Note: This post contains mentions of death due to disease.
When a doctor meets with a patient, it's part of their job to inquire about a patient's symptoms, injuries, and medical history.
But, even though a doctor might ask these important questions doesn't mean a patient might disclose them. This may happen because they either completely forgot about certain medical histories or symptoms, or didn't think certain information was vital for the medical exam.
1. "I had a patient who came in for genetic counseling, went through their whole family history with the counselor, and then concluded with, 'Oh yeah, I was adopted as a baby and don't know who my birth parents are. Does that matter?'"
2. "I once checked in on a guy and asked him if he'd had any previous surgeries. 'No, never.' When I examined him, he had a surgical scar from just above his pubic bone to just below the sternum. 'What's that then?' I asked. He stared down at it and said: 'I've never noticed that before.' WTF??"
3. "While pregnant with me, my mom was wrapping up an OB appointment. The doc had already left the room; mom was gathering herself to leave and mentioned to the nurse her contacts were messing with her — she had spots in her vision. The nurse stopped and asked her to sit down. Brought back in the doc, who had her stay and deliver me via emergency c-section. Without anyone knowing it, she had spontaneously developed pre-eclampsia, and her blood pressure was rocketing sky high. She was dangerously close to having a seizure, and that would've been that if she hadn't mentioned the spots in her vision and just left as the appointment was over, or the nurse didn't listen."
4. "I had a patient come into the ER with some sort of spider/bug bite on her hand that had progressed to a red line running up her arm. She stated she put Benadryl cream on, and it was very itchy. We continued talking, and I asked if she had any allergies, 'Yes, Benadryl.' I thought, 'good lord' — and I’m sure it was reflected on my face. We washed the Benadryl cream off her arm, and miraculously, it stopped itching."
5. "I intercepted a young woman who was just hit by a car. Her boyfriend was standing with her freaking out. I do a basic physical exam and get a history, and make her comfortable as we wait for the ambulance to arrive. Once the ambulance arrives, they ask for the same information, except this time, the boyfriend mentions he was the one who was actually hit by the car and was shielding his girlfriend's body. The entire car's windshield was cracked by the impact of his back. He was just freaking out and worried about her, and was in shock and hadn't begun to feel any pain yet."
6. "This 20-year-old guy came into the hospital. He had a lot of conditions where he wouldn't make it past 40, and he currently had some infection. We kept giving him antibiotics, which helped, but not as much as we would have liked. After about a week of being in the hospital, I walked in, and I'm talking to him, and he tells me that he got a medically necessary circumcision on his last admission to the hospital. I ask if it's okay if I take a look to make sure it's healing okay. It was black with all kinds of infection. I'm just not sure how a 20-year-old married man (or his wife) never thought to tell anyone about this for the past week."
7. "Me: 'Do you have any medical history? Including things like heart attacks, strokes, high blood pressure?' Patient: 'No, nothing ever.' Me: 'So, why do you take [list of heart meds]?' Patient: 'Oh, I've had multiple cardiac arrests.'"
8. "Me: 'Any prior surgeries?' Patient: 'No.' Me (examining them): 'Did you know that you only have one testicle down here?' Patient: 'Oh yeah. I had one cut out.' I always ask specifically about gallbladder, appendix, and testicles because patients forget about having AN ORGAN CUT OUT."
9. "We were asking a patient about prior medical history because she was on a waitlist for an intestinal transplant, and we asked her in every possible way if she had any history, and she was like, 'No, I was very healthy before this.' Finally, we ask her, 'Do you take any medications at home?' and she goes, 'Oh, just the meds I take for lupus.'"
10. "I had a guy in his 50s who had been seeing an acupuncturist for an area of numbness and weakness traveling down his legs. He’d had two months of acupuncture with them with no improvement, so very reluctantly booked a routine GP appointment. At that point, he’d started to have issues with his urination, too. As soon I started speaking to him, it became obvious that the symptoms he presented with were consistent with spinal cord compression — an absolute medical emergency. We got him straight into the hospital, and imaging showed cancer, with a tumor pressing onto his spinal column. Although he started treatment and steroids that day, by then, it was too late. He lost the ability to walk and died a few months later from the cancer. It was enormously sad and frustrating as that constellation of symptoms would have raised an immediate red flag with anyone with medical training. Had he come in months earlier, maybe his prognosis would’ve been quite different."
11. "I had a male in his 50s walk into trauma to have his left thigh stitched up. This isn't an uncommon wound. While I was speaking to him and stitching him up, he tells me he fell off a ladder while cutting a branch, and the machete sliced him on the way down. I told him I was going to write him up for an X-ray of the entire leg just in case. He kept on saying he was fine and that his knee hurt a bit, but logically, that was from the fall. I agreed, but I asked him to go to the X-ray department just in case. He reluctantly walked there and back.
12. "Did a bunion and hammertoe surgery on a lady with no allergies. New patient packet and primary care note all said, 'No known allergies.' I always ask about metal allergies anytime I plan on putting in hardware. The surgery went great. I’m on call for the practice and receive a phone call for the group 18 hours post op. Her nerve block had worn off, and she was in excruciating pain. We give instructions on what to do. Next morning, she is in my office before I even arrive. 10/10 pain, sweating profusely, blood pressure elevated, foot is massive. Clearly, not faking it. Have to send her to hospital for intractable pain. Blood work indicates elevated eosinophils but everything else normal. No blood clot or infection. Hospitalist convinced its complex regional pain syndrome. I rack my brain and think of WTF could be going on.
13. "I was an internal medicine resident who had a patient come to my clinic for 'persistent flu.' I had never seen her before, and she was a healthy appearing woman in her 60s. About a month before seeing me, she was seen by her PCP with persistent coughing, and otherwise, had no shortness of breath or other infectious symptoms. Just a dry cough. She got tested for flu and was negative, but got Tamiflu just in case it was a false negative. She had a chest X-ray, which was normal. She came to me a month later because her cough persisted despite completing her therapy. Everything sounded great. Heart, lungs, everything. To be honest, I don’t usually do this, but something in my gut told me to feel for lymph nodes. I felt around and found something above her left clavicle. It was hard, round, and she was completely unaware of it. I told her it was probably a reactive lymph node, but just in case, I wanted to get an ultrasound.
"This cascaded into her getting a biopsy, which showed squamous cell lung cancer. A CT scan showed stage IV lung cancer, not seen on her chest X-ray. All diagnosed because of a lymph node that almost by chance I was lucky enough to find by being thorough.
"I checked her chart about a year ago, and she was doing well. She got therapy and was in remission after a very long road and many obstacles. I’ll never forget her or her case."
14. "As a patient, but this is too fresh not to share. I'm 32, and I was at work Friday morning (as in two days ago). I started having pain in my lower molars around 10:40 a.m. It eventually got so bad, I left work and went to urgent care (around noon). I thought it was a gum infection, and I'd get some antibiotics and ibuprofen and be told to see a dentist or something. I had to keep apologizing to the intake person because I was stumbling over my words, unfocused because of pain. When the urgent care doctor came in (around 1 p.m.), she talked to me for about 30 seconds before peeping in my mouth and saying my gums were fine, then checking my eyes with a flashlight and calling an ambulance.
"By the time I got to the hospital (around 2ish?), I was basically nonverbal, and my attempts at texting had become disjointed. My spouse met me in the ER after a CT scan and helped me consent to an IV clot buster (TPA) at about 3 p.m.
"I'd had a stroke. For those doing the timeline math at home, YIKES. Good news: The TPA worked very fast, and I'm hopefully getting discharged tonight. I owe that urgent care doc a thank you note."
15. "Had a male come in with pancreatitis. Asking him some basic history: 'How much do you drink alcohol?' 'I don't drink alcohol.' Ok, well, not my first time so I asked: 'Do you drink beer?' 'Yeah, well after using the sauna, I have some beer.' (We are in Finland where sauna and beer go very well and frequently together.) 'Ok, how many beers you have after sauna?' 'A case.' (24 cans are in a case.) 'And how many times per week you go to sauna?' 'Three to four times per week.' So, he doesn't drink any alcohol, but 70-100 cans of beer per week."
16. "Emergency radiologist here. I see plenty of people presenting with understated symptoms that turn out to be mind-blowing advanced diseases. The saddest one was probably a 4-year-old boy who presented with a rigid abdomen for a few months. Was told by their pediatrician it was constipation months ago, but his parents never followed up when it didn't resolve. When I imaged his abdomen, I found his entire liver was replaced with a mass consistent with hepatoblastoma. I asked the parents why they waited so long to work it up. They said they were satisfied with the diagnosis of constipation. That one left a mark on my soul."
17. "When I was in my final years of med school (English division of a European university in a country where I speak the native language fluently), we were to do patient interviews and physical examinations on our own and then circle back to our supervisor. I was translating back and forth between the patientand a fellow classmate whom I was doing the interview with. The patient said, 'So, you guys are coming in on a Saturday to do patient work? Good for you for going the extra mile.' (It was a Friday, which I initially brushed off as a mistake.) My classmate asked me to ask the patient if he could tell us the date. I was like, 'Are you sure? He's here for an infection, not head trauma. He might think it's a bit degrading.' I thought it wasn't important, but she insisted, so I translated the question.
"Patient replies, 'Ah, well, it's 2002, of course!' (It was 2018.) After more questioning, we realized all of his replies were all as if it were 2002 (eg. 'The last trip I went on was to Africa in the '80s, so about 15 years ago'). As it turns out, he had neurosyphilis that went unchecked for many, many years.