Noah's Ark Phenomenon in Medicine: A Novel Description of Clustering of Clinical Conditions, the Surgical Perspective.

Patients with similar diagnoses often arrive in clusters, followed by periods lacking such cases. I observed this pattern during internship and continued to do so throughout my training and years as a surgeon. During specific call hours, clusters of ectopic gestations would occur, while obstructed labour dominated another day. Similar phenomena were noted across various clinical rotations, including paediatric surgery, where multiple intussusception cases would present in quick successions. I have termed this pattern the "Noah's ark phenomenon in medicine (NAPM)." Collaborating with a colleague, we researched to understand the scientific basis for this observation. Seasonal variations, infectious diseases, behavioural and cultural factors, genetics, healthcare policies, geographical factors, and referral systems have been documented to influence the clustering of surgical cases. This phenomenon highlights the importance of recognizing patterns in clinical case presentations. Understanding NAPM can aid timely resource management, improve targeted training opportunities, engender peer support among patients, and inspire further research to uncover underlying causes and optimize clinical practice. It can also solve master surgery scheduling problems. The clustering of surgical conditions implies more volume, and this translates into better outcomes for surgeons and institutions.