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The Stubborn Rib: A Neurosurgeon on Medical Myths and the Stori

  • The other day, I was reviewing a complex post-operative MRI of a patient's cervical spine. My world, at that moment, was a grayscale map of vertebrae, nerve roots, and titanium hardware. The patient, a pleasant woman in her 60s, was recovering beautifully. As I was explaining the excellent progress, she looked at me with genuine curiosity and asked, "Doctor, this might sound silly, but since you're the expert on bones and things... how many ribs does a woman have?"

    I confess, for a moment, my own neural pathways stuttered. Of all the questions I anticipated about spinal fusion, nerve compression, or recovery timelines, this was not on the list. But I smiled, because her question wasn't really about anatomy. It was about a story.

    Let's get the simple, biological fact out of the way first. A woman has 12 pairs of ribs, for a total of 24. A man also has 12 pairs of ribs, for a total of 24. Barring the occasional anatomical anomaly—some people are born with an extra cervical rib, some have one fewer—the skeletal framework is identical in this regard.

    So why does this question persist with such tenacity? Why did this intelligent, curious woman feel the need to ask it?

    The answer has nothing to do with biology and everything to do with the architecture of the human brain. Our brains are not fact-filing cabinets. They are story processors. A dry, numerical fact like "24 ribs" is neurologically slippery. It has no emotional hook, no narrative weight. It’s a piece of data we might memorize for a test and then promptly forget.

    But a story? A story is "sticky."

    The story of Eve being created from Adam's rib is one of the oldest and most powerful narratives in Western culture. It's a story of creation, of partnership, of primordial origins. It has drama. It has imagery. It has been passed down for millennia. In the brain, a story like that doesn't just get stored; it carves a deep, well-worn neural pathway. It becomes part of our cultural firmware.

    A scientific fact, by contrast, is like a new footpath next to this ancient, six-lane highway. It takes conscious, repeated effort to choose the new path over the familiar, well-traveled one.

    I see this phenomenon constantly in my own field. I have patients who are utterly convinced they need their back "cracked" into place, a belief rooted more in cinematic sound effects than in physiological reality. I have others who are terrified that their spinal implant will be ripped out by airport security magnets—a compelling, dramatic, and entirely false story.

    It’s not a matter of intelligence. It’s a matter of brain function. We are hardwired to favor narrative over numbers, drama over data.

    When that patient asked me about the rib, she was doing something remarkably human. She was holding a scientific fact in one hand and a powerful cultural story in the other, and she was asking a trusted authority to help her reconcile the two.

    It's a profound reminder that my job as a doctor is never just about presenting data. It's not enough to show someone an MRI and say, "The science is clear." I have to understand the stories my patients are telling themselves. I have to respect the power of those narratives, even as I gently guide them toward the biological facts.

    So, how many ribs does a woman have? Twenty-four. But the question itself is worth more than the answer. It’s a beautiful little window into the most complex and fascinating structure in the universe: the story-telling human brain.