Posted on 02/10/2014 11:13:06 AM PST by nickcarraway
If you're unlucky enough to be stricken with a rare medical condition, you'd better hope your doctor watches the right television show.
That was the lesson for one German man with severe heart failure and a puzzling mix of symptoms including fever, near blindness, near deafness, reflux and enlarged lymph nodes, which baffled doctors for months. All of the symptoms had appeared in the last year, after the man underwent a hip replacement to replace a faulty ceramic hip.
The 55-year-old man was diagnosed only when he was referred to Dr. Juergen Schaefer, a fan of the U.S. television medical drama, "House."
"After five minutes, I knew what was wrong," said Schaefer, who works at the Center for Undiagnosed Diseases in Marburg, north of Frankfurt.
He said the man's symptoms matched up almost perfectly with a patient on an episode in which the fictional Dr. Gregory House, played by British actor Hugh Laurie, identified cobalt poisoning as the cause. The series ended in 2012 after an eight-year run. Schaefer regularly uses the television series to teach medical students. When he saw the patient with heart failure in May 2012, he had recently prepared a lecture on the show's cobalt poisoning case, where House's future mother-in-law falls ill after receiving a faulty metal hip.
Though the German patient's previous doctors thought he needed a heart transplant, Schaefer and colleagues immediately tested his cobalt levels.
Schaefer said some small fragments of the ceramic hip remained and were grinding into the metal replacement, which leaked cobalt and chromium into the patient's bloodstream. Once the hip was replaced, the patient's heart got better and his other symptoms improved.
More health news: Morning Rounds with Dr. LaPook Schaefer and colleagues wrote about their experience in a case report published online Friday in the journal, Lancet. The patient wasn't identified.
"We would have diagnosed this even without Dr. House," Schaefer said. "You could have also typed his symptoms into Google and gotten the diagnosis."
He said doctors should be aware of possible cobalt poisoning in patients with metal hip replacements.
While Schaefer said he is sometimes referred to as the German Dr. House, he isn't sure the nickname is a compliment. The television doctor was known as much for his rude, abrasive manner as for his expertise in diagnosing rare ailments.
"I would have fired this guy after the first three episodes," Schaefer said. Still, he said the fictional doctor's appalling bedside manner was ultimately outweighed by his unparalleled diagnostic skills.
"It's important to be nice, but you don't get patients healthy just by being nice."
I was a big fan of the show, but I don't see how a guy who just tried various treatments until he got it right was a diagnostic expert.
“We would have diagnosed this even without Dr. House,” Schaefer said. “You could have also typed his symptoms into Google and gotten the diagnosis.”
With TV and Google, who needs medical school?
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This hip may have been one of a troubled type. Recalls & litigation are happening. His new ‘doctor’ should be ashamed.
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2960037-4/fulltext
Free registration at the link, or search for ‘cobalt hips’ and you’ll see not all is rosy on the medical manufacturing side of things...
He thought outside the box, which would be helpful if you have something weird and disgnosis-resistant. But remember the old saying “If you hear hoofbeats, think horses, not zebras”. Thinking outside the box, while entertaining for TV, if carried to extremes can hinder more than help. You have to be able to balance both.
In the 80s, I was in law school during the time the “LA Law” series was popular. I wouldn’t substitute it for Law School, but they actually did a pretty good job of bringing some cases that we studied to life, and getting the legal principle across.
I don’t mind someone getting insight from a tv show, assuming they follow it up with real research.
What always cracked me up about House was the panicked diagnosis and the urgency about treating it now! The patient will die!
When that didn’t work there was another panicky diagnosis and treatment that can’t wait for confirmatory testing.
Shotgun medicine at it’s best.
Heh - I thought for SURE it was going to be Lupus.
Well they only had an hour to find the cure.
...because the are tens of thousands of possible treatments...and getting it down to a handful is an accomplishment.
Leave out the snarky remarks and smoldery bedroom politics and you’d have the full 43 minutes for diagnosis, up from probably 20.
I suspect when Obamacare is fully implemented they’ll just be emailing my symptoms to some screenwriter for House...
If you contributed to Obama last election. If not, you get the blue pill.
I watched a couple of seasons, until it got to be too much of a soap opera. Did anyone else notice that most of the first season’s diagnoses were lifted from the book The Medical Detectives by Berton Roueche?
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