Oh, The Zebras Keep Coming Poem by Paul Hartal

“Yes”, he repeated, “the zebras keep coming”.

I looked out the window. The sun was shining.
Tired snow patches melted on the pavement.
A few cars passed by but there were no zebras
in sight.

“No”, he said, “don’t expect real zebras
appearing out of the thin air.
I’m talking about Zebra Medicine.”

“What is that? ”

“Well, a medical aphorism introduced
in the 1940s by Dr. Theodore Woodward,
at the University of Maryland:
'When you hear hoofbeats, think of horses,
not zebras’”.

“And why do the zebras keep coming? ”

He smiled and then bit his bottom lip.
“If you are in Maryland and not in Ethiopia,
the animal making hoofbeats
is probably a horse.”

I crossed my legs.
“All right. I understand this, but what is
exactly your point? ”

“Oh, the zebra metaphor cautions doctors
that in searching for the causes
of the patient’s symptoms,
they should think first of a commonplace
explanation rather than arriving at an exotic
medical diagnosis.”

“I am not entirely sure that I follow you”,
I said. “Could you give me an example? ”

“Oh, sadly enough, examples are aplenty.
And since the pharmaceutical industry
controlls mainstream medicine, its impact
overspills to all segments of society
dominating the politics of disease, the use
and abuse of drugs and the medicalization
of life. Take, for instance,
high blood pressure.
In most cases life style changes,
such as a healthy diet, exercise and
stress management can prevent and reverse
this common disorder.
But, instead, for hypertension
physicians prescribe drugs, which have
extensive and dangerous side effects.

“Another example involves the so called
Attention Deficit Hyperactive Disorder.
Now, mind you, many children are exposed
to emotional pressures, they also easily
become bored and often don’t get along
with their teacher, and perhaps
they are bullied, or they bully others
and perhaps they are sensitive
and allergic to certain foods,
like wheat pasta and bread,
which contains gluten, or dairy products
and peanuts. So they misbehave
and fail their exams.
However, instead of trying to go
to the root cause
of the child’s behaviour, medicine
offers a short cut called Ritalin”.

“And what is wrong with that? ”

“Oh, every drug has side effects and
Ritalin can cause loss of appetite,
anxiety, vomiting, insomnia, diziness,
headache, increased heart rate,
high blood pressure,
psychosis, nervousness and agitation.
Thus, the side effects of Ritalin
can reinforce and aggravate the same
behavior patterns
for which the good doctor
prescribed the medication”.

He smiled and bit his lower lip again.
“Oh, the zebras keep coming”, he said.