In my first few months working as a rheumatologist a referral letter arrived from a local doctor about a lady with rheumatoid arthritis. She had recently moved to the West of Ireland from the UK, where her original diagnosis had been made. Her GP had originally referred her to a general physician in a small local hospital who had struggled with her care and she was looking for second opinion.
After assessing her, it quickly became apparent that original diagnosis had been incorrect. The patient had numerous explanations for her pain other than rheumatoid arthritis and the investigation that was likely to have prompted her original diagnosis (a positive rheumatoid factor test) as due to the fact that she had Sjogren’s syndrome (a condition which causes dryness of the eyes and mouth).
My specialist pride congratulated itself on making such a clever diagnosis and for being smarter than either the physician who had cared for her of late or the rheumatologist who had made the original diagnosis. Gosh I’m good, I thought.
‘That’s wonderful news Doctor. You mean I don’t have rheumatoid arthritis after all?’
‘Not in my opinion you don’t.’
‘Its great to see someone who knows what he’s talking about. Do you mind me asking where you did your training?’
‘In the UK. In Cambridge mainly.’
‘Really Doctor? In Addenbrooke’s?’
‘I was there for 4 years.’
‘That’s amazing. That’s where I was told I had rheumatoid.’
With that she thanked me, stood up to leave, and just before she left the room, turned to me and said;
‘I knew you looked familiar.’
It’s never a bad idea to get a second opinion. Even if it’s from your self.
Here’s a TED talk by Dr. Brian Goldman, who’s an Emergency room physician from Toronto speaking about medical errors.
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Thank you for the little chuckle this morning Dr Kavanagh! :)
I like that! I’m sure we’ve all had that issue of a slightly wrong diagnosis but most times, we don’t hear about it.
That’s a great story Ronan, didn’t see the punchline coming.
Great story…short, succinct and an unexpected punchline. More, please…
Praise indeed. Thanks Muiris.
Enjoyed your story, Ronan.
One of my many mistakes occurred as a newly qualified GP, when I heard a foetal heart in a woman who was not pregnant. I didn’t doubt my hearing as I had completed a year’s Obs and Gyne as part of training and this was my area of expertise. A scan proved me wrong but not without causing the woman quie a bit of distress.
When I next saw her it was as a very humbled “expert”! Amazingly, she continued to attend me and I learned a very valuable lesson!
I hear myself repeat “…but I am may be wong” with ever-increasing frequency since then-and that was a long time ago!
Lovely anecdote. Keep up the laughing material – good for pain I hear?
Loved this…wasn’t expecting the end so choked slightly on my tea!
My very first job on my very first day as a student nurse was to take a pulse. It was tricky, but I counted for the whole minute as sternly instructed by tutors. Patient and his friend tried not laugh. Then he said “you might find it easier on this side of the wrist”. Nervous laugh. I said “Gosh you know a bit about it” and he said “Yeah, we’re ambulance attendants”. Scarlet even posting this…..
Hilarious, and very honest. A rare trait these days, particularly when it comes to admitting having made a mistake on diagnosis *applauds*
Oh, you may want to take a look at this. I’m a journalist/author with ankylosing spondylitis and scoliosis. I used to have a very exciting life. It is less so these days. I wrote a book about it. Dr Raj Sengupta’s reading it… http://amzn.to/Jkr30l
Hi Ronan
Came across the Second Opinion blog this am via Kevin MD.com
it made my day ! Hope you enjoy the buzz of Galway this week…