Of Horses and Zebras

There is a common saying in medicine:

When you hear hoofbeats, think horses, not zebras.

In other words, look for and rule out the common causes of symptoms before you turn to the exotic. That headache is much more likely to be caused from the tension of the day than a malignancy spreading alongside your cortex.

Doctors in training (as well as the layperson who spends too much time on WebMD) are famous for seeing zebra illusions. They hear of these rare and unusual diseases and are convinced that this time, it is the correct diagnosis. For the young doctors, they learn over time that they may see thousands of horses for every one zebra. Their high alert tones down.

But there are problems with the horse philosophy. It is possible to become so focused on believing that every hoofbeat is a horse that you fail to see the zebra in their midst. Famously, until very recently, this often happened with women attack victims. The symptoms mirrored other, more common complaints and they were dismissed before further consideration.

Doctors usually have a systematic way of diagnosing illness. They start with the most common causes of the symptoms at hand, perform tests and ask questions to eliminate some illnesses and include others. Each piece of data is added to the puzzle until the particular horse is named.

Unless it’s a zebra.

The problem with zebras is that once you have seen one, you cannot unsee it. Rationally, you know that just because this hoofbeat was made by a rarity, the next one is still more likely to be the common equine.

You know this. Yet those hoofbeats will never be the same.

Because once they heralded the arrival of a zebra.

We all experience hoofbeats in our relationships, data points of indication. Most of these are benign, evidence of a stressful day or wandering mind, the equivalent of the common tension headache. But sometimes these impressions are an indication of a malignancy within the relationship.

Some people always look for zebras. These are the ones that are always on red alert, searching through emails, calling insistently. They are convinced that the zebra is there, they just have to find it. Some of them go so far as to paint stripes on the common horse. They are as hypochondriac in their marriages as some are with their health.

Others don’t believe in the zebra. They let the sound of hoofbeats wash over them, secure in the knowledge that they come from the harmless pony. They believe that if ever presented with the zebra, that the beast would be so evident as to be impossible to miss. But zebras hide. They blend in with the everyday hoofbeats. You have to watch carefully and look for their distinctive patterns.

Those two approaches, although at odds, originate from the same place.

Fear.

The zebra-spotters are so afraid of the striped one that they are on the hunt. They refuse to be surprised, intent on heading it off before damage is done. Of course, life on the hunt is exhausting when you’re convinced that everything is an attack.

The zebra-blind are also afraid. But instead of going on the offensive, they hide, believing that the zebra cannot find them. But living on the defense is limiting when you’re trying to avoid every potential attack.

There is a place in the middle. A place where hoofbeats are heard. Data is collected. Hypotheses made and tested and either accepted or discarded. A place where the existence of the zebra is acknowledged but not hunted. A place where you trust your ability to spot a zebra among its brethren and you trust that you can survive its approach.

I was once one of the zebra-blind. I trusted that my ex would never introduce zebras into our lives. So I didn’t see them. Of course, it didn’t help that he also knew the powers of disguise, hiding their stripes with plausible stories and Photoshopped documents. When he left, my tears washed the brown paint off the surrounding creatures and I discovered I was living in a world overrun with the striped beasts.

I was trampled.

But alive.

And changed.

Once you’ve seen a zebra, hoofbeats are never the same again.

I hear them.

And I look, without assumptions.

Knowing that they are most likely horses but also realizing that may not be benign.

But also believing that just because I met a zebra once, does not mean that every sound is a sign of impending attack.

When I hear hoofbeats, I think horses, not zebras. But I still look for stripes.