Being an expert at problem solving is absolutely an art. Being a great engineer shares the qualities of a great doctor. One needs to look at all the clues, connect the dots, and think outside the box. Not only is it incredibly difficult to diagnose a problem you cannot see, a bigger problem arises when the problem itself is not widely accepted and recognized.
A great example of this within medical literature is topical steroid addiction, also known as Red Skin Syndrome (RSS). While this condition has been well know within the scientific research community, the condition is not part of the standardized medical education or the diagnosis repertoire amongst dermatologists.
When dermatologists do not recognize the proper diagnosis to even exist, how can a doctor prescribe the correct treatment for the patient? The answer is simple, they can’t. RSS is an iatrogenic syndrome which means that the complications are caused by the treatment itself. Imagine the following scenario.
A patient with red rashes goes to a dermatologist and seeks treatment. The doctor notes the visual appearance of the rashes and allergic history of the patient to conclude that the patient simply has eczema. The doctor prescribes some weak topical steroids like hydrocortisol for the patient to apply. Weeks later, the patient comes back with a more severe rash, the doctor again holds firm on his diagnosis and prescribes a moderate topical steroid like Mometasone. Weeks later the patient comes back with a rash even larger and more severe, so the doctor prescribes a strong topical steroid like Clobestasol.
The problem all along was the treatment. While in a vanilla case of eczema, the treatment would have been appropriate, instead over time the patient had developed an addiction to topical steroids by constantly treating for the so called “eczema.” Had the doctor realized that the prescription of ever stronger and stronger steroids as the root of the problem, the worsening of the syndrome wouldn’t have happened.
The correct treatment is actually the complete cessation of all steroids. This is especially difficult as it is completely unintuitive and goes against what the doctor has learned throughout his or her career.
There are many lessons one can learn. First, one needs to acknowledge the potential diagnosis so that it is even considered. Second, the right observations and criterion for differential diagnosis needs do completed. Had the doctor noted that the patient was experiencing a severe burning sensation which is not conducive to eczema, the doctor might not have continued treatment. Lastly, in the wise words of Hippocrates, first, do no harm. While the doctor has good intentions, the doctors ignorance and arrogance while being completely fixated on their initial diagnosis should have never happened. If only they listened carefully to the patients with an open mind, they would hear the diagnosis.
These theories are easily applicable to engineering, where engineers themselves often find themselves trying to solve a problem. It therefore follows that for an engineer to properly address the problem, they must know the potential causes of the problem, perform the correct tests, and not implement a solution that makes the system worse. That only comes with proper training and experience.
