I was so excited when I received my Sunday New York Times, and the magazine section included a Diagnosis column by Dr. Lisa Sanders.
It is one of my favorite columns because her column includes interesting medical cases that I love to read and learn about. This week’s column on September 12, 2018, titled Traveling in Vietnam, His Leg Swelled Terribly. Had He Caught Something? had a few special twists. I won’t give away the ultimate diagnosis but I will share with you why I found this story so amazing.
The Medical Case or More Aptly Named – the Mystery Medical Case
The general history of the case was a young man nineteen years of age who developed lower calf swelling while on a trip to Asia. The swelling was serious enough that he had to limp his way through his entire trip In fact, the swelling was so severe that he was unable to see his bones, shin or ankle.
The swelling didn’t subside once he returned to the United States and hence the journey of seeing several doctors began. The usual concerns of an infection or a blood clot were evaluated and not substantiated – essentially the doctors that saw him were at a loss as to the cause of the swelling. None of the doctors had any clue as to the diagnosis even after ordering blood tests, checking his thyroid level, and conducting an ultrasound, CT scan, and MRI.
In today’s medical world it is not embarrassing for a doctor to use Google to help make a diagnosis. In fact, I remember a New England Journal of Medicine Grand rounds case that stumped all the superstar medical staff – except the medical students. Why? The students, when asked how they came to the mystery diagnosis, said they “Googled” the symptoms and lab results and the answer came up.
Now, I’m not suggesting every medical diagnosis should be left to Google, but with its “limitless” amount of encyclopedic data at its “fingertips” it can be very helpful to a thoughtful physician to narrow a medical diagnosis.
In this case, Dr. Google was spot on. Of course, it did help that the person putting in the data had a lot of personal information about the patient and a vested interest in a good outcome.
It turns out that when the young man’s doctors were stumped as to the cause of his calf swelling his grandma went to work. Grandma has no medical training (she wasn’t a doctor or nurse) but she loved her grandson and couldn’t stand to see him suffering.
She went to her computer and “Googled” his symptoms of leg swelling but, after a few failed attempts at finding an answer, she also included in her search something none of the doctors could possibly know – her grandson had very thick eyelashes just like his mother. It turns out his mother (the grandmother’s daughter-in-law) also had a history of leg swelling and thick eyelashes.
Grandma wondered if her grandson could have inherited something from his mother. Not only was it this hereditary trait that helped the grandma figure out what was ailing her grandson it was also knowing his personal medical history (that of having a cleft palate when he was born) that helped her discover what was causing the leg swelling.
This key family history turned out to be the clincher to making the correct diagnosis.
What Should You Take Away from This Story?
I tell my patients all the time: be a partner in your health!
What does it mean to be a partner in your health? Even if you don’t have the medical training, you can still educate yourself and be your best advocate in getting the best possible care.
I enjoy it when my patients challenge me with medical information and their concerns. I always tell them: in today’s medical world with Google and other sources the patient-doctor playing field has been equalized. Unlike in the past where the doctor was considered a deity.
But I do tell my patients that the one thing I hope I can offer them with the vast amount of information available to everyone is my medical experience. Being in practice for 25 years and seeing thousands of patients, I try to guide my patients on the right treatment path and part of that comes from partnering with my patients to actively listen to their medical history (something a lot of doctors gloss over as not valuable information) and what information they have researched so far about their condition.
I’m not too worried that Dr. Google’s future partner – Dr. Alexa from Amazon University – will take my place. However, if they can help me and my patients to quicker medical diagnosis and better treatments I’m all in.
– Dr. Dean Mitchell M.D.
Mitchell Medical Group in NYC and Long Island
About the Author – Dr. Dean Mitchell, M.D.
Dr. Dean Mitchell M.D. is a Board Certified Allergist and Immunologist based out of NYC. He graduated from the Sackler School of Medicine and completed training at the Robert Cooke Allergy Institute in New York City. He is also a Clinical Assistant Professor of Clinical Immunology at Touro College of Osteopathic Medicine, a fellow of the American Academy of Allergy, Asthma and Immunology, and the author of Allergy and Asthma Solution: The Ultimate Program for Reversing Your Symptoms One Drop at a Time. Dr. Dean Mitchell, M.D. has also been featured in The New York Times, The Huffington Post, Fitness Magazine, Dr. Oz and News NY 1. Dr. Mitchell also hosts the podcast The Smartest Doctor in the Room – a combination of a lively, personal and in-depth interview with top healthcare specialists.
Sanders M.D., Lisa. “Traveling in Vietnam, His Leg Swelled Terribly. Had He Caught Something?” The New York Times Magazine. September 12, 2018.