Focusing on the red herring

Whenever I make teaching rounds with my medical students, I always tell them to look out for a “red herring”.

Red herrings are clues that are intended to be distracting or misleading. Let’s take the case of a 4 year-old patient with 14 days fever and macular rashes is seen at your clinic. He tests negative in routine dengue test kits except for IgG dengue. A complete blood count with platelet shows a white count of 3,000 (90% lymphocytes) and a platelet of 25,000. Many will be tempted to make a diagnosis of dengue. The red herring is the neutropenia and thrombocytopenia.

Many diseases will present with a low white count and low platelet. This patient was seen by two different doctors in the 2 weeks interval. The final diagnosis in this case was acute leukemia.

I talk about red herrings today to emphasize that there will always be misleading clues that will make one make the wrong conclusion.

The idiom “red herring” was thought to have emanated from using this fish’s smell to train dogs to track scents. The modern meaning of “red herring” as a false trail, was thought to be popularized by English journalist William Cobbett. Whatever the origins are, red herring is something that misleads or distracts us from a relevant or important issue.

Red herrings, while taught in medical science, are seen in contemporary society. Politics is an example of how to use distractions in order to bring to fore an agenda. The real situation of an economy or justice or national security of any country can be fended off through fake news and bad policies and decisions by creating background noise and news. This makes the masses confused with the real current pressing and potential issues surrounding a nation.

Red herrings sow confusion. Confusion results in a lack of focus on what the real problem is. In medical science, this ends up with health care providers working up patients with more unnecessary tests, increasing hospitalization days, instituting unnecessary treatments, placing them at higher risks of complications, and shifting the burden of cost to an insurmountable amount.

It is a fallacy that an argument is correct but does not address the subject being discussed. It is an attempt to change the subject.

In this highly digital age of technology, social media is used to sow confusion and distract us from what is true. It is like medical science where instead on focusing what is the real evidence, we are distracted with the diagnosis because there were too much tests that gave ambiguous results.


In any situation, focusing on Red Herrings is a deadly distraction.

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