My favorite doctor pens another column about how much smarter he is than his patients:

Standard issue medical arrogance accounts for many things but not our incessant itch to call the shots. Rather, it's because we know something you don't know. Not the ins and outs of how tuberculosis is transmitted or the risks of hormone replacement therapy or the easiest and most accurate means to calculate the glomerular filtration rate.

No, the difference between doctors and patients is that you are stuck playing on our home court. We know all the subtle bumps and slick spots, the places where things suddenly can ricochet out of contro

Why he chooses to introduce his superiority with a case where he treated a woman with no evidence of Lyme disease with antibiotics, then gloated as she had a complication I have no idea. Maybe if he has used his knowledge before hand to reassure the woman that Lyme was not the cause in the absence of any evidence of infection she could have been spared both false hope and complications.

The author is right when he notes

According to some, Lyme is able to cause any imaginable symptom, yet laboratory diagnosis remains famously elusive. This combination of plasticity and stealth makes it a convenient explanation for any ailment that otherwise makes no sense.

The mystery is why he decided to treat a patient with no evidence of infection.