There are some patients whom you can diagnose the moment they saunter into your clinic. Sometimes, it’s in the way they walk, either in their limp or the way they get into their chair. Sometimes, it’s in the hand they prefer to use to pull out their papers. Occasionally, it’s in the way they greet you—the intonation of their voice, the sound of their speech, the tilt of their head. 

In the first few minutes while a patient is settling down to narrate their story, a physician is accruing their compounded wisdom of the patients they’ve seen over the years to decipher what the problem is. There is an innate tendency in a doctor that prompts them to evaluate themselves before they evaluate the patient. Unless you’re a bariatric surgeon, where diagnosis isn’t much of a challenge; in neurosurgery, the possibilities are numerous.