"His Liver Was SCREAMING For Help": Doctors Are Revealing The Biggest Medical Mysteries They've Ever Solved, And These Are Straight Out Of A TV Show
That's why when Redditor u/YaaaaaaaaasQueen asked, "Doctors of Reddit: what is the biggest medical mystery you've solved?" medical professionals flooded the comments with their heroic stories of saving "unsavable" patients. Without further ado, here are 15 of their most heart-pounding tales:
1."During my second year of residency, I was called in to cover another resident for the weekend. One of the patients on the list was in her 80s and being transitioned to hospice due to 'terminal delirium.' She had come in confused and had been in the hospital for two weeks with mostly normal test results. Initially, doctors thought it was a UTI and treated her, but she didn't get better. Her mental status worsened, and her fevers continued. No one could figure out what it was, but, because there was no answer, the family ultimately decided to try to take her to hospice rather than put her through more invasive testing."
Asiaselects / Getty Images/Asia Selects RF
"She was still having intermittent fevers and was nearly unresponsive. Because she was constantly sleeping, she couldn't answer any questions. Despite that, I knew exactly what was wrong within 20 seconds of meeting her. She would make weird facial expressions that lasted a few seconds, and then become unresponsive. It looked like something called tardive dyskinesia, a rare side effect of antipsychotic medications, so I looked back in her chart."
"When she initially came in with a UTI, she was confused, so someone started her on a nightly antipsychotic to help with the 'agitation' and kept giving her the medicine because they thought it was helping. In reality, she was having a rare but potentially life-threatening reaction to the medicine called neuroleptic malignant syndrome. I checked a few labs, and her creatine kinase was high, which supported the diagnosis."
"We stopped the medicine, and she walked out of the hospital a week later. I kept an eye on her chart for a long time, and she eventually passed away due to other causes. This was and still is one of my best catches.
As proud as I was for this one, it terrified me. It highlighted how the difference between someone living or dying occasionally rests on whether or not a doctor knows about a particular condition. Luckily, in her case, I had recently attended a lecture that included videos of those side effects, so I immediately recognized it. It doesn't make me a better doctor than the people who saw her before. It was just meant to be that I got to treat her at that time."
—u/Numerous_Birds
2."This case wasn't wildly mysterious, but it had the biggest impact: I was a psych intern doing rotations. As a psych rotation, you are guaranteed to get assigned the patients the attending doctors dread. So, in this particular situation, the attending doc hands me the folder with the oft-quoted, 'Oh, this one is perfect for you.'"
"The patient was a female in her 40s and had been seeing a PCP for over a decade for 'random stuff.' She was described as anxious, dramatic, and attention-seeking. I noticed she had experienced transient intermittent neurological symptoms that seemingly affected random areas of her body. Over time, she stated that episodes happened more often, and she didn't feel like she was bouncing back the same as before.
I talked with the attending and told him I thought we needed to do an MS workup. He rolled his eyes and said, 'She got to you, huh?' He said I could order a workup if the patient were willing to pay. So I did. It was the last week of that rotation, so I couldn't follow up with her.
A couple of weeks later, I was on another rotation, but got a notification for a lab result. Since I ordered the entire workup, the results were sent to the attending doc and me. The patient was positive for MS. This poor woman had been dealing with untreated MS for over a decade. Her description of the symptoms would have been easy for even a first-year med student to put MS near the top of their differential. It still makes me angry for her."
—u/Eshlau
3."Paramedic here: I was on a transfer for a kid with unspecified 'Altered Mental Status.' He was a young male patient who had become strangely altered without a known cause. The patient was hypotensive and tachycardic, and had rapidly lost weight since his last primary care appointment. The ER had drawn labs, all showing normal, so they had decided to send him to the pediatric center for further testing and monitoring."
"I got on scene and looked at the patient, puzzled as to what was making him sick. While hooking him up to the cardiac monitor, I noticed he looked like my brother did as a kid. My brother was diagnosed with adrenal insufficiency and had almost the same symptoms. As we were driving down the road, the patient was getting worse, so I gave him a dose of IV Dexamethasone (the only steroid we carried at the time). The mother and I waited for a change, and sure enough, the kid started to get better.
Later tests confirmed at the pediatric center that it was, in fact, an adrenal crisis, and he had undiagnosed Addison's Disease. The doctor gave me props for figuring it out, but truthfully, I doubt I would have recognized it without knowing what to look for in my brother."
—u/ThatGingerEMT
4."I'm a genetic counselor who works in pediatric oncology, and this was one of my biggest 'trust your gut' situations: I saw an infant with a brain tumor who I was originally told had no family history of cancer. Upon talking to the baby's mom, I learned she had breast cancer in her 20s, and her own mother had died from a rare sarcoma in her 20s. Moreover, all of their maternal relatives had cancer at a young age."
SDI Productions / Getty Images
"Interestingly, all genetic and tumor testing for both the infant and their mom was negative thus far. Usually, in that case, we say, 'We don't know every cause for cancer yet,' and leave it as is. However, I couldn't end things there in good faith because I suspected one particular cancer predisposition syndrome might be to blame.
I ordered a single-gene test on a whole-genome platform, which sequences far deeper into the gene than any other test. Labs don't sequence that far because it's extremely rare to find anything there, but sure enough, the test identified a mutation deep within this gene. It was the explanation for the child's brain tumor and family history of cancer.
It was certainly a devastating result, as this cancer syndrome is associated with a 100% lifetime risk for cancer of almost any type you can think of — it's called Li-Fraumeni syndrome. However, I was so grateful to finally have an answer for this family because we can now pursue intensive surveillance for positive relatives that will be life-saving. Of course, this fueled my paranoia of 'Is a negative ever truly negative?' and intensified my desire to dig deeper for these kids."
—u/littlebronco
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5."A cool call I had as a paramedic many years ago initially annoyed my partner and me. A twenty-something-year-old male woke up with nausea and vomiting (it was a Sunday morning in a neighborhood known for partying). The call notes said there was a small amount of blood in the vomit, so it got up-triaged to paramedics responding."
"When we arrived, the patient's girlfriend was freaked out, but guided us to the patient, who was white as a sheet, drenched in sweat, vomiting pure blood into a trash can that was already full of it.
We start our assessment and learn he has always had digestive issues — chronic diarrhea, horrible hemorrhoids, etc. — and has to eat an extremely low-fat diet. We asked if he had been partying the night before. He said no because he can't have more than one beer, or he's a mess for days. He smoked some weed, but no more than usual, and he had smoked from the same bag earlier and was fine. He had never thrown up blood before. But, because he didn't have insurance, he'd gone anywhere other than urgent care. He had an upper GI bleed, but something clicked in my lizard brain, and I realized precisely what was happening. His liver was SCREAMING for help."
"He can't digest fat, can't process alcohol, and what seemed like an innocuous comment was the key to the whole thing — his hemorrhoids. If the circulation through your liver gets backed up, it causes pressure in the blood vessels that come in and out to build up. If enough pressure builds up, your anal veins balloon out causing a hemorrhoid. If that pressure goes north, you can get esophageal varices, essentially the same as hemorrhoids, but in your throat. They can rupture and bleed profusely."
"Despite our efforts, he lost a ton of blood and rapidly worsened. Upon arrival at the critical section of the ER, he passed out before being intubated and given blood transfusions.
The attending doctor was always aloof and didn't play well with nurses or EMS. However, we returned later in the day with another patient, he pulled me aside to ask, 'What exactly is the scope of your training? That was wild, you caught that!' I reflected on that moment for the rest of my career."
—u/sam_neil
6."I was on night shift when one of my junior colleagues called me to come help him with a puzzling patient. The patient's oxygen saturation was fine while lying down without any supplemental oxygen, but when he would sit up, his saturation went to the 70s. Everyone thought it had to be an infection, a pulmonary embolism, etc. It had been going on for a while, but no one seemed to know what it was."
PeopleImages / Getty Images
"Out of pure luck, I had seen a case like this at a large teaching hospital I'd worked at previously. I was puzzled when I saw it back then, but it stuck with me because it was unique — the condition is called platypnea orthodeoxia.
At first, I thought this patient couldn't have it because, after all, it's super rare! But I kept sitting him up, then lying him down, and seeing the oxygen levels wildly fluctuate with exact correlation to his posture. So I thought it was time to get cardiology involved so they could scan for a hole in the heart.
Lo and behold, he had one. After it was repaired, his symptoms went away. No one congratulated me on the diagnosis, but I was so happy I caught it when no one else could."
—u/chikcaant
7."I'm not a 'medical' doctor, but I am a psychologist who made a life-changing diagnosis for my patient. This particular patient, a 67-year-old woman, came into my practice one day after her physician referred her to me about having anxiety alongside vertigo that had lasted for over a decade. The doctors couldn't figure it out, so they thought it was psychosomatic. After a brief interview, she told me her symptoms had improved while she visited her sister for a week, but immediately returned when she got home."
"I asked her who lived with her, and she told me she lives with her son, daughter-in-law, and their cat. Right then and there, I think, 'This isn't anxiety but allergies.'
I suggested she move the cat out of the house for a few weeks and do a deep cleaning. She returned a month later, telling me that she was no longer fatigued and all of her symptoms had disappeared, including the vertigo. She managed to get off the meds that she had taken for over a decade, all because of a cat..
I felt like I was Dr. House at that moment. It might not have been a huge medical mystery, but seeing her quality of life improve was worth it."
—u/ArcPsy
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8."Not a doctor, but an EMT: I was called to the scene of a car accident. A man had crashed into a fence near a reservoir. He had vomited down the front of his shirt and had a large red mark on his forehead. The police were going to arrest him for a DUI, but asked me to check him out first."
Bluecinema / Getty Images
"I asked him what had happened. He said he was on his way to pick up his son from school when an animal ran in front of him, causing him to swerve, hit a puddle, and skid into the fence. As he spoke, I could smell what I thought was alcohol on his breath. It was also around 7 p.m. on a sunny Sunday in July, there wasn't a puddle in sight, and there were no skid marks. His story didn't add up.
I asked how much he had had to drink that day. He insisted he hadn't been drinking. I pressed a little, and he said, 'I'm a Muslim, I do not touch alcohol.' I asked if he was diabetic. He told me no. I then asked if he had ever been tested. Also no. That's when it clicked: the 'alcohol' smell wasn't alcohol at all. It was the fruity odor of diabetic ketoacidosis. My patient was an undiagnosed diabetic who had likely passed out behind the wheel."
"That explained the crash and the breath, but what about the vomiting and bizarre story? While I was puzzling that out, the patient asked to go to a small local hospital. Normally, a reasonable request, unless I have a trauma patient. I looked at the red mark on his forehead and decided to check his pupils — that's when alarms went off."
"With help from the police, we loaded him into the ambulance and expedited transport to the nearest trauma center. En route, he complained of severe head pain, said he could feel his pulse pounding in his head, and started screaming. His blood pressure was climbing every time I checked it.
When we arrived, the triage nurse tried to send him to general triage. I insisted he needed an immediate head CT. She pushed back. I grabbed a doctor, explained the situation, and he ordered a rush CT. As I suspected, the patient had a brain bleed. He went straight from CT into emergency surgery to stop the bleeding.
It's probably the call I'm most proud of. If I had done one thing differently: if the police had arrested him, if I'd taken him to the wrong hospital, if I hadn't argued for priority treatment, or if I hadn't taken the time to really talk to him, his chances would have been so much worse. He might not have survived."
—u/KunSeii
9."Psychiatrist here: I moonlighted at a standalone Psych ER in residency. Emergency services brought in a man who didn't speak English due to psychosis. With the help of an interpreter, we could identify that he was from Bhutan and had been a Freedom Fighter. But the interpreter told us that most of the patient's words were incomprehensible."
Susumu Yoshioka / Getty Images
"I noticed some tattoos that seemed amateur, possibly from his time in combat. It dawned on me he could have had hepatic encephalopathy from Hepatitis C. I arranged a transfer to a medical ER, and the staff there was upset with me. To their credit, they called back later that night to confirm I was correct, leading to a plan of appropriate medical care instead of inappropriate psychiatric care."
—u/Particular-Bat-6509
10."A young person came into the ER in an ambulance, unconscious. They were septic and losing two organ systems at the time of presentation (kidneys and liver). They can't give a medical history because they are so out of it."
"An IV contrast wasn't much help because the patient didn't have sufficient renal function. The images looked like vague grey mush: edema everywhere. I see four small gas bubbles: one in the portal vein, one in a tributary of the superior mesenteric vein, and two next to the pubic symphysis. These gas bubbles do not belong there and are a grim prognosticator. I have to make some kind of wild guess because this person is close to death.
I look closer and see erosions on the left pubic body. I call the surgeon and tell him to cut out the pubic symphysis (where the two pubic bones meet). I make the diagnosis in 20 minutes: septic arthritis.
They cut out the offending joint, and the patient walked out of the hospital a week later. A follow-up CT showed hundreds of liver abscesses from bacteremia — those cleared with continued antibiotics. My co-worker who read the follow-up CT congratulated me on a brilliant diagnosis."
—u/Spiteblight
11."Not the doctor, but I was taking care of a patient who was hospitalized for multiple days because of massive swings in her blood glucose. The doctors couldn't figure out why her BG would be over 350 and climbing, and then 20 minutes later, it would crash into the 40s. She was [taking] nothing by mouth for reasons I don't recall, possibly a gastrointestinal infection, so we were pumping IV dextrose multiple times a shift to keep her alive. We were down to our last vial, and I was freaking out because I was working alone that night."
Ljubaphoto / Getty Images
"I was working at a small rural outpost hospital that only had one doctor on call in the ER as needed for my unit overnight, and there was no support besides calling EMS for transports to a larger hospital over an hour away. I was so afraid of losing my patient.
I did a deep dive online between managing this patient's crises and my other patients. I found a research paper on the topic of diabetics' reactions to certain classes of antibiotics. I notified the hospitalist in the morning and provided the link to the paper, but never got a response.
I was off the next night, and the patient would be gone when I returned for my next shift. I was afraid she died, but was informed by the outgoing shift that she was discharged home because our hospitalist figured out it was the antibiotic causing the chaos and switched meds. Immediately, her blood glucose stabilized, and with the new antibiotic, the infection was brought under control."
—u/Finklemaier
12."Not me, but my attending doctor. We had an older guy with new severe hip pain, but his X-ray and MRI were normal. It didn't add up, and she felt something else was happening to him. We got an MRI of his spine, and he had a huge abscess on it. Most of the time, you would expect to see weakness or sensory changes with a spinal abscess — he had none of that."
"We imaged his whole spine and found a couple more spots of infection. Then we scanned his brain and found a large abscess. We also got an echocardiogram that showed a massive infection sitting on one of his heart valves. He had NO symptoms other than this sudden onset of hip pain.
Long story short, we think his diverticulitis let bacteria into his blood, and he was unlucky enough to have it affect his heart valve. After a truckload of antibiotics, he did great!"
—u/WoodsyAspen
13."Not sure if this is a mystery, but I connected the dots in the last year of my residency: An 8-year-old kid came into the ER with fever, shortness of breath, and a small lower leg wound after falling two days before. He didn't want to walk due to the pain in his leg (besides the wound, he had a bad limp).
Shironosov / Getty Images
"I was in the last year of my residency. Based on a physical exam alone, I diagnosed the patient with a fever from a septic hip and shortness of breath and fever from a pulmonary embolism. Labs and a CT scan proved I was right about everything.
I was just trying to be a smartass because I had a good relationship with the attending, and PE in kids is far less common than in adults, so I thought I would be obnoxious by throwing in the PE diagnosis. Ultimately, it was humbling because it made me think about what I've missed by not turning over rocks."
—u/GibbsMalinowski
14."It is not the biggest medical mystery I have solved, but the first that comes to mind: I was once moonlighting in an urgent care when a 5-year-old kid came in for cold symptoms. We talked about upper respiratory infections, supportive care, etc., I examined the kid, and when he was getting ready to leave, I noticed one nostril was putting out purulent drainage, and the other was clear. I asked his mom about it, and she told me that his nostrils always drained; she had been told it was allergies. You don't get allergies in just one nostril."
"I also noticed that the room smelled foul (it smelled this way frequently, so it wasn't remarkable, however, it was particularly terrible in this case). So I got a little bulb syringe and suctioned out as much as possible. I saw something in the kid's nostril, but couldn't determine what it was with all the mucus, so I grabbed some forceps, reached in, and pulled out a 3-inch chunk of wood.
The kid's mom started crying. She told me he had had this problem for a few years and had seen multiple doctors, but no one had fixed his problem. He had been relentlessly made fun of at school because of the smell. It only took 15 minutes of my time, but it made a big impact on them."
—u/Outrageous_Card7308
15."I'm a dentist and this isn't a huge mystery, but one that drove me nuts for four years: I had a patient with severe acid erosion on all of his teeth, but one area in particular was the worst. I figured he had to be obsessively eating something acidic and chewing it with one side of his mouth. I would interrogate him every visit to determine what was causing it. I probably asked him 50 times if he liked to eat sour candy, and he always replied, 'Not really.'"
Dowell / Getty Images
"One day, we had a long appointment together, and I just decided to name every sour candy I could think of while I worked. When I said 'Cry Babies', he said, 'Mmm, I like those, they're so sour!'
Come to find out he was eating one or two bags per day. What did he think I was asking about when I asked if he had liked to eat sour candy all these years?"
—u/buccal_up
Did any of these medical mysteries shock you? Doctors, nurses, and other medical professionals, what have been the most mysterious or surprising cases you've ever solved? Tell us in the comments or answer anonymously using the form below!
Note: Some responses have been edited for length and/or clarity.
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