I love engineers.  You see, before I went to medical school I went to engineering school, and graduated with a BSEE.  And during engineering school, they teach you to think logically--I mean they beat it into you with a whip.  So let's review what I've recently written from an engineering point of view:

1. There is an impending  breakdown of our machine (translation:  there is a future crisis in delivering effective allergy care rapidly approaching)
   
2. Our quality control needs ramping up (translation:  we need to produce (and be) better allergists--just more of them isn't the answer.)
3. To be better allergists we need to:
1. Gather better data (translation: be better listeners with our patients than before)
2. Utilize the data in novel ways (translation:  be more curious about our findings than before)
3. AND ???
   

      The Allergist and the Rule of St Benedict)

      Curiosity Killed the Cat but...)

 But what about item #3?  (I'll give you a hint: it's NOT that Der p 1 peptides coupled to highly repetitive virus capsid-like recombinant particles can induce high specific IgG titers--it's true, but not what I'm looking for....)

Let me introduce the third concept with a story...a story about the Allergist and the Mechanic.  Then next time, in my forthcoming entry on The Allergist and the Vagina Monologues, I'll get into the down and dirty of it. 

 The Allergist and the Mechanic

Once upon a time there was an allergist, but he wasn't happy.  He had always dreamed of being a mechanic, and across the street from his office was the American Auto Repair Shop (AARS).  He saved his money, and one day he closed down his shop and bought the American Auto Repair Shop....and his dream became a reality.  He loved cars, and wanted to repair them...but you see, he had one curious trait...

    He loved carburetors.  

    Seriously loved them. I mean really loved them. Everything about them.

To the point he changed the name of his auto shop to:  The American Auto Repair and Carburetor Shop (AARCS). He was thrilled the day his first customer walked in.  

"I have a problem" the customer said.

"I'm sure I can help" said the allergist. "What seems to be the problem"

" My car is making a strange noise", the customer said.

So the allergist poked around with the car (like he used to poke patients with needles) and very thoroughly looked at the carburator.   Finally, after much study, he looked at the customer and said, "I have good news, it isn't your carburetor".

"But what's causing the noise?" said the customer.

"I don't really know" said the allergist.  

"Can you look at other possibilities than the carburetor?" said the customer.  

"Well, the important thing is it's NOT your carburetor that's giving you problems", said the allergist.
"Many times we can't find what causes the noise in cases like this" said the allergist.  "But I have something that can really help".

"What's that?" said the customer.

"Earmuffs" said the allergist.  "It'll take the noise level right down.  We'll start out with a small earmuff, and increase the size if we need to.  Monitor the noise discomfort level with a card I'll give you that you should fill out daily.  It has a red zone, a yellow zone, and a green zone on it.  The red zone is if the noise is intolerable, the yellow zone is if the noise is slightly uncomfortable, and the green zone is for a good noise level.  If the noise level gets really bad--high up in the red zone, then leave your car immediately and run to someone elses car for help."  

The customer dutifully followed his new mechanic's instructions.  But he wasn't happy.  He saw an old sign for another auto repair shop--Earl's & Nick's Auto Treatment (ENT for short) and went over there.  The old mechanic listened a few moments, to the customer's car, and told him, "you know, it sounds like a bad muffler to me..."  

"Really?" said the customer.

"Really", said the old mechanic. 

And sure enough, after getting the car up on a rack, and looking at it, the old mechanic confirmed that the muffler was the problem.

"But why didn't the other mechanic find the problem" said the customer.

"Oh--him?" said the old mechanic.  "He may  call himself a mechanic but he's so hung up on carburetors that's all he thinks about."  I look at the whole car.  And your muffler IS part of the car, afterall. 

And so it is.