80 Medical Professionals Share The Diagnoses That Made Their Stomachs Drop

My dad is a radiologist. Back when he was doing his residency rotations, he had an elderly woman come in, full of joy, talking about how happy she was that she was officially one year cancer free. He had to tell her that her scans were absolutely riddled with cancer. Everywhere. He cried telling her and she comforted him.

In my field (Neuromuscular Medicine) the biggest pit in my stomach comes when I am doing an EMG for something otherwise non-concerning and it starts to look like ALS. I’ll catch myself going from talking and joking with the patient to not talking at all and adding on more body parts to the test, which tends to confuse the patient. For example I’ll be checking the leg for weakness with pulling the toes up and I’ll then have to test the arm, muscles by the spine in the back, and sometimes the tongue.

When the patient asks why I am testing so many body parts, I have to tell them that I’m concerned about a disease that impacts the nerves that move the muscles. I try not to use the word “ALS” at this time because more confirmatory testing needs to take place before confirming a diagnosis.

It reminds me of a quote that I won’t get exactly right but you’ll get the idea.

“Each physician carries with them a tiny graveyard, where, every now and then, they go to pray.”

For anyone considering becoming a physician, please know that you’ll care so deeply about so many people while being told by the public that you do not. This job was absolutely the right choice for me, but cases like this take a toll that will wash over you in your most private moments.

If my rambling comment resonates with any other healthcare providers, or anyone for that matter, please consider seeing a therapist. Many of us don’t recognize how much we are suppressing until we look inward.

Sorry for the long comment that got off track a bit. Please take care of yourselves.

Term stillbirth.

There’s never a good way to tell someone their baby [passed away] before it could even be born. No combination of words makes the delivery any easier. And you know when you see there’s no heartbeat on the ultrasound. You scan again because you gaslight yourself into hoping you’re wrong, even though you’re not new to scanning babies and the heart is obviously not moving. You add color flow to prove to yourself that what you’re seeing is the truth. And then you have to say it even though everyone in the room knows it. It’s not official until you say the words.

Those screaming sobs will always stay with me.

Healthy kid has some new minor neurological symptom (tremor, headache, poor balance) and MRI shows big, huge, bad brain tumor.

ED nurse here. I remember one time a patient was diagnosed with a dissecting abdominal aortic aneurysm; the MD told the patient he'd be rushed into surgery soon and to immediately settle any affairs and talk to his loved ones, as the likelihood of him not making it off the table was high.

It was just surreal seeing this guy talking to his wife and kids knowing it may be his last.

OR Scrub Nurse

STAT Necrotizing Fasciitis cases.

Flesh eating disease. Advancing faster than we can pump high dose antibiotics into them. We basically rush them in and cut away everything infected we can as fast as we can while racing the clock on the patient being too sick to be under anesthesia safely anymore. Pack with iodine and race to the icu. I’ve seen a doctor follow the stretcher still wrapping the packing while they took off out of the OR.

Not only does my stomach drop for the patient, but it’s just the most awful case in every way imaginable. From equipment to smell to clean up all the way to the other end of the spectrum of watching what is actually happening to another human in front of you. No matter what reason you got into medicine, it wasn’t for that feeling.

Patient with the same exact birthday as me, has a one year old in the waiting room, pregnant with her second, and I’m doing biopsies of her cancer, which was at least stage 3. So humbling and scary.

Non accidental trauma (NAT) in kids. I was taught during residency that if you have never diagnosed NAT, you aren’t looking hard enough. I think about those words a lot, and now I teach them to trainees.

Teenage girl came in, with only some trouble eating and other vague discomforts. Nothing serious. Doctor doesn't trust it and kind of by chance sends us her samples. My lab diagnoses her with a rare metabolic disorder. This has no cure, and her version means she will likely pass within a few years after symptoms start. Transplant from an uncle to extend her life got rejected. But it got worse: my lab tests the rest of the family as these are genetic diseases. 3 of the 4 daughters have the disease and will likely not make it through puberty. I didn't get the full details of the mutations but mom has a weird variant but she's fine, but the dad has a known late onset version. Combined, they are deadly during puberty, and dad will likely get sick soon and pass as well. 

In a few years, it will just be the mother and her one daughter, having lost everyone else as they slowly lose their bodily functions. 

From minor discomfort to losing your entire family. There were a lot of tears.

Bacterial meningitis. In the lab we are the first to see it. It’s very scary to think about how close someone could be to the end while you look at their spinal fluid on a slide.

Late teens patient diagnosed with inflammatory bowel disease but CT showed metastatic colon cancer.

Veterinarian here to mix up the just horribly depressing human stories with a hopeful one.

The worst ‘pit-in-your-stomach’ diagnosis for me used to be FIP. (Feline Infections Peritonitis) It is caused by corona viruses, but seems to be more due to viral interactions, not one specific causative agent so no vaccine was ever able to be developed successfully.

Horrible, slow disease that, until recently, was entirely incurable. And it usually, but not exclusively, hit young cats. I’m never going to forget the family with the 8 month old kitten who hadn’t even wanted a cat…but whose kids just fell in love with this kitten…and eventually wore the parents down only to learn like 3 months later that this new member of the family was going to [perish] slowly and painfully and the best thing we could do was offer to euthanize it now.

BUT I promised hope and uplifting…this disease now has a CURE! Turns out Remdesivir (and a couple of its related molecules) works GREAT on this disease, like 80-99% cure rate great. While Gilead won’t actually license any of the family of molecules, or produce a veterinary labeled medicine, thanks to Remdesivir hitting the market (and being largely not that helpful) for COVID-19, there are legal ways to get ahold of a cure now. AND, despite not licensing it, they’ve (tacitly at least) made no move to enforce their patent against compounding pharmacies making versions of the medicine commercially for use in cats.

There’s lots of times I’ve felt that sinking feeling…but the feelings I got from FIP cases a decade ago still top the list. So to get to watch a cure be developed and become more and more accessible has been a career highlight.

MD here.

Pronouncing kids d**d with their parents there.

Seeing an intoxicated man smiling while continuously vomiting pure blood from esophageal varices while trying to get a line in and he just dies right there sitting up.

Schizophrenic patient who tore her own eye out and swallowed it because it would help her “see inside herself”.

Obviously very advanced, previously undiagnosed cancer presenting to ED for anything. Feeling multiple golf ball and baseball sized lumps or an abdomen full of tumor is sobering.

Advanced cervical cancer in a pregnant patient. In a state with the most restrictive ban.

Patient came into the ED for difficulty finding her words. MRI after admission concerning for Creutzfeldt-Jakob disease, the human version of mad cow disease. Prion disorders scare the [hell] out of me.

18 year old kid was worried about an STD because his girlfriend found a lump. My stomach dropped when I examined him. Metastatic testicular cancer.

When I didn’t find a fetal heart beat on a patient at her 39 week prenatal appt. It’s happened twice in the last year. Full term fetal demise.

Specific to my field (occupational therapy) when patients get spinal cord injuries and plateau after improvements. It all looks like they’ll recover mobility but you know they won’t, but they still think they will.
Or when you get a post stroke and you know recovery is minimal but they think they’ll recover fine.

Im an ED nurse and was working triage one day. I had a lovely 22 year old lady come in who had given birth to her first child 3 months prior. She had a large, non-painful lump come up on her chest overnight. I knew it was cancer. I checked her chart the next week, and sure enough she was diagnosed with metastatic cancer, it was so far along that they couldn't find the primary. Poor thing. 22 years old and a brand new mother. I couldn't bring myself to check her chart again.