Here are the 3 examples that make you wonder what are they are thinking while making the diagnosis?

Case 1

Just happen last week during my oncall, a man admitted with Chest pain and was diagnosed as heart attack. The problem is he was 24 hrs into the heart attack (yes, he is lucky because the damaged heart will holding on).

This man had chest pain on the monday the day before. He is seeing a locum GP and the Chap give  him some painkiller for the arm pain. I just wonder why this GP can ignore a complain of chest pain in a high risk ethnic group and with even a simple ECG. Obviously the GP is very focus after all this man was diagnosed of gouthy arthritis some months ago.


Case 2

This happened 2 year ago when I was in a Nephrology ward. And this gentleman was presented with end stage renal disease with all the signs of fluid overload in the body and symptoms of  tachypnoea.

This man having difficult of breathing for couple of months already and in fact he had been seeing a ENT. I was puzzled why this man seeing a ENT doctor, may he thinking breathing is from the nose. Well, the worst part is the ENT doctor actually that this gentleman sufferred from nose block!!!

A basic clinical examination may already determine the cause of difficult to breath, the crepitation sound at the lungs and the swellings of the both leg.

AND this remind me why is happened to my mom. My mom had a simple surgery of removing a infection lymph node and then was noted the wound was difficult to heal.

The doctor in charge could have easily diagnosed her for having a diabetes condition. Instead she was diagnosed after we bought her to see another general physician.