The Premonition: A Pandemic Story

by Michael Lewis

In her first year of residency at Santa Barbara Cottage Hospital, Charity had worked under a doctor named Stephen Hosea. Dr. Hosea was a poor boy from Kentucky who had trained at Harvard in the 1960s and then spent a decade researching disease at the National Institutes of Health (alongside a young researcher named Tony Fauci) before coming to California to treat infectious disease. He was tall and easygoing and wore his learning lightly, but he had a genius for figuring out what was wrong with patients, and for training young doctors. Each morning, he’d take the new doctors with him to visit patients whose illnesses remained undiagnosed. “The Dr. Hosea Show,” the young doctors called it. “He said you should always put your hands on the patient,” said Charity. “He’d get right in close into the patient’s space. You know there are people who stand a little too close. He’d be like that.” Soon the patients would be babbling on about their travels, their love lives, their workplaces, their extended families. It could seem like a natural conversation, but it never was. “The patients were all like, ‘Oh, he wants to know all about me,’ ” said Charity. “But not really. He was digging into the parts that helped to inform his differential diagnosis.” The differential diagnosis was Dr. Hosea’s mental list of the infectious diseases that might have caused the symptoms, along with his best guess of the odds of each being right. Over and over again, Charity watched the older doctor tease...

The Art of Diagnosis: Lessons from Dr. Hosea