Shoot First and Ask Questions Later

My 72 year old mother went to the local clinic for a chest x-ray as a follow up for pneumonia. She seemed OK, not showing symptoms and having no particular cause for concern.

The x-ray came back showing her lungs were clear but the radiologist said there was “an irregular non-distinct swelling or mass in the liver.”

They recommended more tests, the next one was a CT scan of her abdomen. They said it showed the liver seemed OK, but now they saw something that looked like a concerning abnormality in her kidney.

That was diagnosed as a malignant tumor. I personally talked to the surgeon who said he was “100 percent certain” the tumor was malignant and she needed her kidney removed.

So he removed the kidney and it was sent off for analysis. When the results came back, the tumor was benign. There was no malignancy. My mother had lots of pain and was so worried, not to mention how much it all cost, all for nothing. And all because of a chest x-ray.

Comment from Dr. Neustatter:

This story reminds me of the joke about the three doctors duck hunting in a boat:

Hospital HallwayA bird flies over, and the first doctor, an internist, says, “Hmmm... It looks like a duck. It flies like a duck. It must be a duck.” But by then the duck was out of range. Another bird flies over. The second doctor, a surgeon, immediately raises his gun and fires, and the bird falls into the water. He turns to the third doctor, a pathologist, and says, “Go see if that was a duck.”
It's a joke about the impetuosity and lack of self-doubt of surgeons. And this sounds like the error in this horror story.

It also illustrates a potential downside of tests: it's pretty common to see “abnormalities,” and it can be tough deciding how far to keep pursuing them. Plus, false positives like this can cause a lot of undue complications.

As for advice, when you or a loved one are faced with the prospect of some drastic treatment like surgery or chemotherapy, get a second opinion.

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