Pompei,the Vesubio, the error and the system

20151025_160232We all know the sad story of Pompei. Their citizens were living there for centuries and they never thought that the vulcano could kill  them. A new town was rebuild exactly at the same place. What can I learn from this?People in general think that a second episode is not going to happen  because the first one was exceptional. Is this true? Can we take some lessons for Medicine?

Thinking about diagnosis two situations are possible with a direct influence on clinical reasoning. The first one is called availability, a bias associated with a wrong calculus of the prevalence of a disease due to previous experiences,as an example you can think in a splenic rupture in a person with a strong pain in his left upper quadrant if your recently worked with traffic accidents.But the second situation can be worst and in a way is similar to Pompei,imagine attending an abdominal aortic aneurysm and thirty minutes late attending a secind patient with a strong abdominal pain.Your reasoning in this situation could go to the “is not going to be a second one based on your personal probabilities. In Medicine a first case doesn’t change the individuál prevalence for a second one. We could named this bias “the Pompei bias”,although properly speaking this bias is named as “the gambler fallacy”.