Earlier this month, I suffered a fairly serious heart attack. My blood pressure and cholesterol are good, and there is no evidence of disease or damage. With more exercise, better eating and a handful of pills each day, my prognosis is excellent. Throughout the ordeal, I couldn’t help but draw comparisons between the diagnostic evaluations by the medical professionals and a typical construction defect investigation.
I wrote about my heart attack in more depth over at my personal blog. Please read that article first if you’re interested.
The scientific method is the same regardless of discipline. You start with a reasonable hypothesis and then conduct experiments or evaluate various conditions seeking to eliminate as many variables as possible. Results are measured, assumptions realigned and modified, and then more testing is done to further isolate variables and to arrive at some reasonable conclusions.
That is the approach that my colleagues and I use for evaluating building performance, and it is the same approach that doctors use when treating patients. (At least that is the ideal…)
Below are some of the ways that my heart attack is like a construction defect investigation:
- Begin with the most likely causes in mind. When we see a stain next to a window corner, it most likely is caused by a defect or damage in the window itself, rather than the adjacent flashing materials. Chest pain and extreme sweating were a good indication that I was experiencing some sort of trauma involving my heart.
- Deal with issues in order of decreasing magnitude/impact. Sometimes property owners will want to make sure that we notice that the screws in their light switch covers aligned perfectly, interrupting our investigation of missing firestopping. When I arrived in the ER, my tonsils were really swollen due to a nasty Strep infection; the potential life-threatening blockage in one of my coronary arteries took precedence.
- Analyze risks versus benefits when considering more invasive procedures. The only way to know for sure what is causing a certain symptom is to disassemble the various components. If we were to perform intrusive testing at every building assembly, the cost would far exceed the original cost of construction. In my case, I’m grateful the doctors decided to limit their intrusive testing.
- No two experts will ever agree with one another. Sometimes they disagree with themselves. Hearing one cardiologist slam the opinion of a cardiologist from another hospital reminded me of sitting in a mediation with a bunch of experts. Also true: The more letters an expert has after their name, the less open they are to considering alternative viewpoints.
- The best diagnosis puts detailed observations into context. There are two approaches to investigations: Deductive reasoning and inductive reasoning. Know the difference.
- The expert’s role should not include advocacy. Some experts feel that “the customer is always right,” and therefore become advocates for the parties they represent. That is called bias, and it has no place in the scientific method. As a patient, I had to (and must continue to) be my own advocate. I have my own theories as to what might have happened, but thankfully, my doctors are forming their own opinions based on evidence.
- The insurance company’s obligation is to its shareholders first. Make no mistake.
- Ongoing maintenance is really important. Have you ever seen any of those TV shows about hoarders? I’ve seen it in real life. It is amazing how quickly a little neglect can cause long-term and very costly damage to a building. The human body is the same way. I’m eating better, exercising more, taking my medicine and working on ways to reduce stress.
This experience has been both enlightening and terrifying. If you wondered why there hasn’t been many posts lately, now you know.
About the picture: That is the small bottle of nitroglycerin tablets that I must carry with me at all times in case I start having chest pains.