80 Medical Professionals Share The Diagnoses That Made Their Stomachs Drop

Harlequin disorder in a NICU baby and explaining to the parents that it does not go away. Don’t google it unless you’re okay with grotesque. Listening to the attending explain that there is no chance it will go away as mom stared off into space because Im sure it was all too much to take in shortly after an unplanned section. The way her eyes lost every bit of light was startling.

Patient discharged from the ER a couple days ago due to high blood pressure, readmitted for Bell's Palsy.

CT of the brain was negative for stroke.

I did his swallow eval. Oral stage was unremarkable...but he could not swallow anything no matter the texture or amount. Would start coughing, choking etc.

Bell's Palsy can affect the oral stage of swallow but never the pharyngeal stage. 

I told his nurse "I know his CT was negative but can we ask the attending for a stat MRI of the head, this definitely isn't Bell's Palsy."

The agreed. MRIs will show fresh strokes whereas it may take a few days to show up on a CT.

I was right. MRI showed he had a brainstem stroke, too fresh for the CT to pick up on.

I got a certificate and a biiiiig plate of cookies for my "Good Catch!" .

Necrotizing fasciitis. She went from walking to the bathroom under her own power while casually chatting about her pets to floridly septic and unconscious in about 30 minutes. She didn’t make it.

Huntingtons.

Kursed_Valeth:

I'll never forget the first the I was caring for a patient with Huntington's. It still haunts me. If it ever happens to me I'm going to take myself out before I lose myself.

Participating in a right pneumonectomy for necrosis on a 17 year old who had vaped for 2 years.

Five year old carried in through the ER doors by dad, in complete cardiac and respiratory standstill due to a ping pong ball stuck in his throat.

It was too late. So so sad.

Anytime I see pathological fractures, meaning fractures not caused by a fall or trauma but fractures that just happen. Especially if it’s in a femur.

9/10 it’s cancer that has metastasized to bone. The outlook is not great, and the pain is awful.

It wasn’t when I opened up the imaging for a “back pain” referral and saw a whole spine of cancer. What got me was when I loaded his screening chest CT from 7 months prior and saw the primary tumor on that scan, which was unnoticed. I had to tell an otherwise healthy active man I had never met that he had cancer, it had spread everywhere, he needed to go to the ER…*over video*.

I saw a patient for severe uncontrolled itch. I always order an SPEP as standard of care. It can be a clue that there’s underlying cancer, but I’ve never seen it be positive… until it was. I told the patient that one of the proteins was off, and it could very rarely be a sign of a serious underlying issue. She interrupted to ask if I thought she had cancer, and I said it’s possible. She looked devastated and said her uterine cancer must be back. Sure enough— she had no other signs, but her heme/onc said without this test, the cancer would have been caught at a more advanced age.

When I was in residency, I was rotating in peds ED. A kid came in for anemia. The blood counts came back and my attending went really quiet and then goes “aw frick”. She had critically low white blood cells and platelets as well as severe anemia. Multiple cell lines being low is usually a sign of bone marrow dysfunction, usually hematologic cancer. I still remember the grandma’s wailing in the hallway when she heard the news. I don’t know what the final diagnosis was but the attending was pretty sure leukemia.

Quite specifically it’s pancreatic cancer. There’s something like a 5% survival rate. And I’m not sure about reoccurrence after remission.

The pancreas is a unique little organ and any time it gets angry it goes scorched earth. Some of the things that make it unique help the cancer spread rapidly before it’s detected. After I became a nurse the first time someone I knew was diagnosed with this I just thought, clear as day “oh, he’s already d**d”. And I was so *mad* at everyone trying to push him into treatment and all of the “rah rah rah” of it. Because treatment would take the time he had and make it so much worse.

In my field - brief psychotic disorder or schizophreniform disorder. It doesn’t always happen, but often they convert to schizophrenia.

“I’ve had a sore spot on the side of my tongue for two months and it just isn’t going away”. It was squamous cell carcinoma, the patient was gone about 12 months later. The initial treatment actually went quite well apparently, but it metastasized.

I'm a nurse.

A good friend of mine was diagnosed with pancreatic cancer. As soon as he said the diagnosis, I knew it was likely in the late stages, and likely to be a terminal diagnosis.

30yo single mom with two kids and new onset ALS.

Anoxic brain injury in a teenager who took a few of their mom’s Percocets.

First time I saw cervical cancer. Placed a speculum to do a Pap smear and just immediately knew I was looking at very advanced cancer. There was nothing that remotely looked recognizable as cervix.

Placenta percreta. Nightmare fuel.

When I was a medical student, I did a sub-i in psych. I was seeing this pt who was the same age as me and in for psychosis. Turns out she had schizoaffective disorder, but she was in medical school during her first break and had to drop out. Her entire career as a physician was ruined because of it. She retained a lot of info from school too so she believed she was a surgeon / ER physician etc. Just hit reallly close to home. Not that I have a very extensive career or anything yet, but I think about her often.

I was an intern doing my OBGYN rotation. My sister’s childhood friend (female early 20s) came in as a patient, sent in from the ER for ascites. Imaging suggested ovarian cancer with peritoneal implants.

Definitely not the worst case I’ve seen, but it was a devastating diagnosis in someone I’d known for over a decade. She was d**d within a year.