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WWL: Medical Mysteries
Where We Live - with John Dankosky
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In this episode:

"In medicine, uncertainty is the water we swim in."  -Lisa Sanders,  M.D.


Episode Audio

48:56 minutes (23.49 MB)
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Coming up, Where We Live, Dr. Lisa Sanders joins us to talk about her new book, Every Patient Tells a Story: Medical Mysteries and the Art of Diagnosis.  Dr. Sanders writes the monthly column "Diagnosis" in the New York Times Magazine and is technical advisor for the TV series House, M.D.    We'll talk about those difficult cases where despite everything modern medicine has to offer, patients suffer from illnesses that elude certain diagnosis.  We'll go with Dr. Sanders to the front lines of medicine and inside the diagnostic process, a process that Sanders calls, "the most difficult and most important component of what physicians do."

Join the conversation--leave your questions and comments below.


*This program originally aired on August 13, 2009.

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Listener Email from Denise

I work in anatomic pathology laboratories. Just want to make a comment that Doctors today are missing out on significant learning potentials of autopsies.

The number of autopsies performed after a patient’s demise has dropped dramatically and this often leaves the patient’s Doctor with unanswered questions.

Listener Email from Ashley

I'm currently a student at Middlebury College. In January of 2008, I traveled for 5 weeks to Africa, visiting the countries of Malawi, Zambia, and South Africa. Though I was unaware immediately upon my return, I contracted a parasite that the CDC has only recently (within the past 2 months) confirmed to be a 'mycetoma; I did not even know that I was sick at first. After my body broke out into sores in September, 2008, however, I recognized that I had many symptoms that had become progressively worse since my travels. My parents, who are doctors in New York (my father at NYU, my mother with a private practice and on staff at Columbia) took me to several infectious disease doctors in the area, but no one listened to my symptoms because they were so strange (black hue of the skin, GI symptoms, muscle spasms...). I was passed off as having some type of 'delusional parasitosis'. Ultimately, I was forced to drop out of college for the rest of the semester and was motivated to look up medical research articles on my own to discover what I had. Finally I convinced my parents to read what I found, since I believed I had some type of internal mycotic infection and should be on a combination of bactrim and itraconazole. My parents (although neither are infectious disease specialists) thought the symptoms fit, and after consultation with doctors at the NIH and CDC, I was put on those two medications. The CDC also agreed to take my case to do antigen testing for the most potentially deadly organisms. I began treatment on January 1, 2009, and must continue the medicines until a year from when I started.

In light of my experience, I very much appreciate that you acknowledge how many doctors do not listen to their patients. If not for the fact that my parents listened to me, I might not be here.


Listener email from Fred

What is the % of correct diagnosis? given the time pressures on the Dr.s and the advances in modern medicine? How does a disease like Lyme, as covered in a recent WWL, manifest itself so differently in many different people? How has modern genetics play in diagnosis? medicines?

Listener email from Elizabeth

I love the show "House," but I get frustrated that as rare or strange the symptoms are, there IS always a diagnosis. This assumes that every possible disease or syndrome has already been discovered and named. I have three separate syndromes, none of them, thankfully, seem life threatening, but none has gotten a diagnosis either. I've been to dozens of doctors, some referred, some I went to independently. When are the "House" team going to discover their own disease and name it after themselves?