My Tailbone Hurts: A lesson in making assumptions

by | Oct 18, 2022 | Blog | 2 comments

Assume: To take for granted or without proof.

Twelve-year-old John is experiencing severe tailbone pain. The pain is so bad that his parents decide to take him to the local children’s hospital. As the secretary at the hospital’s orthopedic department is checking John in, she asks, “What are you here for?”

John replies, “I have pain in my tailbone.”

Because the general model of orthopedic treatment is getting an x-ray before a patient sees the orthopedist, the secretary orders an x-ray of the sacrum, coccyx and the tailbone.

X-rays are taken and John and his mother make their way to the exam room.

As the orthopedist enters the room with the x-rays he begins, “Well, I have reviewed your x-rays and I don’t see anything wrong with your tailbone. Since your x- rays are normal, I’m going to get a CT scan of that area.”

No history or physical examination was done. On to scan number two.

A CT scan of the abdomen and pelvis is the equivalent to 300-600 chest x-rays. This 12-year-old boy has received radiation to his reproductive and internal organs. The testing is putting John at risk for potential cancers as radiation exposure is a cumulative risk throughout life.

When John returned for his second visit, the doctor reviewed the CT scans. Just like the x-rays, these scans appeared normal. So, the doctor ordered a bone scan of the area. This is the equivalent of 900 chest x-rays.

Now, John has had 1500 chest x-ray equivalents. If you had a lung disease, like emphysema or cancer, you would never have that many x-rays in your lifetime.

The result: The scans all came back normal.

The orthopedist’s response, “I don’t know what is wrong with you.”

John’s next visit was with Dr. Michael Geraci, a specialist in this area.

When you see Dr. Geraci, one of the first things that you do is draw where your pain is on an outline of your body, called a pain diagram.

As Dr. Geraci began to take John’s history he reviewed the pain drawing.

“I notice in your pain drawing that you didn’t draw it in your tailbone. Why don’t you stand up and just point to where you are experiencing the pain?”

John stood up and pointed to a place in his back a few inches above his beltline.

That was easily five inches above the tailbone.

Dr. Geraci quickly realized that all along, John misunderstood the terminology of his anatomy. After conducting an MRI of the lumbar spine, the results showed that John had a herniated disc which was the cause of his “tailbone” pain.

Fortunately, John responded well to exercises that included floor press-ups and back bends. After a few weeks, he was completely pain-free.

Lessons learned:

  1. Challenge assumptions. John’s orthopedist never challenged the assumptions he made when he looked at the first x-ray. He made his decisions based on one frame of reference.
  2. Look for the details. The doctor failed to look for all of the details in John’s case, because he did not question him thoroughly in the initial examination.
  3. You don’t know what you don’t know! John’s first doctor assumed that a 12-year-old boy actually knew where his tailbone was.

This assumption-busting story and more are from my new book, Solve the Real Problem due to be released later this year. I am so excited to share it with you.

Here is a link to pre-order. Thanks for reading!

Register Now For Roger's


Through a series of structured learning experiences, you will learn to become deliberately creative and build your skills to lead innovation teams in your organization. You will be instructed by Dr. Roger Firestien who has presented programs on innovation to over 600 organizations around the world including: fortune 500 corporations, government agencies, universities, associations and religious institutions.


  1. Joette Field

    Roger, I absolutely love what you are doing. Please continue to get the message out there. I will spread the info about your book. Can’t wait to receive mine. Already pre-ordered it!Great work!

  2. Dorte

    Wonderful story! Love it!


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