncommon conditions alike. Even if I can’t figure out exactly what the zebra is that is standing before me (which drives me nuts as I pride myself on being a master diagnostician), I can very often find a treatment plan to be able to help it out. I always base my treatment models off of the four principles of osteopathic medicine:
  1. a person is a unit of body, mind, and spirit.
  2. structure and function are reciprocally interrelated.
  3. the body is capable of self healing, self-regulation, and health maintenance.
  4. rational treatment is based upon adhering to the above mentioned principles

By using these approaches I am able to come up with effective treatment plans to not just paint the stripes over the zebra, but to get the entire animal that is trampling over you to be able to go away; to be able to restore function, resolve pain, and allow you to be your normal self again. Using these principles allows me to be able to see and treat what is inside the box (the horses), but also it allows me to be able to see and treat things outside the box (the zebras). This makes me a more well-rounded physician and gives me the ability to diversify the number of treatments I can offer someone to be able to get them better again.

Many times we call my clinic the “zebra clinic”, as we see so many people who have seen someone else, maybe numerous other physicians, people who have gone to numerous institutions, universities, even the Mayo Clinic, but not gotten an answer, not figured out what their zebra was. At Motion is Medicine I’m proud to say that we have figured out many of these zebras, and we have been able to come up with treatment plans allowing them to return to their normal and active lifestyle.

If you have a problem that others have not been able to figure out, then you might have one of the zebras we are talking about. Come in to see if we can find a solution to get you moving again!

Comments (1)

Tamiflu
September 10, 2020 at 4:20 pm
Reply

It is shorthand for the aphorism coined in the late 19 by Theodore Woodward, professor at the University of Maryland School of Medicine, who instructed his medical interns : “When you hear hoofbeats behind you, don’t expect to see a zebra”.

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