Bright people have a capacity for handling grey areas--or grey matter, for that matter--and can step outside the algorithm
when necessary. And I have no explanation, really, for the rudeness that I've seen described repeatedly on the MS board, either. Of course, there are two sides to every story, but...all of these stories carry consistent, typical features.
In my cases, the neuros who said "CD" and "RLS" were clearly coming from a specific perspective.