Wednesday, August 09, 2006

I swear by Apollo the physician.......

There are people we meet who touch our lives and change it forever.

I heard a story yesterday that truly inspires. It is about a young girl X. X was just 24 years old. She was bright. She was pretty. And when I say pretty, I absolutely mean it. Now everything was going great for X. She had a loving husband and she had just given birth to a beautiful baby. Things couldn't have been better for her. And then suddenly things started changing. She started noticing changes in her appearance. She was gaining weight. She did not feel well. Her beautiful long hair started falling out. She went to see a doctor who told her that it was probably because her hormones were all crazy after the birth of her baby and things would be okay with time.

But things just kept getting worse. She could not bear to look at herself in the mirror anymore. It was like looking at a total stranger. And she started noticing increased facial hair. At first she tried covering up using makeup but then it got a point where she had to shave to stop people from staring at her. She went to see more doctors. Yet every doctor told her that it must be a side effect of her pregnancy and childbirth and would go away soon. Then she started getting these streaky marks along her lower abdomen and thighs. Grostesque purple streaks. Like stretch marks. Terrified she went to see her doctor. And he asked her if she was being abused physically at home. She denied it and begged him to help her. She showed him a photo that had been taken two years back on her birthday. She burst into tears just looking at the bright and happy woman in the photo. What had happened to her in these few months? She looked nothing like the person she was before. Now she was a grossly overweight, ugly woman with rough features, hoarse voice, beard and a mustache.

So they started investigations on her. She seemed a clear case of Cushing's syndrome. Her cortisol level was way over the limit. Her ACTH level could not be suppressed. Yet all investigations drew a blank. There was no pituitary tumor, nothing apparently wrong with her adrenals. And there she was withering away everyday. No one knew where the cortisol was coming from. But they had to keep her from dying. So the endocrinologist decided that they would have to take out her adrenal glands. Even though it would mean lifelong treatment, it would keep her alive.

So they took her for surgery and the surgeon takes out one adrenal gland. Right at that time the surgery resident notices a slight enlargement of one of the ovaries of the patient. So they removed the ovary that appeared to have a cystic teratoma and sent it for a frozen section and examination by a pathologist. The pathologist took a look at the slide and immediately sent word to stop the surgery and prevent the surgeon from removing the other adrenal gland. Although not apparent at the first cursory glance , the pathologist knew right away that they had hit upon the right organ. The ovary in all likelihood was the source of the problem.

Further examination confirmed the initial suspicion. X had an active pituitary adenoma that had been growing within the ovarian teratoma and had resulted in the hypercortisolemia leading to the manifestation of Cushing's syndrome. Within days of removal of the ovary the patient's condition stabilized. Her cortisol levels fell to normal and her physical appearance started reverting to her pre-Cushing state. The patient left the hospital with most of her gained weight gone, her features restored, her voice and skin normal and no traces of hirsutism.

And if it weren't for the young surgeon who noticed the ovarian tumor and the pathologist who recognized the tumor for what it was, X would have withered and passed away. Says a lot for the doctors, the techniques and medical marvels that go on to save people's lives, every single day.

I heard this story from the pathologist who saved the life of the young girl. I saw her picture, both before she fell sick and after she was hospitalized. And also when she left the hospital. And honestly, it left goosebumps on my arm.


"If I keep this oath faithfully, may I enjoy my life and practice my art, respected by all men and in all times." The Oath of Hippocrates of Kos, 5th century BC

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47 Comments:

Anonymous KK said...

Looks like an episode out of House MD.

2:03 PM  
Blogger Seashells said...

Medicine is a profession where you'll see accidents, coincidences, and miracles. Fine lines separate them and when the light does shine, you're either wishing or thankful for being on the right side of the line...

Y'know what the irony is ??? The morals of life are easier understood when you're closer to death...

3:38 PM  
Blogger M (tread softly upon) said...

@ kk "house MD"?? is that a TV serial or something?
@ seashells couldn't have said it more eloquently. I just hope I'm on the right side of the line. Always. BTW I am working on that tag :)

3:52 PM  
Anonymous KK said...

Yes, its a TV serial comes on Fox, 3rd season due to start next month. And ofcourse its also avaialble in India, probably the 1st or second season going on there.

It consists of cases which are bizzare and have no explanations and House is the brilliant diagstician who treis to put 2+2 = 22 to determine the disease, which are equally bizzare, rare conditions or extreme complications of common events.

This Link will show you various disease they deal with in their various episodes. And its not like Greys Anatomy.

5:10 PM  
Blogger Shankari said...

oh wow! My friend just told me today that her relative is suffering from some of teh symptoms u mentioned, I must tell her abt this

8:21 PM  
Blogger Fosix said...

yeah, sounds like an episode from House... am glad she's ok now... i got goosebumps just reading this post..

9:06 PM  
Blogger Tabula Rasa said...

there are more things on heaven and earth, arent there? *shudder*

11:17 PM  
Blogger Ekta said...

lovely story and yes sometimes doctors prove to be angels in our lives!
Saw this serial on Discovery this week where the docs helped save the lives of 5 babies born together to a mom and born in 6 mths(pre mature) and all that they had to do to keep the babies alive!
Was a very touching episode and makes u want to thank god for such doctors!

11:52 PM  
Blogger sapna said...

aah! i always hear such stories from my parents who are docs. one thing i can't understand is how doctors manage to see so much suffering day in and day out and still continue with their lives... its such a noble profession.. but these days so much has changed, at least in India. will do a post on that soon, hopefully!

4:57 AM  
Blogger Priya said...

Thanks for the post. Very useful. And I wish, there were more of such docs in this world. We'd start believing in them, slowly, but surely.

4:58 AM  
Blogger Dadoji said...

I am not a doc but my first instinct as I was reading the post was to check her uterus and ovaries.

I was also reminded of my uncle who is a cardiac surgeon. He kept telling his students - "You will never know what exactly you will find once you open the patient. Be prepared to think quick while operating. Don't use those findings to re-paint your earlier diagnosis. As a doctor you should be interested in why the diagnosis did not or could not have found what you did in the operation theatre."

6:12 AM  
Blogger Ghetufool said...

nice one. though i hate the profession, but had to accept. doctors are God.

7:41 AM  
Blogger M (tread softly upon) said...

@ kk well I hardly watch TV so I'm a little slow when it comes to discussing serials or other shows. But I know there are tons of these medical serials that are big hits and people watch a lot. But this one was a true story.
@ shankari do ask her to get checked. it might be thyroid too. But any sudden changes in weight and voice definitely warrant running a few tests.
@ fosix this is something that happened years back. 1987 to be precise. So X has probably been living a happy and healthy life for the last twenty years!
@ tabula rasa absolutely! And I'm thankful for that.
@ ekta yes there are good ones and there are not so good ones. I want to believe most of them graduate wanting to do something good in the world. But sometimes the power of healing can go to your head and the lure of money and power takes away the "good" in the profession. But yes there are wonderful doctors who have changed the lives of people in ways beyond measure.
@ pearl well ultimately I guess it is the constant battle to overcome suffering and disease that rule. I think there is nothing quite as rewarding as being able to heal and make well a person who would have suffereed and may be died if weren't for you. I have been there. And I thank God everyday for giving me the ability and opportunity to do something good. It makes life worth every bit.
@ priya One bad apple in the pile lends a bad name to the entire profession. I believe in giving people a chance until they prove me wrong.
@ dadoji excellent point. I think the greatest asset a doctor has is accepting where he/ she went wrong, and learning from that and keeping an open mind. In this case there was nothing to show what the problem might have been. Inspite of all kinds of tests. And that happens. sometimes. And having a pituitary tumor in a far away organ is not that common either. This case went on to be published in a journal because of the unique nature. However the bottom line is they were able to diagnose and treat the patient. And she lived. And nothing can be more rewarding than that.
@ ghetufool "i hate the profession" would you care to elaborate on that?
"doctors are God" I wouldn't say that. Because when doctors start thinking that they are God that is when things start going wrong. And when they do, nobody, no doctor atleast can make them right. Yes they do save lives and that may appear to be God-like, but isn't aren't they just doing their job? This reminded me of a quote I once read, I think it was from a movie where a surgeon says something to that effect (being God and all that). I come from a family of doctors and I have grown up seeing people treat my grandfather, my Dad as Gods. They would be willing to do anything for "daktar-babu" and "daktar-shaheb". They would say things like "uni manush na, debota" and actually believed in it. But doctors are only human and there's so much they can do. And sometimes when a patient is dying and the doctor is unable to save him/ her I can assure you that they wish that they were God. But they are not. and every so often they are reminded of the fact. We can try. And I hope to God we try enough.

9:27 AM  
Blogger jhantu said...

I often hear the thing from folks in india especially that the medical care in the US (or UK) for that matter is, how should i put it, not too adept at dealing with things that are in the initial stages and might ;ead to complications later on. Primarily bcos of the way the whole insurance thing is set up.
Any thoughts on this?

1:36 PM  
Blogger karmic_jay said...

nice read. Don't know if you read the Sunday times mag? They have this piece by a Yale doc, dont' think it is weekly piece though. it has to do with conditions that often defy an immediate diagnosis. They are always an engrossing read read.

1:40 PM  
Blogger Brown Magic said...

just incase you aren't sick of tags already, i got another one for you

1:56 PM  
Anonymous 100 best career said...

This comment has been removed by a blog administrator.

3:01 PM  
Blogger Kausum said...

Here is a quote

Dr.F: Isn't treating patients why we became doctors?
Dr.H: No, treating illnesses is why we became doctors. Treating patients is what makes most doctors miserable.

What do you think?

3:28 PM  
Blogger erebus said...

happened to a friend of mine actually... similar symptoms... but she is very younf and was never pregnant.. so that made the diagnosis a wee bit easier. But still there was plenty of confusion.

The final one being, where the tumor was. Right or left ovary.

Funny... how can they get these thigns wrong?

11:23 PM  
Blogger Szerelem said...

gosh i would wish that no one has to live through something like that.
sometimes its hard to imagine the kind of stress doctors live under, the margin of error is so small, id be terrified of being in charge of someones life.

11:53 PM  
Blogger GhostOfTomJoad said...

Reading that gave me goosebumps too. Just goes to show what a good doctor can do and how much joy, happiness and peace s/he can bring to people.

12:44 AM  
Blogger Anand said...

What wld we do without such doctors ard...there wld be so much more misery ard the world...

2:52 AM  
Blogger M (tread softly upon) said...

Is anyone else having trouble viewing my blog? I just can't get it to open up in Firefox. The only way I see it is in IE. Any solutions/ suggestions? BTW I did try republishing it.

@ jhantu I wouldn't say primary care is bad/ inferior. What is bad is the approachability. The whole HMO and PPo scheme makes getting to see a doctor so much harder and then getting the doctor to give you tests harder still. From what I hear the doctors do not have much room to do stuff but are forced to follow set guidelines from the insurance people. And that at times can really mess you up. I know a couple where the girl had some kind of backache, went to see the doctor but was covered under a HMO who would not let her get certain tests done. And she was treated empirically resulting in a major side effect and she ultimately passed away. She was in her early 20s. That I think is criminal and disgusting.
@ karmic_jay no I haven't. But will try and read it if I can. Thanks!
@ brown magic aha! I smiled when I read your hypothetical meeting with me. I am not very fond of doing tags and this one is harder. But I'll get to it sometime.
@ kausum well honestly treating illness/ patient usually aims at cure. And usually brings a lot of happiness and satisfaction. It is when one fails that it hurts the most. But you deal with it. May be I will elaborate on this on my next post which I think will be a continuation on this theme.
@ erebus sometimes a diagnosis can defy all tests and it is really difficult to find something unless you are actually looking for it. This woman in my post had a tiny little tumor in her ovary which was not seen on USG. There were no other telltale hormonal changes that would direct you. And a pituitary tumor in the ovary is almost unheard of. I don't think one can blame the doctors who were treating her.
@ szerelem well we all play roles in other people's lives. Some more than others. And soctors have been trained to deal with the physical aspects of a persons well being and when they carry out that responsibility they are just doing their job. But yes, it is scary to be in charge of people's lives.
@ ghostoftomjoad well it should actually be "what a doctor can do". But unfortunately we have to say "good doctor". And isn't that sad?
@ anand *sigh* there's enough misery going around these days. We need more people who can alleviate misery.

8:59 AM  
Blogger Jinguchakka said...

If you don't give a comment box above, how can I offer the shoulder? Guess you have disabled to stop people asking why you need.
Take care!
I hope this thing shall pass, whatever it is.

8:44 PM  
Blogger sapna said...

Cheer up M! Right here for you :)

12:35 AM  
Blogger ss said...

Treading softly upon this unknown heart, what do I find? A rainbow? Some idle brilliance? A bird in chains? My own confused agony of bygone days? Or a mind fast maturing to realize that there is no joy, no regret, no hope, no despair in a dream. And this is a dream we are living in.

Float around freely :-)

(Liked the "about me" very much. It is weird to hear your own thoughts from someone else. hNeh!)

3:02 AM  
Blogger Dadoji said...

.

4:51 AM  
Blogger karmic_jay said...

Hey. everything ok? I noticed you have comments turned off on your latest post. Can we help in anyway?

8:57 AM  
Anonymous Just Mohit said...

Hi, noticed you seem to be really morose. Hang on there pal! And if you need a shoulder, do remember we're all here.

5:10 AM  
Blogger karmic_jay said...

It may be hard to stay strong, but you will prevail eventually. The human spirit is amazing.

Is there a reason the comments have been turned off?
Can we help in any way?

10:58 AM  
Blogger Aparna said...

Hey, what's wrong?
I noticed you have comments turned off on your latest posts.
Any way we can help...?

5:23 AM  
Blogger Ashmi said...

why is there no way to post comments in the latest article of yours? I loved the last one you wrote....anyways this story in fact very touching and all the more scary....i could imagine how you must have felt seeing her pix....yeah perhaps that's the reason ppl hail doctors as god's in disguise on earth:)

6:51 AM  
Blogger M (tread softly upon) said...

Hey everyone thanks for all the comments! Yes the comment option was turned off on purpose. And I'm fine.
@ ss thanks for visiting my blog and leaving such a evocatve comment. you really are a poet.
@ ashmi cannot tell you how wonderful it is to see you back. Hope things work out for you just the way you want them to.

9:08 AM  
Blogger ubergeek said...

Wow. Now I know why good doctors seem to be the only people on the planet who love their jobs.

@M: Thx for stopping by. Couldn't reply to your comment then bcoz blogs were blocked. Saw ur comment in my e-mail alert. Thx again :-)

4:08 AM  
Blogger jhantu said...

i was abt to ask why ur posts were disappearing but tht q has been asked and asnwered..

stay well and put up a new post
betst

1:29 PM  
Blogger Kausum said...

Is there a possibility you play tennis again?

I meant as soon as your endorphins release , we seem to get a new post!

Waiting for one soon!

2:04 PM  
Blogger Jinguchakka said...

Hey, why have you deleted your last post too?

2:49 PM  
Blogger GettingThere said...

Are you playng mind games with us? :P I came here to add to my comment on your last post and couldn't find the post. So, being that my memory is like a sieve these day, I thought maybe it was some other blog that I saw that post on - went around on ALL the blogs that I visit looking fo rthat post :D Came back, read these comments and realized I was looking in the right place fromt he start. Everything OK? Give a holler if you need a virtual shoulder - mine is right here...

3:16 PM  
Anonymous KK said...

Mysterious M has disappeared for a while it seems, lets see when can she return back!

I know we are all addicted to her blogs. But lets give the lady a break to sort out her issues.

4:43 PM  
Blogger karmic_jay said...

Did your post disappear again? The one about being checked out and one other right?

6:21 PM  
Blogger Cacophoenix said...

Hi. Sorry for the really long silence. I am at home in India. It is impossible to stay silent here even for a minute and I just didn't feel like blogging. Thanks a bunch for caring. I am really touched. I will be back by the month end. Will get back to life then. Hope you are doing fine. Will be glad to bring back a little cheer and love from here....

9:37 PM  
Blogger Arthur Quiller Couch said...

Good one.

4:13 PM  
Blogger M (tread softly upon) said...

@ ubergeek thanks for stopping here.
@ jhantu :) I will. Soon.
@ kausum hang on. Will play this afternoon :)
@ jinguchakka ah the mystery strikes yet again.
@ gettingthere I'm sorry if I put you through so much trouble. I'm here. And thanks!
@ kk such understanding! Thank you!
@ karmic_jay I did leave a comment on your blog but it has disappeared.

1:16 PM  
Blogger Mike Todd said...

m -- So glad to have found my way over to your blog. Excellent! I'll be back often.

10:21 PM  
Blogger M (tread softly upon) said...

@ cacophoenix glad to know you're okay. Don't worry about not blogging. Take care and sap up all the attention and love you can. Look forward to all the cheer that you can bring back.
@ a.q. couch nice seeing you here.
@ mike todd thanks for stopping by.

7:53 AM  
Blogger Chander Dogra said...

Doctors...if they do good they become god ...else they become devils ...life on a constant edge...hope these kinds of incidents are rarest of rare.

1:37 PM  
Blogger The Smiling Girl said...

Oh baap re... looks like a story out of the book of miracles!!!

5:34 AM  

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