Getting the diagnosis right

So this man can’t breathe; he feels like he’s drowning; he’s coughing and his chest is painful. At the hospital, doctors can’t find the source of his problem. He doesn’t appear to have an infection and has no fever. But an X-ray does show cloudy white patches over both lungs. The docs decide he has congestive heart failure and they begin treating him for that. But his coughing and chest pain continue. He decides to go to a big university hospital for a second opinion. There, the docs talk with one another about what this could be. One doc has an idea.

It turns out he is having an allergic reaction (pneumonia) to an antibiotic (Cubicin) he’s taking for an infection following knee surgery. The allergic reaction is caused by his own white blood cells, called eosinophils (don’t ask me how to pronounce it). Normally, these cells play a central role in defending our bodies against parasites, but sometimes they run amok. Diseases, such as asthma and eczema are caused by eosinophils overacting to environmental triggers and releasing an excess of chemicals such as histamines. Eosinophilic pneumonia can be triggered by medications, including non-steroidal-anti-inflammatories, such as Advil, and also by drugs of abuse such as cocaine. It can also be triggered by chemicals including cigarette smoke and sulfites. Who knew? I certainly didn’t.

The reasons I’m sharing this with you are these: I think it’s interesting; it shows how the delicate mechanisms in our bodies can be thrown out of whack; it shows the importance of information sharing—of asking others for help.

Speaking of getting help: it’s on the way. IBM’s Watson, the program that beat Ken Jennings in Jeopardy, is accumulating tons of medical data for making diagnoses. So far, according to Forbes, “Watson has analyzed 605,000 pieces of medical evidence, 2 million pages of text, 25,000 training cases and had the assist of 14,700 clinician hours fine-tuning its decision accuracy." Considering that one in twenty adults are misdiagnosed every year, I think Watson will be a terrific asset.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.