Your Medical Mind_ How to Decide What Is Right for You - Jerome Groopman [59]
He tapped on the keyboard, and a graph appeared, showing what he had already noted on the spreadsheet, that his usually low white blood cell count had risen into the normal range. Something had changed. This bothered him.
Paul sat back in his chair, deep in thought. In his world, everything had to have a rational explanation. He could think of no explanation for the increase in his white count. He was taking the same doses of his medications as always. He took an inventory of his body: He did not feel sick; he didn’t have pain in his muscles or anywhere else, for that matter; his energy level was good; he hadn’t had any fevers or sweats to suggest an infection that might raise his white blood count. Nothing seemed off. He never ignored discrepant data, never dismissed as an “outlier” some finding that he couldn’t readily understand. There must be a reason his white count had increased.
Paul Peterson grew up on a farm in Kansas and studied engineering in college. After graduation, he took a job in Wichita in a chemical factory, and although he excelled at his work, he soon grew restless. “I wanted to be my own boss,” Paul told us. “And that meant pursuing a career where I would be the one laying out the strategy.” He returned to school and studied a wide variety of subjects, including anthropology, psychology, sociology, mathematics, and finance, and ultimately obtained a PhD in the field of organizational behavior. Although his faculty adviser suggested he continue on an academic path and ultimately become a professor, Paul’s determination to be independent led him in a different direction. He founded a consulting company and advised corporations in the United States and abroad. “My background was key. I applied the principles of rational decision making to show managers how to create the kind of future that met their goals.”
Drawing on his mathematical and computer skills, Paul excelled at creating so-called decision trees, analyzing each potential choice a client faced and charting its chances of success or failure. “There literally were thousands of decisions that could be made over a long time frame. I showed the CEO how to get his arms around a very complex series of decisions, where to place resources, what kind of technology was required, what was the optimal management system to put over it. My work was both quantitative and qualitative, and involved making sure that the thought processes brought to bear were rigorous and identified with precision the kinds of risks that were to be taken and the expected benefits that would be reaped.”
Now in his fifties, Paul Peterson is a tall, lean man with a full head of red hair. Before his muscle disease, he was a cyclist and lifted weights. His home in Connecticut bordered a forest, and he chopped his own firewood for a wood-burning stove, about eight cords a year. “I was in very good shape,” he told us. “Then in the summer of 2000, completely out of the blue, I lost weight, felt weak, had difficulty pushing hills on the bike. I’d never been sick before, so I just kept saying, ‘Well, it’s probably just stress, my recent divorce, the traveling with my job, no wonder I feel tired, no wonder I feel weak.’ It was an awful time. But finally, after almost a year, I went to see my doctor.” Over the course of the next year, Paul saw numerous specialists and had blood tests, X-rays, and CT scans. Despite the extensive evaluation, no one was able to make a diagnosis. “Finally, one of the doctors figured it out with a simple blood test, a CPK,” Paul said. “I had polymyositis.” Polymyositis is a disorder in which the immune system attacks the muscles, causing inflammation with the