Top Stories

That's Not Normal: Doctors Share Their One-In-A-Million Cases

Think about the last time you were sick; the ritual of checking WebMD, thinking you have a life-threatening illness, then finding out it was a harmless rash that was causing you all that stress. Regardless of the symptoms, we’ve all been there—but what of the unlucky few who actually did have some sort of ill-fated, isolated illness?

A Bad Bridge to Cross

red and white massage chairPhoto by Atikah Akhtar on Unsplash

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.

SirNobealot

The Neighbors

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?"

chasealex2

Just a Nibble

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.

psilord34

Pill Problem

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.

wastelander

Hoofbeats

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.

wastelander

A Staple Food Source

man in blue dress shirt sitting on yellow chairPhoto by Mark Williams on Unsplash

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.

UnfairCanary

No Face

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.

SamDaManIAm

Spinal Tap

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.

drdeeppakjoseph

One in a Million

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.

corf1

The Living Dead

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.

cohen14722

Catching Zebras

zebra standing on wheat fieldPhoto by Jeff Griffith on Unsplash

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.

implante

Cat Calling

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.

stheonlyone

Socrates’ Demise

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.

wastelander

The Worse of Two Evils

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.

gettheread

A Bad Prognosis

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.

yourredditMD

Hard to Miss

person in blue denim jeans lying on bedPhoto by National Cancer Institute on Unsplash

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).

eatonsht

A Hard Revelation

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.

drdeepakjoseph

The Meat of the Issue

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.

thepunctuator

Unexpected Guests

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.

kgjohnson2

More Than Meets the Eye

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.

Permalink

My Old Mother

woman wearing eyeglassesPhoto by Todd Cravens on Unsplash

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!

Permalink

On a Hunch

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!

sam_galactic

Growing White

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.

Allyeknowonearth

Ignoring the Issue

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.

Weird.

Awesam

Flippant Flipping

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.

Kirsten

A Quick Diagnosis

person holding baby feetPhoto by Omar Lopez on Unsplash

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.

blizpix

Caught in Her Throat

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.

En_lighten

Rare and Terrible

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!

Proxyfloxacin

Dr. Google

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.

Digitlnoize

Miracle Porridge

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.

greedo4president2016

Wearing Your Heart on Your Sleeve

pruning topless babyPhoto by Jakob Owens on Unsplash

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.

Say No to Drugs

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.

2ThineOwnZelphBeTrue

Against All Odds

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.

drcopperfield

A Rare Talent

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.

throckmortonsign

Improvise. Adapt. Overcome.

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.

aussie-vault-girl

Subtle Symptoms

man reading papers in front of computerPhoto by National Cancer Institute on Unsplash

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.

DudeWhoSaysWhaaaat

Jaw-Dropping News

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.

cloud_watcher

Benadryl to the Rescue

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!

1llumina

Face-palm Parenting

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.

TomTheNurse

Non-FDA Methods

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.

duck_doctor

Like Flipping a Switch

man in white dress shirt wearing black framed eyeglassesPhoto by Usman Yousaf on Unsplash

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.

DrTapioca

Factitious Disorder

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.

Milesman1971

People Reveal The Weirdest Thing About Themselves

Reddit user Isitjustmedownhere asked: 'Give an example; how weird are you really?'

Let's get one thing straight: no one is normal. We're all weird in our own ways, and that is actually normal.

Of course, that doesn't mean we don't all have that one strange trait or quirk that outweighs all the other weirdness we possess.

For me, it's the fact that I'm almost 30 years old, and I still have an imaginary friend. Her name is Sarah, she has red hair and green eyes, and I strongly believe that, since I lived in India when I created her and there were no actual people with red hair around, she was based on Daphne Blake from Scooby-Doo.

I also didn't know the name Sarah when I created her, so that came later. I know she's not really there, hence the term 'imaginary friend,' but she's kind of always been around. We all have conversations in our heads; mine are with Sarah. She keeps me on task and efficient.

My mom thinks I'm crazy that I still have an imaginary friend, and writing about her like this makes me think I may actually be crazy, but I don't mind. As I said, we're all weird, and we all have that one trait that outweighs all the other weirdness.

Redditors know this all too well and are eager to share their weird traits.

It all started when Redditor Isitjustmedownhere asked:

"Give an example; how weird are you really?"

Monsters Under My Bed

"My bed doesn't touch any wall."

"Edit: I guess i should clarify im not rich."

– Practical_Eye_3600

"Gosh the monsters can get you from any angle then."

– bikergirlr7

"At first I thought this was a flex on how big your bedroom is, but then I realized you're just a psycho 😁"

– zenOFiniquity8

Can You See Why?

"I bought one of those super-powerful fans to dry a basement carpet. Afterwards, I realized that it can point straight up and that it would be amazing to use on myself post-shower. Now I squeegee my body with my hands, step out of the shower and get blasted by a wide jet of room-temp air. I barely use my towel at all. Wife thinks I'm weird."

– KingBooRadley

Remember

"In 1990 when I was 8 years old and bored on a field trip, I saw a black Oldsmobile Cutlass driving down the street on a hot day to where you could see that mirage like distortion from the heat on the road. I took a “snapshot” by blinking my eyes and told myself “I wonder how long I can remember this image” ….well."

– AquamarineCheetah

"Even before smartphones, I always take "snapshots" by blinking my eyes hoping I'll remember every detail so I can draw it when I get home. Unfortunately, I may have taken so much snapshots that I can no longer remember every detail I want to draw."

"Makes me think my "memory is full.""

– Reasonable-Pirate902

Same, Same

"I have eaten the same lunch every day for the past 4 years and I'm not bored yet."

– OhhGoood

"How f**king big was this lunch when you started?"

– notmyrealnam3

Not Sure Who Was Weirder

"Had a line cook that worked for us for 6 months never said much. My sous chef once told him with no context, "Baw wit da baw daw bang daw bang diggy diggy." The guy smiled, left, and never came back."

– Frostygrunt

Imagination

"I pace around my house for hours listening to music imagining that I have done all the things I simply lack the brain capacity to do, or in some really bizarre scenarios, I can really get immersed in these imaginations sometimes I don't know if this is some form of schizophrenia or what."

– RandomSharinganUser

"I do the same exact thing, sometimes for hours. When I was young it would be a ridiculous amount of time and many years later it’s sort of trickled off into almost nothing (almost). It’s weird but I just thought it’s how my brain processes sh*t."

– Kolkeia

If Only

"Even as an adult I still think that if you are in a car that goes over a cliff; and right as you are about to hit the ground if you jump up you can avoid the damage and will land safely. I know I'm wrong. You shut up. I'm not crying."

– ShotCompetition2593

Pet Food

"As a kid I would snack on my dog's Milkbones."

– drummerskillit

"Haha, I have a clear memory of myself doing this as well. I was around 3 y/o. Needless to say no one was supervising me."

– Isitjustmedownhere

"When I was younger, one of my responsibilities was to feed the pet fish every day. Instead, I would hide under the futon in the spare bedroom and eat the fish food."

– -GateKeep-

My Favorite Subject

"I'm autistic and have always had a thing for insects. My neurotypical best friend and I used to hang out at this local bar to talk to girls, back in the late 90s. One time he claimed that my tendency to circle conversations back to insects was hurting my game. The next time we went to that bar (with a few other friends), he turned and said sternly "No talking about bugs. Or space, or statistics or other bullsh*t but mainly no bugs." I felt like he was losing his mind over nothing."

"It was summer, the bar had its windows open. Our group hit it off with a group of young ladies, We were all chatting and having a good time. I was talking to one of these girls, my buddy was behind her facing away from me talking to a few other people."

"A cloudless sulphur flies in and lands on little thing that holds coasters."

"Cue Jordan Peele sweating gif."

"The girl notices my tension, and asks if I am looking at the leaf. "Actually, that's a lepidoptera called..." I looked at the back of my friend's head, he wasn't looking, "I mean a butterfly..." I poked it and it spread its wings the girl says "oh that's a BUG?!" and I still remember my friend turning around slowly to look at me with chastisement. The ONE thing he told me not to do."

"I was 21, and was completely not aware that I already had a rep for being an oddball. It got worse from there."

– Phormicidae

*Teeth Chatter*

"I bite ice cream sometimes."

RedditbOiiiiiiiiii

"That's how I am with popsicles. My wife shudders every single time."

monobarreller

Never Speak Of This

"I put ice in my milk."

– GTFOakaFOD

"You should keep that kind of thing to yourself. Even when asked."

– We-R-Doomed

"There's some disturbing sh*t in this thread, but this one takes the cake."

– RatonaMuffin

More Than Super Hearing

"I can hear the television while it's on mute."

– Tira13e

"What does it say to you, child?"

– Mama_Skip

Yikes!

"I put mustard on my omelettes."

– Deleted User

"Oh."

– NotCrustOr-filling

Evened Up

"Whenever I say a word and feel like I used a half of my mouth more than the other half, I have to even it out by saying the word again using the other half of my mouth more. If I don't do it correctly, that can go on forever until I feel it's ok."

"I do it silently so I don't creep people out."

– LesPaltaX

"That sounds like a symptom of OCD (I have it myself). Some people with OCD feel like certain actions have to be balanced (like counting or making sure physical movements are even). You should find a therapist who specializes in OCD, because they can help you."

– MoonlightKayla

I totally have the same need for things to be balanced! Guess I'm weird and a little OCD!

Close up face of a woman in bed, staring into the camera
Photo by Jen Theodore

Experiencing death is a fascinating and frightening idea.

Who doesn't want to know what is waiting for us on the other side?

But so many of us want to know and then come back and live a little longer.

It would be so great to be sure there is something else.

But the whole dying part is not that great, so we'll have to rely on other people's accounts.

Redditor AlaskaStiletto wanted to hear from everyone who has returned to life, so they asked:

"Redditors who have 'died' and come back to life, what did you see?"

Sensations

Happy Good Vibes GIF by Major League SoccerGiphy

"My dad's heart stopped when he had a heart attack and he had to be brought back to life. He kept the paper copy of the heart monitor which shows he flatlined. He said he felt an overwhelming sensation of peace, like nothing he had felt before."

PeachesnPain

Recovery

"I had surgical complications in 2010 that caused a great deal of blood loss. As a result, I had extremely low blood pressure and could barely stay awake. I remember feeling like I was surrounded by loved ones who had passed. They were in a circle around me and I knew they were there to guide me onwards. I told them I was not ready to go because my kids needed me and I came back."

"My nurse later said she was afraid she’d find me dead every time she came into the room."

"It took months, and blood transfusions, but I recovered."

good_golly99

Take Me Back

"Overwhelming peace and happiness. A bright airy and floating feeling. I live a very stressful life. Imagine finding out the person you have had a crush on reveals they have the same feelings for you and then you win the lotto later that day - that was the feeling I had."

"I never feared death afterward and am relieved when I hear of people dying after suffering from an illness."

rayrayrayray

Free

The Light Minnie GIF by (G)I-DLEGiphy

"I had a heart surgery with near-death experience, for me at least (well the possibility that those effects are caused by morphine is also there) I just saw black and nothing else but it was warm and I had such inner peace, its weird as I sometimes still think about it and wish this feeling of being so light and free again."

TooReDTooHigh

This is why I hate surgery.

You just never know.

Shocked

Giphy

"More of a near-death experience. I was electrocuted. I felt like I was in a deep hole looking straight up in the sky. My life flashed before me. Felt sad for my family, but I had a deep sense of peace."

Admirable_Buyer6528

The SOB

"Nursing in the ICU, we’ve had people try to die on us many times during the years, some successfully. One guy stood out to me. His heart stopped. We called a code, are working on him, and suddenly he comes to. We hadn’t vented him yet, so he was able to talk, and he started screaming, 'Don’t let them take me, don’t let them take me, they are coming,' he was scared and yelling."

"Then he yelled a little more, as we tried to calm him down, he screamed, 'No, No,' and gestured towards the end of the bed, and died again. We didn’t get him back. It was seriously creepy. We called his son to tell him the news, and the son said basically, 'Good, he was an SOB.'”

1-cupcake-at-a-time

Colors

"My sister died and said it was extremely peaceful. She said it was very loud like a train station and lots of talking and she was stuck in this area that was like a curtain with lots of beautiful colors (colors that you don’t see in real life according to her) a man told her 'He was sorry, but she had to go back as it wasn’t her time.'"

Hannah_LL7

"I had a really similar experience except I was in an endless garden with flowers that were colors I had never seen before. It was quiet and peaceful and a woman in a dress looked at me, shook her head, and just said 'Not yet.' As I was coming back, it was extremely loud, like everyone in the world was trying to talk all at once. It was all very disorienting but it changed my perspective on life!"

huntokarrr

The Fog

"I was in a gray fog with a girl who looked a lot like a young version of my grandmother (who was still alive) but dressed like a pioneer in the 1800s she didn't say anything but kept pulling me towards an opening in the wall. I kept refusing to go because I was so tired."

"I finally got tired of her nagging and went and that's when I came to. I had bled out during a c-section and my heart could not beat without blood. They had to deliver the baby and sew up the bleeders. refill me with blood before they could restart my heart so, like, at least 12 minutes gone."

Fluffy-Hotel-5184

Through the Walls

"My spouse was dead for a couple of minutes one miserable night. She maintains that she saw nothing, but only heard people talking about her like through a wall. The only thing she remembers for absolute certain was begging an ER nurse that she didn't want to die."

"She's quite alive and well today."

Hot-Refrigerator6583

Well let's all be happy to be alive.

It seems to be all we have.

Man's waist line
Santhosh Vaithiyanathan/Unsplash

Trying to lose weight is a struggle understood by many people regardless of size.

The goal of reaching a healthy weight may seem unattainable, but with diet and exercise, it can pay off through persistence and discipline.

Seeing the pounds gradually drop off can also be a great motivator and incentivize people to stay the course.

Those who've achieved their respective weight goals shared their experiences when Redditor apprenti8455 asked:

"People who lost a lot of weight, what surprises you the most now?"

Redditors didn't see these coming.

Shiver Me Timbers

"I’m always cold now!"

– Telrom_1

"I had a coworker lose over 130 pounds five or six years ago. I’ve never seen him without a jacket on since."

– r7ndom

"140 lbs lost here starting just before COVID, I feel like that little old lady that's always cold, damn this top comment was on point lmao."

– mr_remy

Drawing Concern

"I lost 100 pounds over a year and a half but since I’m old(70’s) it seems few people comment on it because (I think) they think I’m wasting away from some terminal illness."

– dee-fondy

"Congrats on the weight loss! It’s honestly a real accomplishment 🙂"

"Working in oncology, I can never comment on someone’s weight loss unless I specifically know it was on purpose, regardless of their age. I think it kind of ruffles feathers at times, but like I don’t want to congratulate someone for having cancer or something. It’s a weird place to be in."

– LizardofDeath

Unleashing Insults

"I remember when I lost the first big chunk of weight (around 50 lbs) it was like it gave some people license to talk sh*t about the 'old' me. Old coworkers, friends, made a lot of not just negative, but harsh comments about what I used to look like. One person I met after the big loss saw a picture of me prior and said, 'Wow, we wouldn’t even be friends!'”

"It wasn’t extremely common, but I was a little alarmed by some of the attention. My weight has been up and down since then, but every time I gain a little it gets me a little down thinking about those things people said."

– alanamablamaspama

Not Everything Goes After Losing Weight

"The loose skin is a bit unexpected."

– KeltarCentauri

"I haven’t experienced it myself, but surgery to remove skin takes a long time to recover. Longer than bariatric surgery and usually isn’t covered by insurance unless you have both."

– KatMagic1977

"It definitely does take a long time to recover. My Dad dropped a little over 200 pounds a few years back and decided to go through with skin removal surgery to deal with the excess. His procedure was extensive, as in he had skin taken from just about every part of his body excluding his head, and he went through hell for weeks in recovery, and he was bedridden for a lot of it."

– Jaew96

These Redditors shared their pleasantly surprising experiences.

Shopping

"I can buy clothes in any store I want."

– WaySavvyD

"When I lost weight I was dying to go find cute, smaller clothes and I really struggled. As someone who had always been restricted to one or two stores that catered to plus-sized clothing, a full mall of shops with items in my size was daunting. Too many options and not enough knowledge of brands that were good vs cheap. I usually went home pretty frustrated."

– ganache98012

No More Symptoms

"Lost about 80 pounds in the past year and a half, biggest thing that I’ve noticed that I haven’t seen mentioned on here yet is my acid reflux and heartburn are basically gone. I used to be popping tums every couple hours and now they just sit in the medicine cabinet collecting dust."

– colleennicole93

Expanding Capabilities

"I'm all for not judging people by their appearance and I recognise that there are unhealthy, unachievable beauty standards, but one thing that is undeniable is that I can just do stuff now. Just stamina and flexibility alone are worth it, appearance is tertiary at best."

– Ramblonius

People Change Their Tune

"How much nicer people are to you."

"My feet weren't 'wide' they were 'fat.'"

– LiZZygsu

"Have to agree. Lost 220 lbs, people make eye contact and hold open doors and stuff"

"And on the foot thing, I also lost a full shoe size numerically and also wear regular width now 😅"

– awholedamngarden

It's gonna take some getting used to.

Bones Everywhere

"Having bones. Collarbones, wrist bones, knee bones, hip bones, ribs. I have so many bones sticking out everywhere and it’s weird as hell."

– Princess-Pancake-97

"I noticed the shadow of my ribs the other day and it threw me, there’s a whole skeleton in here."

– bekastrange

Knee Pillow

"Right?! And they’re so … pointy! Now I get why people sleep with pillows between their legs - the knee bones laying on top of each other (side sleeper here) is weird and jarring."

– snic2030

"I lost only 40 pounds within the last year or so. I’m struggling to relate to most of these comments as I feel like I just 'slimmed down' rather than dropped a ton. But wow, the pillow between the knees at night. YES! I can relate to this. I think a lot of my weight was in my thighs. I never needed to do this up until recently."

– Strongbad23

More Mobility

"I’ve lost 100 lbs since 2020. It’s a collection of little things that surprise me. For at least 10 years I couldn’t put on socks, or tie my shoes. I couldn’t bend over and pick something up. I couldn’t climb a ladder to fix something. Simple things like that I can do now that fascinate me."

"Edit: Some additional little things are sitting in a chair with arms, sitting in a booth in a restaurant, being able to shop in a normal store AND not needing to buy the biggest size there, being able to easily wipe my butt, and looking down and being able to see my penis."

– dma1965

People making significant changes, whether for mental or physical health, can surely find a newfound perspective on life.

But they can also discover different issues they never saw coming.

That being said, overcoming any challenge in life is laudable, especially if it leads to gaining confidence and ditching insecurities.