Going to the doctor can be a stressful experience, especially when the patient is feeling awful and just wants to hear a diagnosis. But doctors are only people; they aren't perfect. That's why it can be important for patients to get a second opinion. Sometimes, those second opinions can save lives. Read on below to find out how some patients had close calls that were only redeemed by second opinions!
The Perks Of Being A Doctor
“Mid 30’s man walks into my office with what looks like a black eye and a broken blood vessel in the front of his left eye. He went to his primary and it was simply assumed that he got punched or hit or something, and he was dismissed. He was noted to have high blood pressure, but a script for medicine was written and a follow up in a few months. Gentleman comes in to see me to get another opinion on the matter and I look at him and immediately start the line of questions: How long has it been there, do you have a headache, and when you plug your ears with your fingers do you hear a ‘wooshing’ sound? He had a cavernous sinus fistula (an atypical connection between an artery in your neck and the system of veins in the rear of your eye). I sent him directly to the emergency room with his family of 4 in tow and he was in the operating room within an hour of arriving. Saved his eye and possibly his life that day.
The best news: He was a kitchen guy at my local diner which I frequent and they still treat me like royalty there when I come to eat. They all remember the time I saved one of theirs.”
The Baby’s Bleeding Cough
“When I was a 21 year old mom in the military, my 6 month old son was running a fever of 102, very lethargic, and barely eating. I took him to the base hospital ER at midnight where they told me he had a cold and to give him Tylenol to bring down the fever.
The next morning, his fever spiked to 105 and his coughs produced blood tinged mucus. I was panicking. Still in pajamas and house shoes, I rushed him to pediatric sick call. The smug women at the desk refused to let me sign him in because I wasn’t wearing my uniform. I LOST MY COOL! My child was laying in my arms limp and burning with fever, and these witches told me to take him to the same ER that was useless the night before. I cussed them six ways to Sunday, demanding that a doctor immediately come see my child. They actually threatened to have me court marshaled!
Then Captain Sims came around the corner, took one look at my boy, and immediately took us to a room. His O2 levels were between 90-95%. His lungs ‘sounded horrific,’ and his temp was still 105. He immediately put my boy on oxygen and had us transported to the university hospital.
After many tests and a week in the hospital, my son was diagnosed with acid reflux induced pneumonia – he was aspirating his stomach contents. He had to have breathing treatments the first three years of his life to mitigate the damage to his lungs, and had pneumonia again a year later, spending another week in the hospital.
He’s a healthy, happy 21 year old now, thanks to Captain Sims.”
A Tad Bit Eaten By Bacteria
“My grandmother had her hip replaced, but the hip always hurt to her. She waited a year, hoping it would go away but it never did. She asked multiple doctors and did multiple x-rays but doctors said the replaced hip was fine. We finally made her go to a private clinic in my hometown, and the doctor saw that the replaced hip was fine and dandy, but the bone around it looked like it was a tad bit eaten by bacteria.
So the new doc did an operation, and there was so much pus in the leg it was insane. If my grandmother waited any longer, her blood would become infected and she would have died.
Thank goodness she went to the clinic.”
Look At Your Patient
“I’m an Emergency Medicine Doc in the midwest USA. I had a patient that was transferred from rural nowhere to our tertiary care facility (big hospital with every specialist). Call was of really bad quality, but the transferring physician described a 21 year old male that had rapid heart rate and breathing rate, low blood pressure, low oxygen, confusion, and very opaque lungs on his chest x-ray on the right side. Diagnosed pneumonia. He gave him a ton of fluids, started antibiotics, put him on a ventilator, but he wasn’t getting better, and wanted to send him to us. Sure, send away.
An hour later the gentleman arrives, and looks young, fit, and not the type to just drop dead from pneumonia. We roll him onto our stretcher and find… A huge stab wound in his back.
The X-ray finding was his entire right chest full of blood. We put a tube in it, gave him back some blood, and he had to go for surgery to fix the bleeding.
Lesson: Look at your patient.”
The Growing Mass
“For 2 years, my friend had been going to her general practitioner complaining about migraines, bouts of severe vomiting, and dizzy spells. Every time, he would order bloodwork, then tell her she was fine.
One morning, she woke up, and after an intimate morning with her husband, could barely stand. She was so dizzy and had such a bad migraine. She told her husband not to worry, sent him to work and had her neighbor drive her to the emergency room. She doesn’t remember arriving.
When she got there, she started acting erratic. They had to sedate her, and sent her for a CT scan of her head. There, they noticed a huge mass in her brain. The hospital wasn’t equipped to deal with that, so they sent her by ambulance to the nearest hospital that could, a 4 hour drive away.
This hospital immediately sent her for an MRI. It wasn’t a mass. They could actually see the ‘mass’ growing as they did the MRI. No, she was having a massive stroke.
She was immediately taken in for surgery. They put in a stent, and had to remove most of the left side of her brain as it was all dead. Afterwards, she was in a coma for nearly 72 hours. They were uncertain if she would wake up, and if she did, if she would ever recover.
Thankfully, she did. It took almost a year of physical and speech therapy (among a few others), but she has made almost a complete recovery. They even had their first child 8 months ago.
Turns out, she had incredibly high cholesterol. With all the bloodwork that was done, her GP should have caught it. When she confronted him, he told her that her diagnosis was wrong. That she hadn’t had a stroke and had made it up. She went after his license.”
The Windows To The Tumor
“I’m an eye doctor and I once had a patient I had already seen several months before they came in for their visit, which often means something could be wrong. In this case, as it turns out, nothing was wrong with her by way of complaints, she just wanted to get updated before getting some new glasses. We decided to just run the regular gamut of tests anyway just because we might as well while she was there. She was a 50-year-old woman, fairly normal exam, perfect vision, retinas showed healthy, but something about her pupils really bothered me before I dilated. They were asymmetric, and the larger one reacted less robustly compared to the fellow eye. This was a marked change from her previous examinations where no pupillary defects were noted. We chatted about it and I asked her if she banged her head or anything weird and she said no, but suddenly reveals this crazy history of an old Meningioma (a type of tumorous brain growth) she had removed a few years ago. She had decided to omit this from her history with us as she didn’t feel it was important, but we went and put it into the charts anyway. Turns out she got a CT done two weeks prior to her exam with me which she says turns up completely normal. I tell her she should tell her doctor about this anyway just to cover our bases.
Fast forward: Patient shows up in my office ecstatic to tell me that my examination revealed that her tumor had returned with an incredible vengeance. She had no idea, was totally asymptomatic and the CT she had prior to me showed what was very literally the size of a spec of dust which the radiologist dismissed as ‘artifact.’ On her return to her doctor, they decided to re-run the CT to cover THEIR Bases, and they found a QUARTER SIZED TUMOR. Within two weeks, the tumor went from the size of a dust particle to a QUARTER. She was rushed into emergency surgery as the tumor was growing SUPER fast and was close to a blood vessel which could cause a massive stroke. She had it removed that day and returned to me after recovery to tell me of what got discovered as a result of my testing. She is now a long time regular patient I have been seeing for about 10 years.”
So How Many Roommates Do You Have?
“I’m a psychiatrist. One day, a 30 year-old man with mild depressive symptoms who was in-and-out of the hospital fairly quickly came in. He was under pressure from his home life, living with 4 roommates who were making it a bit difficult for him. No suicidal thoughts. He was cleared of all psycho-pathologies by me and two other doctors. A few months later he came back. Same symptoms, however this time he talked about 5 roommates. It felt wrong, and I dug into his story.
The patient talked, dressed and acted normally however after admitting him for a longer period, we noticed he talked with his ‘roommates’ often. He was single, no contact with his family and somehow working, however in a routine job with little to no personal contact. After a few talks, he also claimed other people’s thoughts were sometimes ‘thrown at him and sitting on his head,’ and he could thus read people’s minds against his will. The interesting thing about this patient was that his internal world somehow fitted the external world when asked – his roommates sounded perfectly plausible (they were not, for example, shadow-people, vikings, 12 m tall) and they teased him by hiding his stuff. But he ate with them, watched TV with them, so on. Normally a person with paranoid schizophrenia (paranoid meaning all types of delusions) will have multiple symptoms sometimes easy to see for the untrained eye. The patients can dress, talk and present themselves in odd ways, usually different from cultural norms. They can have incoherent speech, make up words and phrases or are clearly separated from reality (another patient of mine insisted that I was in jail for medicating him, even when we talked).
When we quickly ‘scan’ a patient for psychotic symptoms, we basically look for inconsistencies in the patients’ experience of the world – the patients normally know ‘something is wrong’ or ‘weird’ or ‘different,’ but often believe it is the world around them that has changed. This is due to discrepancy between what they experience (input), failed assessment of the inputs (due to the thinking disorder) and testing hypothesis based on failed assessments which collide with the real world. This will activate defense mechanisms: denial, wild explanations, accepting both ‘realities’ at the same time, and so on. (e.g ‘I am not sick, my doctor must be a bad guy, bad guys are in jail, my doctor is in jail, but my doctor is sitting right in front of me at the same time, he must have an identical twin or this is an alternate reality’). This is usually the way delusions are made.
So, I tried to contact his roommates. He lived alone and was severely psychotic. I have no idea to this day how he hid it so well from everyone. This patient managed to live in a subjective psychotic world that just fitted so well with the objective reality that he tricked several psychiatrists including myself.”
Just Stay Out Of The Sun
“In 2002, I started vomiting everything I ingested. About that time, my hands and feet became darker in color. I had no insurance, but my mom paid for me to see my family doctor.
For two years, he would give me nausea medicine and cautioned me to stay out of the sun. The darkened color of my feet and hands travelled toward my torso and I began to lose weight at an alarming rate.
On January 3, 2004, my friends picked me up off my bathroom floor and took me to a the emergency room. I was 5’6” and weighed 100 pounds. I was severely anemic and suffering from malnutrition. The hospital admitted me and the next day a gastroenterologist visited me. After talking about all my stomach issues, I asked him why I was so dark. I showed him a picture taken several years before where my skin was Irish pale. He went home that night and did some research.
The next morning, he ordered blood work and told me I have Addison’s disease. AD is an adrenal insufficiency, if it is not treated, AD is fatal.
The doctor also told me I was within hours of dying. My friends saved my life that day.
Now, 16 years later I am getting along pretty well. I take steroids and a lot of other medications. My skin stopped bouncing back to its original color, so I look extremely tanned.
I am so thankful for that doctor who diagnosed a disease that nearly killed me. It will one day, but not today.”
When You’re Right You’re Right
“My dad (a pediatrician specializing in Neuro issues) was seeing one of his patients at the hospital when he got dragged into the newborn intensive care unit unexpectedly by a nurse who insisted a baby wasn’t well. The attending doc insisted the kid was fine and just tired from a difficult vacuum assist delivery. My dad could tell the baby wasn’t okay and managed to talk the parents into a brain scan. The NICU doc insisted my dad was nuts to the parents. Dad was right and the kid had a brain bleed and was rushed to surgery.
The baby would have died without the nurse bringing my dad in and the parents listening to him. As is, that extra time almost certainly cost brain function.”
It’s Just A Headache Squeezing The Brain Out Of Your Head
“I once went to my family doctor with the worst headache of my entire life. She dismissed it, telling me it was a tension headache and that I should take a Tylenol and lay down in a dark room.
Over the course of the next month, I saw her a total of 13 times, each time with worsening symptoms. First it was dizziness, then vomiting, then eventually I could no longer see out of my right eye. Every time she told me it was just a tension headache or a ‘weird migraine,’ gave me a prescription for pain killers and sent me on my way.
The final straw was when I was no longer able to walk properly. I would try to take a step, but all I could manage was this weird shuffle. She reluctantly agreed to send me to a neurologist.
The next day, I showed up at his office and was in there for less than a minute. He took one look in my eyes and immediately called an ambulance.
Turns out I had hydrocephalus (too much pressure inside my skull). My ventricles were 5x the size they were supposed to be, and my brain was literally being squeezed out of my head. Go figure!”
“I was 19 at the time (33 now), I felt sick for about a week, flu-like symptoms, didn’t want to eat, just felt bad all over. One day at work I feel a very uncomfortable cramp/tear in my abdomen, so I go to one of those 24 hour clinics. At this point, I’m slumped over, can’t stand up straight without an insane amount of pain, just generally uncomfortable and hating life. After a few hours at this clinic, they say, ‘You probably have kidney stones, go home, drink fluids, sleep it off.’ This seemed fine to me, I was ready to go home and listen to the doc, all was good. BUT my girlfriend at the time (didn’t last much longer than that) wasn’t a fan of this diagnosis and drove me to the E.R., against my wishes of course.
After a few minutes at the E.R., they determine my appendix has ruptured and I’m going septic. Apparently I was pretty lucky to not have died, though I did pick up bacterial pneumonia while in the hospital, so the recovery kinda sucked. Now I just have a crazy 6-7 inch scar on my belly to remind me to not avoid hospitals when I’m sick.”
Playing Game With The Kids
“I’m an ER nurse and I had a lady in for simple pneumonia. Her 13 year old son was getting bored, so I showed him some equipment. I connected a simple heart monitor to him and discovered he was in a complete heart block. I printed a strip and showed it to the doc. Hmmm…. We suddenly and unexpectedly got a cardiac patient.”
Danger In Sweden
“When I was 9 or 10, I started having swollen joints after a vacation in Sweden. The swelling would get really intense and weirdly switch from one joint to the next without a sensible pattern. After a while, I also started experiencing extreme fatigue and odd, red splotches appeared all over my skin. Next came the digestive problems, anything I ingested would just be vomited out a few minutes later. This situation worsened until I even started puking without having eaten anything at all. My parents were at a loss and obviously terrified since I was getting worse by the day.
We went to several doctors who all told us that it was nothing to worry about since I had a history of being allergic to mosquitos and bees and since we had been to Sweden, they thought it must have been the several stings I got there, causing a severe allergic reaction. My mom, fortunately, wasn’t satisfied with this diagnosis since everything they prescribed proved to not be helpful whatsoever. After a while (it felt like weeks) of being bedridden, feverish and in a nightmarish amount of pain, she found a doctor for me who specialized in auto immune diseases.
He diagnosed me and told my mom to get me admitted to a hospital right now. I don’t remember much since they put me on so many pain killers and I was asleep most of the time I was there, but the doctor told me that the disease had spread to some of my vital organs and that I could have died if my mom hadn’t brought me in that day. Thank you mom!”
Sometimes Inexperience Is A Good Thing
“I work in poison control. Had a call from a green, but very astute young doctor with a middle-aged female patient presenting with a vague 36-48 hour history of malaise, confusion, hypoxia (lack of oxygen) from hyperventilation, and hallucinations. On workup was noted to have pulmonary edema (lung fluid buildup), metabolic acidosis, acute kidney injury, sinus achy and raised liver proteins, suggestive of infection but no temperature. The initial diagnosis was sepsis.
This keen-eyed doctor, pretty fresh out of med school, decided to do a salicylate (or aspirin) level on this lady because the hyperventilation paired with metabolic acidosis and acute kidney injury was enough to prompt her suspicions of aspirin poisoning, even though they could just as easily be explained by sepsis as well.
The level came back high. Not huge, but high, which prompted her to phone me for a second opinion on how relevant the finding was in terms of the patient’s clinical picture. Simultaneously, the patient’s family investigated the property and located numerous aspirin blister packs suggesting she had been dosing herself for chronic pain, which was present in the medical history.
Chronic salicylate poisoning is insidious and has been referred to as a ‘pseudosepsis’ in the medical literature as it often causes similar features. Comparing a high level in chronic poisoning to the same level in acute poisoning, features are much more severe in chronic poisoning (i.e. pulmonary edema, hypoxia, AKI etc) – there is a disparity. We recommended certain treatments (all hail sodium bicarbonate) and the patient made a full recovery after a 2 week hospital stay.
Whilst there was no question an infective cause was present and contributory, I was impressed with the green doctor’s intuition and willingness to consider other causes – I feel like it greatly improved the patient’s treatment.”
Doing Good Work
“At one of my practica placements, I conduct psychological evaluations for children and adults referred by the court system, typically following court-mandated removal. The referrals almost always ask for differential diagnoses and treatment recommendations. Many of the children have previous psychiatric diagnoses and are prescribed a slew of medications. In this sense, the psychological evaluation is a comprehensive ‘second opinion’ that requires me to sort through previous diagnoses, background information, and data from the assessments I administer.
I would say that the most common misdiagnoses that I see among children are Bipolar Disorder and Attention Deficit/Hyperactivity Disorder (ADHD). Often times when a child has a traumatic history (as many of my clients do), they exhibit signs of hypervigilance, avoidance, emotional dysregulation, and behavioral issues. The hypervigilence looks like the hyperactivity found in ADHD and the hypomania/mania in Bipolar Disorder. Emotional dysregulation and avoidance (e.g., social withdrawal) is easily mistaken for the depressive side of Bipolar Disorder and can also result in disruptive behaviors characteristic of ADHD. There are also some serious repercussions of prescribing children psychotropic medications to treat psychiatric disorders they do not have.
To answer the question directly, it’s rewarding when you have the opportunity to help clarify a child’s psychiatric diagnosis and ideally write treatment recommendations that improve their prognosis. I’m a fan of comprehensive second opinions, especially in the arena of mental health.”