Docs Said It Was Cancer; She Didn’t Believe Them, and She Was Right
— What a 60-year-old refugee taught me about skepticism of medical professionals
The public wants to believe in the profession of medicine. These beliefs are often justified. But not always.
For example, one day, a 60-year-old woman came to the ED for abdominal pain. A refugee from El Salvador, she was admitted to a team of doctors and medical students at a county hospital. The supervising attending physician on that team was an oncologist. He held a high position at the medical school that was affiliated with this hospital. (See link for full article)
There was also a “summary of the case” on that requisition. It said, “60-year-old with liver mass, suspect hepatocellular carcinoma.” When the pathologist read this, she assumed that she was looking for liver cancer.
Most pathologists do not review clinical records. Rather, they read the summaries of the case on the requisitions. This summary seemed straightforward — i.e., “suspect hepatocellular carcinoma.”
The pathologist took the biopsy sample, put it on slides, and looked at those slides with the bias of hepatocellular carcinoma in mind.
This woman never had cancer. Had she gotten chemotherapy she probably would have died. Treating a patient with chemo when they have a serious underlying infection would likely cause that infection to kill. But had she died in that manner, the doctors would have said that she died from liver cancer. No one would have known the truth.
Ends up she had amebiasis – a parasitic infection found in contaminated water which can migrate from the intestine to the liver, where it forms a cyst.
After being treated for the infection she improved.
Doctors are human and have biases. Never forget that.