When we visit the doctor, we often assume they will have the solution to our health-related problems since it is their job to know what is best for us. However, sometimes they come across cases that leave them completely baffled, whether it be an unknown diagnosis or a freak condition. Here are some of the most mind-boggling cases doctors have had in their careers:
In dental school, I had an emergency patient come in complaining of sore gums. Upon examination, I found a massive calculus bridge (google it for pictures) behind her lower front teeth. She only had about 3 remaining lower teeth, but they were all connected with a whitish brown mineral deposit that was about the size of a golf ball. She had never had her teeth cleaned and she was probably 55 years old or so.
I basically performed an emergency cleaning. She could speak so much better afterward. Of course, I had to play it off like it was normal, but in my years of practice, I still haven’t seen a case that bad again. Get your teeth cleaned people. Even if you can’t afford every 6 months, once a year, or every other year is a heck of a lot better than never.
A patient had been involved in a major car accident, leading him into my hospital's private Emergency Room with just a nurse, his girlfriend, and himself. We had the man's girlfriend remove the patient's pants. But first, she had to remove everything from the pockets. I never saw anything like it. She pulled more than thirty ribbons of rubbers out of the man's pocket. I swear, it looked like a magic trick. They just wouldn't stop coming out. Safe to say that lady was tiiiicked.
An elderly lady came into my practice asking if there was anything she could be given to help her sleep, as the Irish terrorists in the flat below were keeping her awake at night. She was reassured that terrorists were not planning to blow her up, or Cannock (a small inconsequential town in the West Midlands) for that matter.
On the second visit, she insisted that they were going to blow something up soon and expressed paranoid thoughts. A full mental health review was conducted by the GP and the community psychiatrist. She came up clean. That's when we contacted the police, a couple of days later the flat below our patient was raided and found to be full of explosive equipment and real IRA members.
"How often have I said to you that when you have eliminated the impossible, whatever remains, however improbable, must be the truth?"
Pathologist here. Biggest mistake I ever made was cutting myself during an autopsy on an HIV patient. Lucky for me, I did not acquire the virus, so everything had a happy ending (For me, anyway. That guy was still dead.)
When I was on peds ID, we had a young girl come in with a rash on the bottom of her feet. She was also having headaches and joint pains. We spent close to an hour interviewing the girl and her mother. Her history was essentially negative. Finally, as a last-ditch effort, I pulled out the weird questions you ask in med school.
I asked if they had any unusual pets, as we had already ruled out normal pets. They said actually they did just return a pet rat for biting her. They thought that this wasn't really relevant. Bam! Rat bite fever.
I had a fella come into the ER who was stone sober, but only because he had spilled all of his rubbing alcohol onto his pants, which meant he couldn't drink it. The reason why he was in the ER if the first place was because he tried to burn the alcohol off of his jeans by lighting the alcohol on fire, thinking the alcohol would burn and not his pants.
He had some pretty rowdy burns from the calves down because he couldn't get his pants off of his shoes. To be honest, pretty nice guy… absolutely the kind you'd expect to light themselves on fire, but he was very pleasant considering the circumstances.
I'm not sure if this counts as a rare diagnosis but it was a neat one. This fellow was at dinner with his wife and some friends when "all of a sudden" he slumped forward into his entree and went unconscious. I saw him as a hospitalist in the IMCU. Despite being unconscious, his labs and vitals were all stable and he appears to be adequately protecting his airway.
The wife was initially understandably distraught and not able to offer the best of histories, but as the patient gradually began to wake up, I was able to put together a few facts. The patient had pancreatic insufficiency and thus needed to take six pills with pancreatic enzymes before each meal. He also had a prescription for Ambien. They were both white pills...you can figure out the rest. He recovered fully without any long-term effects.
Worked security through college at a local hospital. The only "creepy" thing I remember is when a dead man moaned. One of my duties was to help wheel in patients who had expired down to the in-house morgue. Once we were wheeling and older man from the E.R. down, and halfway down the hallway he let out this low moan. I started to panic, thinking that he was coming back to life, but the RN explained to me (newbie) that sometimes the air in the lungs doesn't come out until sometime later, or is delayed for a bit.
I diagnosed a patient with acute intermittent porphyria. He had a history of psychiatric admissions with depressive symptoms associated with nausea (though not much in the way of pain). I saw him as a medicine consult for the psychiatry service and ordered urine porphyrins just for completeness as it apparently had never been tested before. Lo and behold, they come back positive.
There is this old adage in medical school, "When you hear hoofbeats, think horses not zebras." Which while perhaps relevant to a medical student, is actually the opposite for what is needed from a skilled practitioner. The common stuff is easy...practically reflexive. In our case, a better adage would be, "When you hear hoofbeats don't just assume it’s another horse." Too often physicians just hear the hoofbeats and ignore the black stripes.
When I was 16 and dealing with partial deafness: "Sometimes being a teenage girl is hard, but it's hard to parent them too so there's no need to exaggerate things to make things harder for your parents. Knock it off, there's nothing wrong with you." Two tumors, nine surgeries, and a CSF leak later, yes doctor. There really was something wrong.
I worked as a mental health tech to get through undergrad. A 15-year-old female in the adolescent ward claims to have swallowed a staple. Eh, but whatever, as I’m taking her down to x-ray, I tell her about the dime I swallowed when I was a kid. It happens. Well, turns out she underestimated the number of staples by around a hundred.
Every printout given by the therapists had been a swallowed staple. She had gotten staples from the other kids. The x-ray of her abdomen looked as if it were a weird staple-y snow globe. And yet, somehow, she was back to trying to take psych ward staples a week later. Never did figure out how they removed them all.
My parents are nurses. They knew a doc who'd been on a 36 hour shift. Patient came in with a punctured lung (I think) and the doc had to collapse the lung to fix whatever was wrong with it. Through tiredness, the doctor accidentally collapsed the wrong lung, and the patient didn't make it. Doc ended up getting fired and ending his own life.
Baby born without a nose and with non-functioning eyes. Diagnosed with Bosma Syndrome. It was kind of crazy, I saw the baby a few months later and it was doing fine. Children with Bosma Syndrome grow up without any cognitive disabilities, it's very interesting.
OH BOY HAVE I GOT A STORY FOR YOU
A few years ago I worked for a medical device company and got to observe a surgical procedure that involves drilling into a person's brain. My coworker who had observed 30+ times recommended to the surgeon to increase the patient's posture angle to 60 degrees rather than 45. The surgeon, like many, thought he knew everything and just ignored his advice.
Fast forward about 50 minutes to the drilling phase, and the surgeon makes a bad drill angle and pulls the drill out too soon before the brain's internal pressures can even out naturally. CSF (Cerebral Spinal Fluid) comes gushing out of the patient's head, onto the floor, everywhere.
Not only is this a chemical hazard nightmare, and completely disgusting, but this is a procedure where the patient is AWAKE. The patient starts noticeably freaking out only they can't move because they are strapped down and their head is head completely still by the machinery. They must have thought they got abducted by aliens. Darn surgeons.
I am an anesthesiologist now, but was a doctor in charge of a small rural hospital in India about 20 years ago. An elderly lady was brought to the hospital by an irate husband who felt she was faking an illness. She would lie in a room all day with doors and windows shut and complained of a headache. She refused to do housework or look after the kids. Other doctors who had seen her before me had treated her for pain with no improvement.
I examined the patient; who complained of severe headaches and just wanted to lie down and refused to open her eyes. I admitted her to the hospital and performed CSF tap (A needle into the lumbar spine to get a sample of fluid surrounding the spinal cord). As expected, it was tinged yellow (Cerebro-spinal fluid should be clear). These days we have CT scans to diagnose sub-arachnoid hemorrhage (bleeding around the brain); but it was a difficult diagnosis once upon a time.
I was working as a helicopter retrieval doctor in Australia last year. Called at 2am to a car crash in the middle of nowhere. Patient was 150 kg (330lbs.) and 5-feet tall. So drunk you could smell the alcohol in her blood. Had been ejected from the front passenger seat of a car through the front windscreen. Wearing no seatbelt.
She had lain undiscovered for three hours on the side of the road. The temperature that night was 2 degrees centigrade. Her entire right scalp had been degloved. Blood pressure and oxygen saturation were unrecordable at all times on transfer due to shock, hypothermia, and body habitus. Carotid pulse only. GCS 3 (completely unconscious).
Due to her ENORMOUS obesity any movement of her head from the position she happened to land in obstructed her airway. If she had landed in any other position she would have had no way to breathe and died. Two hour flight from nearest trauma center. Unable to intubate her without drugs due to muscle tone. It was the scariest moment of my life.
Gave her drugs to paralyze then intubate in the middle of a paddock, on ambulance stretcher, under lights, with patient placed in RAMP position. With best rewarming we could do in the helicopter core temperature was 29 centigrade on arrival in ER. We didn't carry blood on the helicopter at that time. Survived and discharged neurologically intact.
The morning report was a good one today. We had a 59-year-old male come in with lower leg swelling. Within 3 days he becomes confused, febrile, and stiff. We put him in the ICU, thinking he had meningitis and got some CSF cultures and started antibiotics. Two days later, the cultures were still negative and he wasn't improving.
His wife then says this whole event seems similar to her husband’s (the patient’s) mom. She had Creutzfeldt-Jacob disease and passed from it. It's a 1 in a million (literally) diagnosis and our tests are still coming back for it. Really rare case most doctors will never see.
I'm an apprentice funeral director. We went to a nursing home on a removal and as we were walking down the hall one of the patients got antsy and opened the door to his room and saw us walking with the stretcher. "I'll see you next week boys." And guess who we had to pick up the next week.
When I was an intern, we had a 22-year-old man with persistent abdominal pain, all studies negative. His symptoms were unexplained. His mother was constantly at his bedside, and his medical history, which was extensive according to his mom, included multiple hospital stays with no definitive diagnosis. I noticed that he would frequently take ill after meals, which his mother brought from outside the hospital.
It eventually became clear that he was a victim of Munchausen by proxy. His mother was making him ill. I'd had a patient with Munchausen's when I was in medical school (she was injecting her own waste into her IV), so I was particularly tuned in. Both cases were very sad.
Dr.: *Glances at my genitals* You have Herpes.
Me: But I've never had sex!
Dr.: Oh, stop crying. I diagnose this all the time. It's pretty common.
Me: But aren't you going to at least do a test
Dr.: Fine, but it's going to hurt and it's going to show herpes.
[Indeed, it was an allergic reaction to a medication.]
My first rotation as a medical student was psychiatry. I was really nervous, and made a flashcard for each psych condition and a list of diagnoses to consider. One of the patients being discussed on rounds was psychotic (think: KGB is after me!) but was otherwise put together. He was really into doing art and was very, very religious.
I looked at my flashcard for psychosis and casually mentioned that we should consider temporal lobe epilepsy, which presents with religiosity and exaggerated artistic ability. An EEG showed that he had it. I've caught a few zebras since, but that was my favorite.
Former medical student here. I remember one young patient, 22 years old, was re-visiting the ER, where he'd been seen six weeks prior for sustaining some abrasions and bruises after falling hard off a skateboard. He was all scraped up everywhere but had healed up OK. But now he's in the ER again, feeling awful sick and vomiting.
As the third year med student, I was dispatched to the bedside and hung up the CT films on the lightbox, to much finger-pointing and grunting among the surgeons. I had no idea how to read a CT at the time—I wasn't even really sure what part of the body had been scanned. So when the surgical resident barked "Prep him for surgery," I decided to disguise my ignorance and just go for it.
We got him gassed and prepped and I scrubbed in. The surgeon said "Open." That’s where it all started to go wrong. First, I had to be told what we were doing: The Kocher maneuver, where you basically move the intestines to expose what you want to get it. By now, everyone knows I’m not with it, but they watch me do it anyway.
I slid my gloved hand up, getting ready to grab the entire sack of intestines and move it up and over—but I met unexpected resistance. I peered up, seeing in my confusion that everyone was edging away from the table. "What's the trouble young man, get your hand up there and complete the maneuver! Push harder!" A spongy sort of barrier gave way with a sickening stench.
Suddenly, a gushing cascade of grey-brown, bloody pus roared out of the incision, soaking my gown, scrub pants, and shoes before splattering on the OR floor and walls. The guy had a splenic abscess, as I just found out. After that, the other doctors cleaned it up and mostly cured it. The attending finished up and the patient was good as new. I had to throw out my shoes.
A six-month-old baby was not getting bigger and dropping off the growth charts. The baby wouldn’t move and cried all day long. I couldn’t figure it out. I was making preparations to transfer the baby to the university hospital for admission. One of the clinic nurses commented that the baby's cry sounded like a cat. Ding, a bell went off in my head.
Cri du chat syndrome or cats cry syndrome. Very rare. I looked it up on UpToDate and the baby had a high probability of having it. I referred her to genetics and they confirmed it. The attending called me and marveled at my clinical skills. I chuckled and told him the nurse diagnosed it. Good news, the baby had a small deletion of the 5p chromosome and managed to stay somewhat healthy and functional.
My dad had an interesting misdiagnosis a few years back. Since my dad was about 20 or so, he noticed that two of his ribs (opposite each other) stuck out slightly more than the others. He thought nothing of it, and his doctors always told him not to worry about it. It was especially pronounced when he was lying on his back—the two ribs stuck out about an inch above the others.
Anyway, one day he was forced to see a different doctor for his checkup for one reason or another. The doctor noticed his ribs and asked a few questions. He then strongly recommended that my dad get an MRI done on his brain, as he suspected something might be affecting the bone growth. Sure enough, they found a golf-ball sized tumor. They removed it without issue and he's been doing fine since. He switched to that doctor permanently.
We had a young fellow come in who worked as a landscaper. He showed up in the ER with severe GI distress. The diagnosis was almost entirely from history. Apparently, he forgot to bring lunch so decided to munch on some "wild carrots" he found while he was out working. I Google "wild carrot dosing" and quickly figured out the diagnosis (this was in the this was Northeast USA by the way). I will give you a hint...a certain Greek philosopher also had an affinity for the substance...it was hemlock. AKA: Not good for you.
He recovered fine, though he did get a night in the ICU for observation.
When I went to the hospital, a doctor said the most terrifying thing I’ll ever hear... “We’re going to have to defibrillate you and we don’t have time to sedate you.” They rolled the crash cart with paddles into my room and I said, “Get that thing away from me!” and almost cried. My mom was in the room with me and was absolutely hysterical.
Thankfully a cardiologist was able to look at my EKG in the nick of time and determined my heart rhythm was stable enough for me to just be transferred to a room for further evaluation without defibrillation.
We had a good case a few years ago. An otherwise healthy, 40-year-old migrant worker from Central America started coughing up blood intermittently. Everything suggested tuberculosis: History (they were from an area with lots of TB), chest x-ray looked like tuberculosis, illness script looked like tuberculosis...but his tests for it (sputum/quant gold) were all negative.
I decided to test his urine on a whim to rule out pulmonary-renal pathologies. Ding, ding, ding! Blood. Lots of blood. The patient never noticed it, and his kidney function was superb, so this was a tricky diagnosis. Turns out he had granulomatosis with polyangiitis (Wegner's). Kind of a sad story, because TB is largely curable, but with Wegner's he'll be on chemo for a very long time with this disease. I'm glad we caught it before irrevocable damage to his organs, though.
Not a doctor, but I have a story about one that screwed up and one that saved the day. My grandmother was seeing this physician because she had multiple issues with heart disease and high blood pressure. He prescribed about a dozen different medications to fix all her problems. Soon after she started to speak strangely. She would start accusing people of being in the Mafia, and wanted to kill her and the rest of us. This kind of talk became more frequent as time went on, until finally she just stayed in bed because if she left she would be killed. None of us knew what to do, because who really wants to have their grandmother committed.
During this time, my uncle (my grandmother's son) goes to the supermarket to do some shopping. While there he meets her old physician, who just happened to ask how she was doing. My uncle goes into all the details on what we were going through. The doctor then says he wants to look into the case since she was a good patient of his, and asks for the phone number to the house.
The very next morning he calls and says he found what the problem was. The concoction of medications she was given had severely depleted the salt in the body causing her brain to swell. He was shocked that the other doctor had not realized this before over medicating her. His short-term solution was for us to give her one tablespoon of salt. The long term solution, of course, was to change her medications.
I have never seen such a change in a person before. We gave her the salt in a drink, and within the hour she was completely normal again. It really was an incredible moment for us. One hour before we thought we were going to lose grandma to some institution, and then the next moment she is downstairs in the kitchen making herself a cup of tea. That doctor saved my grandmother, and I can't express enough gratitude to him.
As a third-year medical student, I had a patient come in with four years of worsening balance issues and garbled speech. She had gotten a crazy work up at an outside hospital system with every sort of imaging possible, biopsies of random sites, and a number of very expensive tests. She was at our university hospital for the first time.
When I first entered the room, I reached out to shake her hand, and from her wheelchair she had to raise her head at me because she couldn't look up with her eyes. This was the first red flag. I also asked her if she had the sensation where one of her limbs would move without her controlling it, and she said yes, suggesting something called Alien Limb Phenomenon.
I diagnosed her with Progressive Supranuclear Palsy with features of Corticobasal Degeneration, a very rare disease on the spectrum of Parkinson's plus syndromes, and my supervisors agreed. Unfortunately, it was a bad prognosis, but the family was consoled by the fact that at least they had a name for what was happening.
About two years ago, we treated patients during a fungal meningitis outbreak. Our acute care floor has a census of 20. During this, at least 10-15 were meningitis patients, age ranging from twenties to nineties. There are no shared rooms and all the patients were in isolation, no contact with one another. Many of them had the same hallucinations, children in the corners of their rooms and auditory hallucinations of religious music. Very creepy.
A woman came in with severe opiate withdrawal and some shortness of breath. Because she was so insistent about how miserable she was, everyone sort of wrote her off as drug-seeking. The morning I rounded on her, I decided to do a thorough physical exam. Lo and behold, she has a hard non-mobile clavicular lymph node...it was so big that it was impossible to miss if you just did the exam.
Immediately we got a chest x-ray and then a CT scan. There was a perihilar mass. After a biopsy, we learned it was small cell carcinoma (lung cancer).
Ob-Gyn doctor here, 40 years experience. About once a year would take care of someone in full blown labor, full term, who did not know she was pregnant. Very hard to wrap my head around, I guess the denial power of the mind is substantial.
I was visiting a friend’s house when I was introduced to his dad who had no medical issues. He was a hard-working farmer, but looked a bit too thin. Something told me there was something not quite right, and so I asked him if I could examine him. I promptly discovered hard lymph nodes in several areas. Further investigations revealed he had disseminated cancer. He kicked the bucket less than a year later.
I heard an "Oh God" moment happen…when I was a patient on the operating table. A couple of years ago, I was in labor for 28 hours, pushing for six, when my child started showing signs of distress. The baby had a slightly elevated heart rate. My midwife at the hospital told me the doctor was coming in to check to see if a vacuum assist could help.
She checks me. Then I see a horrifying sight. She immediately stands up with blood on her hand and says “We're going to the operating room NOW.” At that time, I started feeling that zoomed-out tunnel vision I know is shock. I had anxiety, but I figured she knew what was best. She did. We got in the OR eight minutes later, and when they opened me up, I heard the surgeon say, "Oh God. Look at this."
They saw blood in my catheter bag, and upon fully opening me up found my son was actually trying to come through my uterus. He had ruptured it. They got my son out. Those moments where he was stunned and not crying were an eternity. Then he cried and he was born a completely healthy baby. After I woke up and was back in my room, the doctor came in and told me what happened. I knew a ruptured uterus sounded bad, but oh darn I googled and started having a massive anxiety attack.
A ruptured uterus is extremely rare and often fatal. I read from the time it happens, you have about 15 minutes before you bleed out and the baby is gone. When I went back for my follow-up, my midwife let me know she had never once encountered that, and it was such a big deal for them that a few days after my birth, they all got together to discuss my case.
I was so incredibly fortunate I chose to labor in a hospital, and that the doctor just knew from my vitals and baby's that something was off. They just didn't know exactly what until they got me open. I can't even tell you how grateful I am for Dr. S. You saved my life and my son's life and our family will forever be grateful.
A patient came in with an itchy rash that would not go away for weeks, and a new swelling of the mouth and tongue. She had "hives" all over her body and the only thing that had helped was repeated steroids. She was a mid 40s female who worked with dogs, so we assumed that she had a new allergy to pet dandruff, fragrance in a shampoo, flea medicine, or something along those lines. We discharged her home with an appointment for the dermatologist to do a biopsy of the lesions. But that wasn't the last we'd see of her.
Later that day, she turns back up in the Emergency Department with swollen lips, increased rash, and trouble breathing. She started having these problems 15 minutes after eating a roast beef sandwich. Someone on the team remembered that she works with dogs and asked if she'd had any recent tick bites. Sure enough, she had been bitten by a tick a few weeks ago and identified a picture of a Lone Star Tick.
Turns out she had developed an allergy to red meat after a bite from that tick. This allergy is called an alpha-galactosidase allergy, and is a reaction to a carbohydrate carried on the outside of cells (think like the carbohydrates on red blood cells for ABO blood type) by all other mammals except humans and monkeys.
The tick had bitten one of these and kept some of the protein in its digestive system, and then after biting her, her body developed antibodies to the carbohydrate, causing her to have a new allergy to meat.
Put a very expensive implanted device in a patient with government-funded care. She came to the follow-up appointment with a gaping wide infected wound. Said she thought it would help healing if she had her dog lick it. Device had to be removed and discarded.
Ordered an abdominal ultrasound on a refugee from Iraq via Syria, expecting to find gallstones because she felt full easily after eating and was having pain in her right upper quadrant. Instead of gallstones, there were two, 7 cm cysts in her liver. Hydatid cysts from a tapeworm.
I lost 2.5 liters of blood in childbirth. Midwives hadn’t realized, despite me telling them how unwell I felt and that I was going to be sick. It wasn’t until I sort of passed out and remember them saying blood pressure was something over zero. They hit the buzzers, a lot of people came rushing in and I just laid there for what felt like a long time feeling everything go quiet, but it wasn’t peaceful, just absolute sadness consumed me that my husband was about to be left without me and that my new son wouldn’t have a mummy.
A lot of oxygen, drugs, and a couple packs of emergency blood transfusion later and thankfully, I was OK. Still very mentally scarred by the whole thing. But the main moral of the story is—please give blood if you can. It’s only thanks to the kindness of strangers my baby has a mamma and bleeding out during childbirth is a lot more common than I ever realized.
As a fourth year during my rotations, I noticed my patient had a vertical subluxation of her crystalline lens during a dilated eye examination. The part of the eye that develops a cataract later on in life was shifted significantly up. She had severe myopia and astigmatism (-14.00 - 5.00 x 180 OU), and her 6'1" tall body along with disfigured teeth led me to believe she had Marfan's Syndrome.
She had never heard of it, never seen a cardiologist, etc. A few lab tests confirmed. She can live a normal life; she just needs some meds and education. She had very long fingers that jumped out at me and braces on her teeth. As an optometrist, I focus on glasses and contacts, but I see (no pun intended) and treat an unbelievable number of systemic diseases that manifest in the eye or retina.
Three years ago, my grandmother was in the hospital to get her brain tumor removed. Nine hours later, we got to see her—only for the surgeon to say, “It went well, for the most part, dropped the top of her skull though.” Just like that, he walked away eating his apple. We were all just standing there like ???????
One of my favorites is when we had an 85-year-old man in for cellulitis or something, and everyone was documenting he was confused—in part because he kept talking about his mother; his mother was going to be so worried, he had to be discharged to take care of his mother etc. He became agitated and was actually getting ready to be dosed with Haldol because he was insistent he was going to leave to take care of his mother.
Note, the standard is to play along, tell the patient something like "Oh, we already called your mom, she knows you're here" that sort of thing, but he wasn't buying it. Finally, the nurse asks him if we can call his son to make sure the patient's mother is being taken care of (really, just to placate the patient), and the patient agrees. We call the son, the nurse explains the situation, and the son informs us that the patient's mother is indeed alive at the age of 101, but that he is staying in his father's house assisting in her care.
Poor patient was legitimately worried about his mom, and we all thought his infection (or just old age) was causing him to be confused!
There was a 24-year-old patient who was brought in from a jail in a rural county. He was working roadside cleanup when he found a bottle in a ditch that he thought contained alcohol and he quickly chugged it down. To be fair, it did look like whiskey. Unfortunately for this guy, it was the worst possible alternative. It turns out it was a substance that contained sulfuric acid. Its pH was less than 2.5...it just ate up the litmus paper. So shortly after he gets to the ICU he is in excruciating pain.
The gastroenterologist took him to do an EGD (basically a procedure where they can look at the esophagus, stomach and duodenum with a camera attached to a flexible tube) and the pictures were horrendous. You could literally see his stomach and esophageal mucosa eroding away.
He had to be sent off to another hospital where they had an esophageal surgeon who could repair the mess. He, of course, needed multiple surgeries and had a very long hospital stay. I saw him a few months later when he was admitted for another issue. He was down to 90 lbs. from about 150 and was getting fed through a PEG tube.
He was very lucky to be young and otherwise healthy—but obviously not very smart.
ED referred a guy to me who had a platelet count of 2. The guy looked bloody sick with abdominal pain, petechial rash, feverish, diaphoretic, and he was a bit confused and drowsy too. I talked to my boss who said to give him prednisolone and he'd see him tomorrow, but I was convinced this guy had a really rare condition called TTP (Thrombotic Thrombocytopenic Purpura) and so I called the major hospital in my area and sent him to their ICU for a procedure called plasma exchange.
I ordered a test called ADAMTS13 to prove the condition, and still have a paper copy of the result (he had none of this chemical) because it's the best diagnosis I've ever made, it helped save his life!
Night nurse for four years now at an old folk's home. Had a palliative who couldn't sleep because of incredibly vivid hallucinations. She would describe voodoo people around her room that would just stare at her waiting for her to die. I didn't take it seriously until the lady across the hall (who rarely ever spoke) starting seeing them in her room too. Legitimate shivers.
Menkes kinky hair syndrome. I was called to see a 3-month-old boy with hard-to-control seizures. His most remarkable exam finding was his hair: he had been born with a full head of black hair (he was Hispanic), but at the time I saw him, the first 3-5 mm of each hair shaft was nearly white, with an abrupt color change, still black on the tips. The hair was a giveaway for this disorder, almost no need for confirmatory testing, but the admitting team had already ordered whole exome sequencing.
This was not a fun and exciting diagnosis to make, more a sinking feeling upon discovery of the hair (neurodegenerative disorder due to a defect in copper metabolism that is irreversible once symptoms appear), but it was interesting to see at that transitional stage. I had only seen older boys with Menkes before, once the hair was already pale and brittle all over. Usually the hair has changed long before the diagnosis is made.
Used to work in a skilled nursing facility. I was usually assigned to the Alzheimer's ward. One night I'm in the linen room stocking my cart, and I heard someone shuffle up behind me, then I felt a hand on my shoulder. I turned around and there was no one else in the room. The door was still shut too. Another lady started to complain that a man was coming into her room at night (again, Alzheimer's so I didn't think much of it).
So to reassure her, I told her I'd check on her throughout the night. She complained of this man every single night for two more weeks when I asked her to describe him to me. "He's real handsome, and wears a black suit. Oh. He's right behind you now, honey." That freaked me the heck out. Of course, there was no one behind me. She died the next night in her sleep.
I'm an anesthesiologist. This happened when I was a resident. It changed me for life. We had a 29-year-old male in for finger surgery. We had an uneventful induction maintained on Sevoflurane. Within 20 minutes we started to have rising ETco2. I called my attending after trying to hyperventilate the patient (She was a young Harvard trained peds anesthesiologist).
She comes in and asks me what I think is going on. I tell her things seem strange. She tells me to chill. Five minutes later, the ETco2 is over 100 and I'm freaking out! I call her and tell her this is MALIGNANT HYPERTHERMIA (easily fatal reaction to certain anesthetics caused by congenital aberrant sarcoplasmic reticulum receptors).
She says that I'm being ridiculous when I tell her I'm afraid this is the real deal. My pages get ignored by her. The patient’s temperature starts to rise. I'm bugging out and call the board runner (supervising Anesthesiologist for all the operating rooms). He's old. He knows me well and trusts me. Comes in, looks at the monitor—and his face went white.
Needless to say, we save the patient after many dozens of vials of Dantrolene. Six months later I'm made to do an M&M and the young Harvard attending insinuates I did something wrong in front of the department. Most of the rest of them come to my aide. She leaves the job shortly thereafter. I will soon be at her fellowship.
When I was a surgery intern, I was pulled to help out in a circus of a case. One of our older doctors was doing a simple liver biopsy on a patient and nicked her artery. Because the patient was already pretty sick, her tissue had the consistency of toilet paper—so every time they tried suturing the hole, the tissue just breaks apart, leaving a bigger, more leaky hole.
Pretty much all hands were on board. The chief residents were scrubbed in, the seniors were literally squeezing blood bags into the patient's veins, and us interns were runners, going back and forth from OR to the blood bank to transport blood and plasma. We ended up transfusing over 12 liters of blood, so the patient lost over two times her total blood volume during that surgery.
A vascular surgeon eventually swooped in and did a rather slick patchwork that fixed the problem. Then the surgery went straight into soap opera territory. It turned out that the patient was like a daughter to the surgeon. He literally saved this patient's life several times already, and they got really close over the years. She even named one of her kids after him. The poor guy broke down a few times during the surgery and was convinced that he had just killed his daughter.
The chief residents had to take over a few times when he was mentally not there. That was his last surgery...He retired the next day. Heck of a way to end a surgical career.
I didn't diagnose it, but I have a patient with primary Ciliary Dyskinesia with Situs Inversus, aka Kartagener syndrome. The cilia in the body don't move well, and this mainly affects the respiratory cilia/lungs, although it also causes infertility, related to the cilia inside the fallopian tubes and the sperm tails not working well.
Situs Inversus is when the organs inside the thorax are mirror images of normal, the heart is on the right side instead of the left, etc. I was looking over this patient's old medical records and one of the radiology reads of a chest x-ray said, "There has been interval development of dextrocardia. Since this is physiologically impossible, the film has been flipped."
Probably the original film the radiologist had been comparing to had been incorrectly flipped to look "normal," maybe by someone who assumed there had been an error. Another chest x-ray report just read: "The film has been flipped" and then went onto the rest of the interpretation.
So I was like 11 or 12 years old when this happened. I had a hundred acres of woods behind my house, and I loved to play in them. Unfortunately, I am also very allergic to poison ivy. Well, I go out and roam the forest gayly for a few hours. Nothing weird. I eventually come home and go to bed. I then wake up in the middle of the night with an itchy leg.
Now, when I say itchy, I really mean itchy! After a bunch of scratching, I finally pull the blankets down. I immediately do a double-take and go, “What the heck???” My leg is looking like what I imagine the final stages of leprosy to be like! There are huge raised patches of red disgusting bleeding, pusing atrocities. Needless to say, I started screaming in horror.
That escalated quickly. Well, time to go to the Emergency Room decides my mom. After a wait, I'm shown to a room connected to the waiting room. After a quick look, a nurse comes back with a needle the size of a baby's arm. Good news, it's for my behind. Now, I did not want that needle in my behind. I didn't care what angle, which cheek, or for how long.
All I knew was I did not want that needle in my behind. But screw it, I'm a brave man! So, I dropped my pants and prepared for the inevitable. Well, as soon as she bent down to shove the needle in, I panicked and completely lost all the courage I had just built up. I immediately started running for the door, and ran straight into the populated ER waiting room.
Two nurses, one with a needle in her hand, and my mom were chasing me like a football player in front of this whole crowd. All the while, my lonely pants were lying back on the floor of the examination room. My bare behind was flailing about for everyone to see. I managed to outlast my pursuers for a few minutes, but was eventually pinned down and pricked, screaming and crying for all the world to see.
On the bright side, my itch went away!
I once saw a child with mosaic trisomy 8. It was a complete mystery why he had speech apraxia, and the geneticist I was working with took one look at his feet, saw that they had super deep creases lengthwise, and ordered a karyotype with mosaic trisomy 8 in mind. Sure enough, he was right. I was amazed how spot-on he was predicting that.
My body was completely infected with sepsis. The emergency room staff had placed me in a tub of ice to try and help fight the fever. I had two IVs pumping I don't know what all into me. Next thing I knew, everything was dark. I could feel other people around me. I felt so happy and light. I was free. There was no fear.
Somewhere I could hear my best friend yelling at me, “Don't die. I am NOT raising your children.” My mind snapped to. Immediately, I knew I had to go back. There was no way I was going to let her near my children. Woke up right afterward and was amazed at how heavy my limbs felt. I have no fear of dying now. I have raised my kids. And she is no longer my best friend.
Primary doctor here. Had a two-year-old refugee child (whose parents couldn't communicate well) who swallowed a button battery and it was stuck in her throat. For clarity, I didn't know it was a button battery, but something just didn't feel right, so I sent her to the ED. If she had gone perhaps one more day, she might not have made it—it had already destroyed a good amount of tissue in her esophagus and was apparently somewhat close to perforating.
I feel like it would have been very easy to just say she had a sore throat from an illness, particularly with the language barrier. I'm glad that something felt weird to me—she didn't look that bad, but was just holding herself and breathing weirdly.
I very nearly injected a premature baby that had Down Syndrome with ten times the amount of Lasix I was supposed to give him: I had put the decimal in the wrong place when I did the math on the dose. That baby would almost certainly have died if I'd given it to him. I had the liquid drawn up in the syringe and had the syringe actually in the port ready to push through before I looked inside the chamber and realised how uncharacteristically full it seemed.
Paediatric IV doses of anything are simply tiny. I was supposed to give him 0.1 mls, and nearly gave him 1.0mls.
I needed a very large cup of tea after that.
Wolman Disease. A genetic disease that affects about 1/200,000 kids, terrible outcome. It leads to calcification of the adrenal glands, which is how I picked it up on a chest x-ray on-call (I'm a radiologist). The kid had failure to thrive and a big spleen so I brought it up. He got further testing which confirmed the diagnosis.
Bottom line, don't forget to look at the adrenals or ribs on peds x-rays!
I was the patient, and it was a kidney biopsy. I was pretty out of it, but still awake so they could talk to me, laying on my stomach as my kidney doctor worked behind me. He warned me, “You’re going to hear a click and it will feel like Mike Tyson punched you in the back.” “Ooookayy?” I hear, click, feel the punch, then hear, “Oh, GOD. Get on the phone now.”
A nurse came up near my face to calm me, and maybe keep an eye on me. I don’t really remember everything. Apparently, the doctor had nicked a blood vessel, and I was bleeding internally at an alarming rate. I got to spend the night in the hospital and peed what seemed like pure blood for about 24 hours. Never try to fit your kidney biopsy in on a Friday before the doctor leaves for vacation.
Probably Stiff Person Syndrome. Technically it was paraneoplastic antibodies causing a case of mild stiff person-like syndrome, but it was basically a lady who had glutamic acid decarboxylase antibodies which caused her to be really stiff. How'd I figure it out? Well, she was really stiff and it was very odd. I was out of ideas and literally googled "stiff person" and got the result of a disease I'd probably heard mentioned in passing in med school but is so rare you forget about it: Stiff Person Syndrome.
Yes, it's real. I thought it was a joke at first—but it's all too real. Ordered the test, it was positive. Later, after more research, I learned that you can have similar antibodies and symptoms with paraneoplastic syndromes, so I did a scan, and found a lung tumor. Boom. SPS is really rare. Paraneoplastic syndromes are less rare. She was somewhere in the middle.
My doctor didn't actually speak, his reaction was worth a thousand words though: he literally rolled his eyes, threw his head back and sighed very loudly...I had been having a semi-regular pain in my abdomen for years, a terrible cramping pain (I'm a man so it wasn't menstrual in nature) that would double me over in pain and would last for a day or two and then go away. I had seen a few different doctors about it and none of them could figure it out.
I was seeing a gastroenterologist about another problem and mentioned my pain to him. He did some tests, tried a few things, did an endoscopy and told me he couldn't find anything wrong. The next time I got the cramping pains I went back to him and he performed his non-verbal routine mentioned above. It would have been less hurtful if he'd just told me I was a hypochondriac.
I gave up on figuring out the pain. Fast forward a few years and I'm having a bout of these cramps. Middle of the night I get up to go to the bathroom. I puke my guts out and proceed to pass out on the bathroom floor for a few seconds. I make it back to bed without waking my wife and somehow fall back asleep. In the morning I get up and need to puke again.
My wife goes with me out of concern and I pass out on the toilet. She calls 911 and I get whisked away to the hospital. Didn't take too long for the doctors to determine I had a bowel obstruction. After six hours of surgery and a subsequent week stay in the hospital I'm back home and feeling better than I have in years.
Turns out that I had a 99% bowel obstruction caused by adhesions that had been slowly developing on my intestines since an appendectomy that I had in 1980. The surgeon told me that it was so bad in a few places that my intestines had been twisted on themselves. He referred to it as a "rat’s nest." The surgery was in March, 2017, and not only have the cramps not come back once, I haven't felt this great in decades!
I made a clinical diagnosis of fairly early-stage necrotizing fasciitis (the infamous flesh-eating bacteria) in West Africa which was pretty cool... The patient was a young adult male who was writhing and screaming in agony as he was carried in. He spoke a tribal dialect and I spoke ugly French, so it was basically impossible to get any information out of him or the friends who brought him in.
I laid him on the table and did a rapid trauma assessment. When I stripped off his shirt, I saw a small patch (maybe 4" x 6") of blackened tissue below his left nipple along the side of his ribs. It looked like a chemical burn to me at first glance. I realized that some of the skin had torn off the area when I removed his shirt, and when I touched the lesion to examine it, I could feel the skin separating from the tissue below it.
The technical term is "desquamating." It had a horrible odor like spoiled meat/rotting garbage mixed with 100 degree west African heat and 100% humidity. Putrid. His temperature was over 40C (104+ F) and his O2 saturation was terrible. The rotting garbage smell indicated anaerobic bacteria, the skin peeling off indicated connective/soft tissue involvement, and the disproportionate pain (relative to the size of the lesion) is a hallmark of necrotizing fasciitis.
I ran back to my room and grabbed the Oxford Handbook of Tropical Medicine (highly recommend if you work over there in medicine) to double-check because I had never seen a case of flesh-eating bacteria in person before and didn't want to screw up the diagnosis and move things in a different direction if I was wrong. Sure enough, everything matched up and the chief of medicine stopped by to confirm the diagnosis. He basically said, "Oh yeah we see these fairly frequently, people get a cut or a bug bite and then rub dung or dirt into it and the infection takes hold."
The craziest part was the outcome. In the United States, patients with necrotizing fasciitis in one limb frequently die or suffer amputations of both arms and both legs—even in the best ICUs. Here we were in the middle of West Africa at a remote bush hospital and this guy has it on his chest, which pretty much wrecks the standard aggressive surgical approach since you can't exactly amputate the chest.
We loaded him up with high dose IV ampicillin a few times a day and his wife forced him to eat multiple bowls of porridge...miraculously he made a full recovery and left smiling 10 days later. I'm convinced it was the porridge.
When I was a new nurse working in the ICU in a large teaching hospital, I came into work one morning to a patient who was admitted that night, sedated, intubated, and all. Long story short, by the end of the same shift his breathing tube was out and he was completely alert and oriented, so he was able to tell us what was going on.
He was an end-stage renal patient, meaning his kidneys didn't work and he needed dialysis, and he was only in his late 30s. He said he never made urine anymore and didn't need his catheter so he wanted it out because it was hurting. So I went to remove the catheter as I’d done about a thousand times on other patients. It was the start of a nightmare.
As soon as the catheter left, blood started pouring out of his you-know-what in a heavy stream. Turns out, the nurse who placed it on admission hadn't advanced it far enough, since there was no urine production to indicate correct placement. This had caused a massive amount of trauma. It would not stop bleeding. I had to hold this man's nether region "shut" to put pressure on it while my co-worker paged the resident.
The doctor came in, looked at me with pity, and told me to just keep holding this 30-something-year-old man's junk in my hands to staunch the blood flow until urology could get there to assess. It just kept gushing blood every time I eased up to check. For over an hour total, I held it and tried to make polite conversation until the urologist arrived.
I diagnosed a little girl at birth who had Ectopia Cordis. It's a birth defect where the heart is located outside of the chest or thorax (yet it's still underneath the skin). It only happens to about 5-7 per one million live births. Warning, if you plan to search up "Ectopia Cordis," the images available may not be for the faint of heart.
I had my doctor at the time chew me out because I was leaving my newborn son with his dad while I went to a different state due to work for a few months...I just remember her raising her voice a bit and asking me who was going to watch the child while I was gone...I gave her a confused look and just pointed to my son's dad who was sitting right next to me.
She looked shocked and almost repulsed. Still pisses me off to this day...and she was also acting really confused why I was the one that wanted to work and not the dad. The doctor was an old woman who seemed very old fashioned. I was gone for three months but made enough money to where me nor the dad had to work for a while after that. I think being able to afford a roof over our heads is better than breastfeeding and not having rent money.
Today I took care of a man who believed he had been bitten on the abdomen by a baby rattlesnake that had fallen out of his ceiling vent, crawled up his abdomen under his skin, up his throat, and was currently coiled and rattling in his brain. Diagnosis: methamphetamines. Just say no.
I was a fourth-year resident and I was on call that day. Around 5 pm, I went to do rounds and as I got to the first room, I came in to find the first-year resident on top of a patient who had very recently had neck surgery. As I came closer, my blood ran cold. The resident was kneeling next to the guy’s head with his hands and clothes completely covered in blood.
There was blood on the roof, on the sheets, on the bed, dripping onto the floor, you name it. I was instantly petrified. I knew his carotid artery was ruptured, and I’d never repaired one before. I am completely unqualified to help this guy! Someone, please HELP US! I was the senior resident, so I was the only one on call at the time.
Besides that, no one could get there in time to help this guy. He was bleeding out, so it was up to me alone to help him. So I took the guy to the OR as fast as we could and I opened him up, all of the time praying and telling myself “It's OK, I can do this, I can do this!” I was pooping my pants while everyone was looking at me to fix him.
I open him up and I see the freaking artery loose, spraying blood all over. I clamped it, put a knot around it, and that was it. We closed him up, bandage, and transfuse the poor guy, and I went to collapse on a stool.
Five years ago, I spent six months working in a small rural Zambian hospital in the medical ward as part of a volunteer/outreach program. I have done mostly family medicine, and some surgery in my early days, but decided to mix life up a bit. The hospital was typical third world—a few basic medications, rudimentary clinical tools, a small lab on site which was usually broken.
No resuscitation tools whatsoever. HIV, TB and malaria were rife—it would not be uncommon to encounter a loss per day despite our best efforts. On one of my first days there an unconscious person was carried in by a mob of locals. I could smell him before I saw him. He had been in a house fire and his skin was cooked—completely black around his chest, face, and over his legs.
He was still breathing on his own and maintaining his airway but we had no doubt he had inhaled a lot of smoke. With no way to intubate or provide oxygen we merely had to hope that he didn’t swell up and close off and deal with the rest of the burns while he was unconscious. Two colleagues who worked in the hospital came over urgently.
We all kept our cool externally and got the nurses to translate to the man’s family that we were going to do everything we could to get him better. In reality, all three of us knew his chances at survival were in the single-digit percentages. We decided that due to the extent of his burns we were going to have to do an escharotomy (cutting the burned skin to prevent it contracting and stopping him from breathing).
Turns out I had the most surgical experience so despite having never done one before I gave it a go, hoping for the best. We got an IV into a neck vein and got fluids going. The local nurses dressed his burns. We gave him whatever pain relief we had. He was unconscious for a couple of days but eventually came to.
Each day we were expecting his kidneys to pack up but to our surprise, gradually he got better. He was with us for just over four months recovering. He came out severely scarred but he had beaten the odds and survived.
My mom had to have a kidney removed due to her waiting for almost two years to go to the doctor about her pain in her back. The doctors found out it was a large kidney stone and that her kidney was infected and had lots of gross pus shutting it down. After draining the fluids through tubes, she was finally ready for surgery.
Cue last Wednesday, the day of the surgery, and she was ready to finally be done with it. They removed the stent and put in the tubes no problem, next was the kidney. Here comes the “Oh God” moment. As they get ready to remove the kidney, they realized the kidney’s infection had spread to a portion of her lung and a major artery, making them fragile as toilet paper.
As the surgeon removed the kidney, he tore a hole in the lung, and even worse, he severed the artery. At that point, it was a race to save her life and stabilize her. I don’t remember much about how they fixed her up there, but they had to fly her to a different hospital and have a heart surgeon fix the severed artery in a more permanent fashion.
Anyway, the heart doctor saw the grave situation and said she’s got a 1% chance to make it. But he did such an excellent job that my mom is still alive and getting stronger each day. The moral of this story is: If you have insurance and are experiencing pain, go to a doctor as soon as you realize it. You may save your life, and also save some doctors from an “Oh God” moment like this.
I've diagnosed anti-NMDA receptor encephalitis in a patient that was thought to be withdrawing from an unknown illicit substance. Then, not two months later I had another patient with the same disease. I was talking to a neurologist recently and he thought it was a condition that is far more common than we thought it was, but still a pretty good catch for an internist.
I've caught a few conditions that were rarer, but it's nice to talk about one that's treatable.
This might get buried and is not really nurse related other than the fact my grandmother's nurse told me. My great grandmother was 94 and just started suffering with dementia. She told the home nurses and me that there was a little boy in the corner of the living room who would taunt and tease my great grandmother while laughing at her telling her she was going to die.
Well at first it was a little disturbing and we all shrugged it off because of her dementia. But then everything got real when my best friend came over with his little boy who is about 3 or 4. The little guy pointed over to the same corner and yelled: "I'm going to beat you up!" When we asked him what that was about, he told us that he saw another little boy in the corner and he is not nice! We flipped out! I got shivers just typing this. Maybe Nana wasn't hallucinating.
I'm PhD, not MD. The weirdest to me was a bloodstream bacterial infection that looked sensitive to antibiotics in the clinical lab, but the patient could not be cured. We got samples of the bacteria and turns out it was "tolerant" to antibiotics in a biofilm (heart valves) but not sensitive in the clinical sense. Opened my mind as a microbiologist to how insanely adaptive bacteria can be, and how they're more a population than individual cells. The most interesting paper I ever published, and unexpected.
Ugh, a dentist. I went in for a cleaning, and had another appointment to take care of a wisdom tooth "You're fat, you know that? Your teeth wouldn't be so bad if you weren't so fat. God you Native Americans are all so fat." Let's discuss what's worse. Her visibly uncomfortable dental technicians, who are all Natives. The fact the clinic was EXCLUSIVELY for my tribe. The way off-color remarks she made later about tribal members being poor, and how she was better than this. Or perhaps the fact she just insulted the medical director's grandson.
It's really sad because they had trouble finding a dentist (because we are a disgusting people I guess) but she magically "found a job in Florida" the second time I was there. She wouldn't shut up about how she was leaving for this great job in Florida. She bragged so much it seemed almost unbelievable. Almost like it was a total lie and a racist jerk was losing her job. I should have called her out, but I'm sure her techs already knew.
Not super rare but sort of diagnosed/missed Myasthenia gravis. I was an intern in the emergency department. A woman presents with the classic vague symptoms of fatigue and weakness. Notably, her father had very recently passed. Full blood panel was normal, her examination was almost completely normal but I did find she had proximal weakness (her upper arm strength and thigh strength were poor but her hand and feet and shins etc. were normal).
I presented to my superior and we decided to send her home because we couldn't diagnose her with anything and we can't admit someone to hospital for fatigue. She was upset that we couldn't help her. After she left, I couldn't shake this terrible feeling. I asked my superior, what about Myasthenia Gravis? Well, too late now, besides the testing takes weeks.
She represented a week later (I didn’t see her). She was admitted this time and seen by a physician. More tests were ordered and eventually she was diagnosed and treated for Myasthenia Gravis. I saw her 6 months later and she remembered me, she was doing much better and wasn't upset that we missed the diagnosis.
It can be very hard to diagnose some things because of how non-specific the symptoms are. In this case I had a feeling she had a real disease especially with her proximal weakness but there wasn't much we could do about it.
When I was about 12 years old or so, my doctor knew that I really didn't like needles. So, he put a shot that I needed in his pocket with his pens so that I wouldn't notice it and get my guard up. In the middle of a sentence, he pulls it out and comes at me. Terrified, I punched him directly in the face and broke his glasses.
It wasn't intentional, per se. The dude was coming at me with a sharp object. I didn’t even have time to process what was going on. It was all instinct and reflex. He ended up grabbing me by the shoulders, pinning me down, and doing the injection. I can only imagine what he must have been thinking. For years afterward, I couldn't bear to face him.
I'm not sure if I count because I'm a veterinarian, but I saw trigeminal neuritis in a dog. Basically, the dog can't move his lower jaw, but it's not stiff or painful or anything, it just hangs slightly open. It looks like the dog has just received some unbelievable news, basically. It goes away on its own in 2-4 weeks, but the dog can't eat or drink very well, so you have to syringe feed them, do elevated food bowls, etc.
It was my wisdom teeth removal. All four were impacted, and they had to break out the heavy hardware. I'm knocked out, don't even know the dentist entered the room. I wake up, but not able to move, just eyes open awake but my limbs won't react to my brain. I can feel the dentist hammering a chisel into my tooth to break it for extraction.
My jaw is just coming undone on every hit. My eyes are wide open, jaw even wider with some evil metal contraption. I'm staring at the assistant begging for her to see me, and after about a dozen hammers to my jaw, she glances over and drops the suction, jumps up and shrieks. The dentist stops to look at her, then looks at me and I see him say "Oh God.” Next thing I know, I'm waking up post-surgery. What nightmares are made of.
I had a patient transferred to our hospital for a STEMI (major heart attack). When they arrived, I noticed they looked a bit red and asked them, other than the chest pain, what symptoms they were having. The person said that they had been having a rash for a few days as well as nausea, vomiting, and diarrhea. Those symptoms go along with a condition called scombroid poisoning which you get from eating old, dark meat fish (tuna, mackerel, etc.).
I asked the person if they had recently been eating fish and sure enough, they had been eating salmon for the past few days. Assuming they had it, I treated them with Benadryl which fixed the rash, nausea, vomiting, and diarrhea. They were taken by the cardiology service to get a cardiac catheterization (how you find clogged blood vessels in the heart) for the heart attack and the results came back normal (no vessel occlusion).
Best I could tell, the condition stressed their body and made them tachycardic/hypotensive which made their heart work harder. The increased demand on the heart + an already weak heart led to the heart attack. Also, was pretty awesome to see the EKG go from showing a clear heart attack to normal after being treated with Benadryl!
I’m a nurse. I was on call one night and woke up at two in the morning for a "general surgery" call. Pretty vague, but at the time, I lived in a town that had large populations of young military guys and avid substance users, so late-night emergencies were common. Got to the hospital, where a few more details awaited me: "anal abscess."
Needless to say, our entire crew was less than thrilled. I went down to the Emergency Room to transport the patient, and the only thing the ER nurse said as she handed me the chart was "Have fun with this one." Amongst healthcare professionals, vague statements like that are a bad sign. My patient was a 314 lb. woman who barely fit on the stretcher I was transporting her on.
She was rolling frantically side-to-side and moaning in pain, pulling at her clothes and muttering Hail Marys. I could barely get her name out of her after a few minutes of questioning, so after I confirmed her identity and what we were working on, I figured it was best just to get her to the anaesthesiologist so we could knock her out and get this circus started.
She continued her theatrics the entire 10-minute ride to the O.R., nearly falling off the surgical table as we were trying to put her under. We see patients like this a lot, though, chronic users who don't handle pain well and who have used so much that even increased levels of pain medication don't touch simply because of high tolerance levels.
We got the lady off to sleep, put her into the stirrups, and I began washing off the rectal area. It was red and inflamed, a little bit of pus was seeping through, but it was all pretty standard. Her chart had noted that she'd been injecting IV substances through her bottom, so this was obviously an infection from dirty needles, but overall, it didn't seem to me to warrant her repeated cries of "Oh Jesus." I soon discovered how wrong I was.
The surgeon steps up with a scalpel, sinks just the tip in, and at the exact same moment, the patient had a muscle twitch in her diaphragm, and just like that, all heck broke loose. Unbeknownst to us, the infection had actually tunneled nearly a foot into her abdomen, creating a vast cavern full of pus, rotten tissue, and fecal matter that had seeped outside of her colon.
This godforsaken mixture came rocketing out of that little incision. We all wear waterproof gowns, face masks, gloves, hats, the works—all of which were as helpful as rain boots against a fire hose. The bed was in the middle of the room, an easy seven feet from the nearest wall, but by the time we were done, I was still finding bits of rotten flesh pasted against the back wall.
As the surgeon continued to advance his blade, the deluge just continued. The patient kept seizing against the ventilator, and with every muscle contraction, she shot more of this brackish gray-brown fluid out onto the floor until, within minutes, it was seeping into the other nurse's shoes. I was nearly twelve feet away, jaw dropped open within my surgical mask, watching the second nurse dry-heaving and the surgeon standing on tip-toes to keep this stuff from soaking his socks any further.
I'll spare you the rest of that horrible day, but as a sign of how bad it was: The next morning, the entire department still smelled. The housekeepers told me later that it took them nearly an hour to suction up all of the fluid and debris left behind. The OR suite itself was closed off and quarantined for two more days just to let the smell finally clear out.
I'm a nurse and I work in a pediatric ER. A young woman brought her baby in to be seen for vomiting. I ask her to put the baby on the scale. While on the scale I notice a strong odor of bug spray so I asked about it. Her response made my blood run cold. Mom: "A roach crawled into her mouth so I sprayed a little Raid in there." She said it in a matter of fact tone, like it was no big deal.
Queue up calls to the police, CPS and a 1:1 sitter for the child and the mom. When all was said and done the baby was fine and turned over to her grandmother so no worries there. I have no idea what happened to the mother. I don't believe she was intending to hurt the child. I think she was just completely ignorant.
I’m a biomedical scientist, and my officemate was a medical doctor working on his PhD. He once did an appendectomy and cut into this person’s abdomen—only to find no appendix. He started freaking out. The support nurses in the room, however, started snickering at him because they knew right away what the problem really was.
Occasionally, they see someone with a rare genetic disorder where all their left-right asymmetries are reversed. This patient’s appendix was on the other side.
We had a case a couple of years ago that still gives me chills whenever I think about it. A younger girl goes to her family doctor in a small town outside of the bigger city where I live. She had persistent headaches, which just started a few days prior. No past medical history of anything similar or really at all about her that stood out as relevant.
Unable to diagnose or treat her headaches (which were rapidly growing more severe), she was sent to our hospital (X state's Childrens' Hospital) for evaluation. We ran her through the typical gauntlet of testing for common causes, CBC/CMB/CT/MRI etc. still with no clue. Nothing came up on blood cultures either. At this point she was in the PICU rapidly deteriorating, with high fevers and periodic losses of consciousness.
After eliminating all the horses, we had to start looking for zebras...and quick. We collected a CSF sample for culture thinking it might be one of the rarer forms of bacterial meningitis. While this was cooking (cultures usually take at least a few days) we tried again to get any other possible info from her parents...that's when we learned the whole story.
For the first time, they mentioned that they had visited a local waterpark a week or two before the girl’s symptoms started...and this was in the middle of summer. For any Peds doctor, or especially ID doctors in the room, those words made their hearts sink. Sure enough, the cultures came back, positive for Naegleria Fowleri, the pathogen responsible for Primary Amoebic Meningoencephalitis (PAM). Which up until that point, I don't think there was a documented case of a patient being diagnosed with PAM who survived.
It’s the incurable brain-eating amoeba that lives in warm stagnant water and can enter through the cribriform plate at the top of the nose if the patient gets water up there...which happens all the time at waterparks. Anyway, long story short, we basically cook up a (very non-FDA-approved) drug cocktail as a sort of Hail-Mary attempt at fighting this infection, as nothing else in any other case had ever worked.
In addition to this, we basically stick her in a Mr. Freeze chamber, lowering her body temp to below what N. Fowleri can usually survive. Unfortunately, most people can't survive it either. But for some reason, (though in an induced coma the whole time) she steadily improved. When we took her out of the deep freeze and allowed her to wake up, it was incredible...
She was alive with no apparent neuro/cognitive deficits, and the new cultures showed no growth of N. Fowleri. It's not too hard to figure out where this occurred, as it may still be the only successfully treated case in the US.
I worked on a ward once that had a patient who was a psychic/medium. We had a bit of a laugh with her as she was on the ward for a while because she'd had a stroke which affected her mobility, and she would do “readings” for the staff from time to time. I took it all as just a bit of fun until one chilling evening that I'll never forget. She pressed her nurse call buzzer and told us to go check on a patient in a side room. She said he had passed.
We went to check and sure enough, found that the gentleman had passed. Later on, we asked our psychic patient how she had known, and she told us she had seen him coming out of his room obviously distressed. She realized he had passed and had to explain to him what had happened and help him to go to the light...Now, I am not a believer, but that gave me the creeps.
I can't remember all the details though so bare with me. I'm at a big tertiary hospital, and had an elderly veteran brought to us one day after being found unconscious in a park. He had alcohol in his system and a quick look at his records showed that this was an ongoing problem with him. He was a sweet old man who was very grateful for our help, up until day 3 of his hospitalization. That's when things took a dark turn.
He developed pneumonia-like symptoms and became somnolent for a few days. Then, out of nowhere, he became very inappropriate—he begins grabbing the nurses and repositioning them, touching himself, and constantly licking his lips in a disgusting manner when anyone even looked at him. He went from a sweet old man to a deviant almost overnight. We even had to wrap his hands up in bandages to stop him from touching himself and others. Oddly though, he hit on anyone and everyone (women and men) except for me. I guess I wasn't his type.
We ended up diagnosing him with Kluver-Bucy syndrome, caused by HSV encephalitis (herpes). Symptoms include hypersexuality and hyperorality. It's pretty rare and I haven't seen it since, but as you might imagine, it left a lasting impression on me. He improved with treatment though, and was incredibly embarrassed after finding out what he had done.
When I was a patient care technician in the emergency department, I often worked closely with a specific doctor. She had a habit of thinking that there was always more to symptoms than there were, so no one ever took her seriously. She paid especially close attention to young patients and always ordered way more tests than the other physicians.
There was a 12-year-old boy whose parents brought him because he kept talking about how he hated himself, wanted to die, hated his parents and siblings and often thought of hurting them. Before this, he had no history of being mentally ill, but everything he described was typical for a depressed pre-teen. However, when the doctor spoke to him, he mentioned having frequent headaches, dizziness, and nausea.
The doc thought something more might be going on, so she got a CT on his brain. It turns out, the kid actually had an atypical teratoid rhabdoid tumor (ATRT), which is INCREDIBLY rare, like less than 1% of childhood brain tumors kind of rare. It’s honestly amazing that the child lived long enough for the tumor to spread so far.
I will never forget that a doctor always looked further into things than people thought “necessary.” If it weren’t for that specific doctor being on, he’d be toast right now. Eventually, he will live a normal and long, healthy life.
I had a lady come into the ER listed as “Multiple Medical Problems”. This usually means diabetes and the issues stemming from it, or maybe bleeding issues from another disease or maybe odd blood tests results at a clinic. I hadn’t seen the patient yet, but the doctor came to the nurse’s station asking who had room 15. I jumped up and followed him into the room.
I walked in and saw what I thought was a corpse. Then the patient’s eye swiveled over to look at me. She truly looked like one of the people they found in a concentration camp. I could see every bone, and her body was twisted in a decorticate position with her jaw locked open. Then the smell hit me: rotting flesh and body fluids. I struggled to keep a neutral face and not gag.
I tried to place a blood pressure cuff on her arm and her skin just started flaking off in my hands. I gagged. The doctor started removing her clothes to examine her. Her feet were black to the ankles. Her hip bones were poking through her skin and were black. The skin around her ribs was worn away to oozing muscle fibers.
Her calves were incredibly swollen and the skin was splitting like ripped pants. I removed her Depends, and there was excrement coating her entire genital area. Then the doctor went to remove a large bandage on her lower back. Her entire sacrum was exposed and the bones were BLACK! The skin around it was a black liquified mass.
It smelled like nothing I’ve ever smelled. I can’t even describe it. The doctor told her family I would clean up her ulcers and wounds in preparation for surgery (liar, no surgeon would operate on her). I had no idea how to clean dead bone tissue and liquified skin (they don’t cover that in nursing school). When I went to clean her sacral area, all the liquified skin separated and oozed all over the bed. I really struggled to keep myself together.
Afterward, I needed a moment in the supply closet to cry it out for a second. I had no idea the human body could break down so much without dying. I still think about that woman sometimes, and what led to her living like that. It still breaks my heart. My guess is that she had some sort of traumatic brain issue or a stroke.
Family members were taking care of her, and I think they were treating her absolutely horribly. I think as her skin deteriorated, she developed terrible pressure ulcers that never healed. The swelling was probably due to starvation and a lack of protein in her diet. I’ve had nightmares about her face since then. Once, I dreamed she crawled into bed with me.
I freaked the heck out and ran into the hallway. My toddler walked out after me, rubbing his eyes, asking why I ran away.
My husband is a doctor. One night, he came home with a surreal look on his face. He had been seeing a patient and noticed that although he was in his mid-20s, he didn't seem to have gone through puberty. The patient didn't mind his state too much but my husband believes that medicine should improve your life, not just keep it going.
So, on a shot-in-the-dark hunch, my husband sent him for an MRI. The patient had a previously benign and now malignant brain tumor suppressing the part of the brain that controls puberty. The test led to a very early brain tumor detection.
Just over four years ago my dad was driving to work in peak hour traffic when he had a heart attack. He sideswiped a few cars, ran a red light, and hit the traffic lights. One of the cars he sideswiped was a paramedic on her way to work. She pulled him out of the car and found him unresponsive. She couldn't find a pulse, so she started CPR.
People were all over the place trying to help and divert traffic and out of nowhere comes a fire and rescue department car with two trainer firefighters who were on their way to some training event. They had a freaking defib in their car! It took another 10 minutes or so for the paramedics to arrive. My dad was in a coma for almost two weeks before they could bring him out.
He had heart surgery a couple of times, and the sucker still lives on even though he should be toast.
I had a patient with a Hemoglobin A1C (a blood test for diabetes) result of 13, which is high. This guy believed that he could control his liver’s production of glucose with his mind. He believed himself to be very fit and active and felt that with his mental control he was a better athlete than most other people, because he could ramp up his glucose production when he needed to. He was in the hospital for a diabetic foot ulcer that required part of his foot to be removed.
My dad works in an emergency room. He once had someone come in who was shot point-blank in the head. They gave him a ton of antibiotics, and the surgeons were able to remove the bullet and skull fragments from his brain. He walked out later that week.
I’m an ultrasound tech and I did a third-trimester growth scan on a pregnant patient. The scan wasn’t needed, but she'd had a previous IUFD (baby passed in the womb—happens later than a regular miscarriage and is thankfully much rarer) and the doctors wanted to give her peace of mind that everything was ok. What I found was a baby with a belly full of fluid (hydrops).
That’s very, very bad. The fluid was surrounding all the abdominal organs and the heart. Our doctors sent the mother to a specialist and they gave the same diagnosis. Tragically, the baby was not expected to survive. The mother came back about two weeks later for a follow-up scan. My jaw dropped. The fluid around the baby was GONE. Totally normal scan. Normal looking baby.
If the office had not happened to schedule this woman’s ultrasound for that day, we would never have known it had been there in the first place. None of the doctors at my clinic have ever seen a case spontaneously resolve like that.
Not my story, rather, my colleague’s. A patient was admitted for anemia and a localized cancer was found. She was referred to surgery so that the cancerous cells could be removed. She started telling everyone that it was the doctors who had caused the cancer and that she was doing just fine before coming to the hospital. She lectured the surgeon and my colleague, who pleaded with her to get surgery, so that the cancer doesn’t advance, and yet she refused, saying she knew better and probably didn’t even have cancer...
My father is an anesthetist. I remember his one in a million (way more rare actually) thing happened when I was 13. During pre-op, the patient's consultation showed no flags for anything major but then she had this horrible reaction to the medication. Her own skin started to split and peel away from her body in large chunks. Her own body was rejecting her skin.
The woman spent quite some time recovering. There was an investigation into the whole thing, but everything was done by the book and there was no reason for this to happen. The drug company was contacted and they had never heard or seen about this happening with any of the drugs. Turns out it was an allergic reaction but it was so rare that no one had seen it even the drug had been used for decades all over the world.
My father ended up writing a paper on it.
When I was an intern in the Emergency Room, a 30-something-year-old guy came in with simple URTI symptoms, essentially coughs and flulike stuff. However, the paramedics at triage found that the oxygen concentration in his blood was low and that there were some crepitations in his left lung. Pretty standard, early-stage pneumonia.
I didn't like the sound of his crepitations, however. It was way too loud, but the patient was very comfortable so we sent him off to get some x-rays. I got my answer and the shock of my life when he came back. His left chest cavity was filled with bowels. The crepitations that I heard were bowel sounds.
The guy had no left lung, and his intestines had moved into the empty area. Judging from his comfort level and his own shock, we suspected it was congenital. We diagnosed him with a simple throat infection and sent him home after routine observation.
Back when I was a paramedic in Oakland, I was taking care of an elderly gentleman in the back of my ambulance. He looked up into the upper corner of the ambulance and said "It's okay Lulu, I'll be with you soon." His daughter was with him and told me that Lulu was his wife who passed 20 years earlier. A few minutes later, he went into cardiac arrest and passed on.
I had a pregnant woman whose ultrasound showed the baby had Hypoplastic Left Heart Syndrome. It means the baby has half a heart, and it’s 100% fatal without surgery. She stopped seeing her obstetrician so she could have the baby in the forest and bathe it in breast milk to cure him.
I was in a coma for two and a half months in 2015 when I was 27, following a serious car accident. When I woke up, I still had a tracheotomy and couldn’t speak. I don’t remember a damn thing from the time I was in a coma, but what blew my mind is when I woke up, my new boyfriend at the time was standing there with my parents.
They were chatting to each other like they knew each other. I am a super private and had made every effort for them to not even know of him, so I found this disturbing. I also had no recollection of the accident for months and for a week or two after waking up I had to be retold where I was and what had happened every time I dozed off and woke up.
I had no idea where I was and I thought I was 23, not 27, over a period of months. I also had a really hard time recognizing faces. Like I would see people I knew that I knew but I couldn’t remember why or their names or anything, they would just look familiar. One time, about a month after I had woken up, my parents took me in my hospital bed for a walk in the courtyard of the hospital.
We passed a large mirror in the lobby and I freaked out. I saw my reflection and I knew it was me because I recognized my parents pushing the bed, but I didn’t recognize my own face. There were no injuries to my face or anything, I just didn’t recognize myself. It also blew my mind that I had gone into the coma in late winter, and there was quite a bit of snow on the ground.
When I woke up it was spring, and there was no snow (I had a large window in my hospital room). The news that shocked me the most was the fact that my parents had gone in and packed up my entire apartment. Like I mentioned, I was super private and the idea that they went in there and boxed up all my stuff and gave up my lease was hard to grasp. Obviously, it made sense, but I was troubled by it all.
I saw a patient who was concerned because she was still lactating, despite the fact that she stopped breastfeeding her twins two years ago. She said: "Sometimes I wake up in the middle of the night and find my husband sucking on the breasts. He says he's trying to drain the milk for me." I had to explain to her that breastfeeding her husband will lead to continued lactation.
So, I'm a therapist and I work with kids. Worst misdiagnosis was a family with a two-week-old who was convinced the baby had 1) anxiety—because he cries, 2) autism—little eye contact, and 3) bipolar disorder—because the baby would seem content then suddenly angry. I spent HOURS explaining child development, what these diagnoses mean, how they would present in kids.
I provided them with books, handouts, etc. Then they did something that made me furious. They insisted on going to see my co-worker and a psychiatrist as I was surely lying to them. Even after meeting with the other two professionals, they still weren't convinced. They requested psych meds from the doc.
When I was in EMT school, we were told about a paramedic student (the instructor was a paramedic as well) who observed a stabbing call. They arrive at the bar and see a dude with a knife in his abdomen. Medic student takes lead and pulls the knife out, something you never do, as I’m sure you know. Senior medic loses his freaking mind at this dumbass, asking him what the heck he was thinking.
Student freaks out and, you guessed it, puts the freaking knife back in. The patient died as a result, student lost any chance of having a good job (not even just in EMS) and was charged with the death of the patient (might’ve been manslaughter I don’t remember). His entire life was ruined because he freaked out and made a mistake on a call, not a rookie mistake or a common slip-up, but in about half a minute, he ruined his life.
I'm a nurse, but I was working in the ER when a guy came in for a scratch on his neck and "feeling drowsy." We start the usual workups and this dude's blood pressure TANKED. We scrambled, but he was dead within ten minutes of walking through the door. Turns out the "scratch" was an exit wound of a .22 caliber rifle round. The guy didn't even know he'd been shot. When the coroner's report came back, we found that he'd been shot in the leg and the bullet tracked through his torso shredding everything in between. There was really nothing we could've done, but that was a serious "what the heck just happened" moment.
I worked for a doctor who was unbelievably cruel to his patients. I had to sit by and watch him deny medication to people who clearly needed it—but one dark day, he took it too far, and I knew I needed to act. Because he assumed that everyone who claimed to be in pain was clearly faking it to get pain killers, he never treated them properly. Then one day, a senior director from Microsoft came in, but this doctor assumed, as always, he was faking it. The man died from a heart attack soon after. Finally, I stepped in and went to management. I wish I’d done it sooner, but at least he can’t hurt anyone else.
We had a forty-three-year-old woman who had a very rare form of cancer that spread incredibly fast to just about everywhere in her body. From diagnosis to death was about twelve weeks. The medications and therapies and the general lack of mobility caused her to become swollen and obese. She was a terribly sweet lady. They took her down to Radiology for a scan and the technician made a bunch of really mean comments about her weight because she was too large for our machines.
They had to arrange for a transfer to another hospital for her scans and then have her transferred back. The technician thought that because Miss Jeannie was dying and sick that she was deaf or didn't understand English any longer, and so while they were alone, she made so many mean comments. Miss Jeannie waited until she was back in her room waiting for her transfer before, she started crying. I'll never understand people who feel the need to make others feel less than or badly.
Nurse here. A very panicked nursing assistant came running to the desk one day, saying, “You have to see this! I don’t know what this is!” She then brought me into a private room where she was giving the patient a bath. She pointed to an area on the patient’s buttocks. “What is that?” I leaned in for a closer inspection, and my face went white.
The patient then started to turn back around and said, “IS THAT MY EYE?!” Sure enough, my patient had a prosthetic eye that came out of the socket at some point and it became suction-cupped to her buttock. I left the room and had never laughed so hard in my life. Truly one of the most bizarre and hilarious moments in my career.
I had just gotten my first job out of college at the local hospital. My first week went by with the usual stitches and broken bones. My second week around midnight, this very obese woman came in complaining of chest pains. So, we rushed her back, grabbed her vitals, and did an EKG and blood work. Everything was normal—or so it seemed.
The problem was, she was still complaining of chest pain. So, my supervisor and I asked the lady if we could do a head to toe check-up. Now this woman had a rather pungent smell to her when she came in, but I have learned to not think of it as the people in the area weren't known for their cleanliness. We were looking at her chest.
I noticed that her left breast was reddened and swollen. I told her that I was going to lift up her breast to rule out any skin infections. As I lifted up her breast, a wave of noxious stench engulfed the air around me. As I kept lifting her breast, I could see what looked a mass of rotting tissue going into her chest.
My supervisor ran out of the exam room and proceeded to vomit in the nearest trash can. I looked at the lady and asked her why she didn't come in earlier as it looked like a massive skin infection was raging under her left breast. She replied that she did not have insurance and that she didn't think it was a huge deal.
I called in some nurses and the doctor to assist cleaning the wound. As we’re cleaning, one nurse noticed a bit of fur and bone. That's when we made the most horrifying discovery of my career. We found out it’s a small animal of sorts. They collected the sample and sent it to pathology. We removed it and noticed that it had rotted into her chest so much that her ribs could be seen.
In the end, it was the lady’s missing kitten. She spent four months in the hospital for massive sepsis and other related issues.
I’m a biomedical scientist, and my officemate was a medical doctor working on his PhD. He once did an appendectomy and cut into this person’s abdomen—only to find no appendix. He started freaking out. The support nurses in the room, however, started snickering at him because they knew right away what the problem really was.
Occasionally, they see someone with a rare genetic disorder where all their left-right asymmetries are reversed. This patient’s appendix was on the other side.
I was in the hospital following a motorcycle accident. My hospital roommate, who was beside me, had been in an 18-wheeler accident. He was complaining that his back itched and someone finally came in and rolled him on his side. When they turned him over, their faces dropped—his back had pieces of glass stuck all over it. I still don't know how that was overlooked.
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