27 April 2010

Still more cancers

This is getting spooky now.  Last night's new cancer was a young man whom I diagnosed with lymphoma.  So, counting the others, I'm getting all the systems covered: GI (rectal and pancreas), Pulmonary (lung), Neuro (brain), GU (endometrial), and now Heme (lymphoma).  I worry about how many systems are left, though.  This could take a while to work through them all.

In response to a few questions in the comments, there has been no real pattern to the presentations, or why the diagnosis came ultimately from the ER.  One guy was a curmudgeonly sort who had insurance but just didn't like to see doctors.  One was a very earnest fellow who had been seen by his primary and specialists on multiple occasions without them ever figuring it out.  I suspect they missed it because of his young age, but it was a clean miss.  One was a very complex patient with a whole team of specialists following her, but perhaps each was so focused on their body part that nobody asked the salient question that would have led to a sooner diagnosis.  And a couple were just a new onset problem that probably would never have been picked up until it clinically manifested itself, and when it did, the ER was the appropriate place to work it up.

These cases don't much seem to reflect the larger dysfunction in our health care "system."  Each on its own would be explicable and just bad luck or happenstance.  As a group, they are a little more alarming, but still it's just some very freaky luck.

1 comment:

Annemiek said...

Thanks for answering that question. I hope this streak ends! But also a good thing they come across you and you put the diagnosis together that others have missed.

About that streak, maybe it's time to buy a lottery ticket.