While the medical field usually attracts people who value evidence and facts, even healthcare professionals can be susceptible to superstitions.
Not everybody believes superstitions, but everyone has heard them circulate. In the words of Michael Scott from “The Office,” “I’m not superstitious, but I am a little stitious.” With that in mind, MedPage Today asked its editorial board about what ‘stitions they’ve encountered — even if they don’t believe them themselves.
Mikkael Sekeres, MD, MS, chief of the division of hematology at the Sylvester Comprehensive Cancer Center at the University of Miami, explained that certain aspects of the industry can make superstitious thinking tempting.
“I think any job or situation in which you repeatedly see outcomes that include extremes of good and bad lends itself to superstitions,” Sekeres said. “In medicine, where on a daily basis we may witness the triumph of the human spirit or the tragedy of disease, superstitions may give us a sense of control over the outcome.”
Loralei Thornburg, MD, a maternal-fetal medicine specialist at the University of Rochester Medical Center in New York, said that superstitions can be harmful in situations where they lead to blinders in a situation or knee-jerk reactions. She noted that medical superstitions “are passed down in the ‘hidden curriculum’ of hospitals” and are the “things that we all ‘know’ but don’t write down.”
Sekeres, on the other hand, said superstitions aren’t inherently harmful — “particularly when invoked with a tongue-in-cheek wink.” However, applying personal anecdotes to inform treatment decisions is a no-go, he added.
Here are some examples cited by the MedPage Today editorial board:
Blame the Weather
- If it’s a hot night, assume everyone will come into triage dehydrated
- If it’s a snowy, cold, or rainy night, the only people who come in are really sick
- If it’s a snowy, cold, or rainy night … there will be a birth wave coming in 9 to 10 months
- Trauma events are more common when it is hot and on federal holidays
- If the home team lost, lateral violence cases are probably coming in
- Of course you’ll get the page you’ve been waiting for when you finally take a bathroom break
- Diagnoses come in threes — for instance, if you’ve seen two ectopic pregnancies that week, a third one will be coming soon
- Believing a week is an inherently special interval despite studies showing that shorter antibiotic intervals are often better when treating infections
Don’t Say ___
- Don’t utter “the Q word” (quiet) … because if you do, it’s about to not be quiet anymore
- Don’t say anything is “going well” until the absolute end when everyone is indeed fine. Anything in a case can change at any time
- Don’t “speak out loud about a no-hitter while it is in progress”
But Don’t Forget!
- Bring extra supplies because if you don’t, you’ll certainly need them
- Some people believe they have a lucky pair of scrubs or shoes that help things go well
- If you forget to eat or don’t use the bathroom before going into the OR, the case will probably go badly and/or last longer than you expected
Thornburg said that “there is absolutely no data when this is studied that these are true.”
For instance, she noted that a 2019 randomized controlled trial in The BMJ tested the superstition about saying “quiet” — and found that saying “the Q word” did not in fact impact clinical workload. Another study published in the Wisconsin Medical Journal in 2022 found that weather can lead to no-shows, but likely due to difficulty getting places. In 2019, research in the Journal of General Internal Medicine found that there was no association between weather and admissions in New Orleans, despite residents believing there was — though the subtropical climate does not have extreme heat or cold.
Sekeres said that “superstitions represent an attempt to identify a cause” in a cause-effect relationship. But, “we don’t want to fool ourselves into thinking that our personal experience represents an evidence-based approach to practice.”
Thanks to editorial board members David Aronoff, MD; Jeremy Faust, MD; Mikkael Sekeres, MD, MS; and Loralei Thornburg, MD, for their contributions.