Robert A. Norman - Discover Magazines Vital Signs: True Tales of Medical Mysteries, Obscure Diseases, and Life-Saving Diagnoses

Copyright 2013 by Robert A. Norman

Introduction copyright 2013 by Corey S. Powell

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Library of Congress Cataloging-in-Publication Data

Norman, Robert A., 1955

Discover magazine's vital signs : true tales of medical mysteries, obscure diseases, and life-saving diagnoses/by Dr. Robert A. Norman.

pages cm

Includes bibliographical references.

ISBN 978-1-62636-173-7 (alk. paper)

1. Rare diseasesMiscellanea. 2. Diagnosis, Differential. 3. MedicineMiscellanea. I. Discover (Chicago, Ill.) II. Title. III. Title: Vital signs.

RC48.8.R68 2013

616.07'5dc23

2013024615

Printed in the United States of America

Many thanks to Corey Powell, Eric Powell, Steve George, Sarah Richardson, and all the editors and assistants at Discover I have worked with over the last fifteen years. Great appreciation goes out to Bill Wolfsthal, Wesley Jacques, Emily Houlihan, and all the staff at Skyhorse Publishing. Rita Rosenkranz, my super agent, helped me every step along the way to bring the book to fruition. Thanks to Tony Dajer for taking the time to read the book and provide comments. A special thanks to all the contributing writers who witnessed the birth of each of their stories and took the time to craft this fine collection. Much love to my family, friends, patients, and to all those that help fuel my creative energy and learning.

Note: The cases described in Vital Signs are true stories, but the authors have changed some details about the patients to protect their privacy.

TABLE OF CONTENTS

INTRODUCTION

By Corey S. Powell, editor at large and former editor in chief, Discover Magazine

For the patient, every trip to the doctor comes with a large dose of anxiety and intrigue. There is a fervent desire that whatever symptom prompted the visit has a perfectly benign causeor, if it is a routine checkup, to find out that there is no cause in action at all. There is an always-present fear buzzing around in the back of the head that there might be something wrong. And then, still deeper down, the urge to know: If there really is a serious medical problem, what is it, what causes it, and what can be done?

One of the revelations of this anthology, a collection of the best Vital Signs columns that have run in Discover Magazine, is that doctors experience that mix of anxiety and intrigue too. The desired end result is also the same, of course: diagnosis, treatment, andif possiblecure. But the path there is littered with obstacles, both personal and scientific. Patients are not always clear in describing their symptoms. Sometimes they lie, omit information, or fixate on extraneous or even imaginary details. Even accurate reporting can lead to an ambiguous diagnosis, and even a definitive diagnosis can lead to wrenching decisions about the best treatment.

Another revelation here is that these forty case studies are just plain great reads. Anxiety and intrigue are not just inevitable aspects of the doctor-patient interaction; they are also the essential elements of a mystery tale. So yes, each of the chapters in this anthology is a medical mystery, but they are also much more than that. They are character studies that examine the whole range of ways that people live and, in a few cases, how they die. They are meditations on the complementary processes of logic and intuition. They are pointillist-precise paintings of the ways that modern science seeks to control the biological processes that were once considered acts of fate.

And as you will soon see for yourself, these stories answer the question that many of us have wondered when looking at a doctors illegible scrawl on a prescription pad: Geez, can these people even write? Yes, they can, and with remarkable insight and lyricism. No wonder, then, that Vital Signs was consistently the most popular section in Discover . It is the only column that has run the entire sixteen years that Ive been with the magazine. It was the first column adapted to podcast and now the first column to inspire its own ebook.

Inevitably, you will bring some personal experiences along with you as you read these intensely human, personal episodes. I certainly did. The first things I recalled were two major health problems of mine that had concrete explanations. When I was eighteen, my shoulder erupted with a bumpy red rash that then continued in a line up my neck and onto the right side of my face. My physician took one glance and said, Oh yeah, youve got shingles. I got it at an unusually early age, in a slightly unconventional location, but the diagnosis was straightforward. (The treatment, at the time, was to sit and wait it out. Fortunately, medical research has advanced at least a little since then.) Likewise when I was thirty and noticed a strange flickering in the left-hand periphery of the vision in my right eye: detached retina. A retinal cryopexy put things right, with only minimal damage to my sight.

But even in my mostly healthy life I have run into less clear-cut cases. That scary, recurring twinge of pain on the left side of my chest? Not heart disease, according to my EKG. Stress, maybe, or muscle strain from tossing my young daughters into the air too enthusiastically. Those odd red spots on my chest and arms? Pityriasis rosea perhaps, cause not entirely clear, treatment subjectivebut at any rate, likely to go away after a few weeks. (It did.) And the peculiar dots, squiggles, and temporary subtle flutters that I occasionally notice in my vision? My retina specialist smiled reassuringly. Those are nonspecific visual anomalies, he said. Lots of people get them, theyre not diagnosable, and as long as they are transient, they are not serious.

Many different symptoms appear on the upcoming pages. Some of them will be familiar to you personally; all of them will in some way echo experiences you have heard about from friends, relatives, colleagues, or the inevitable medical-themed TV shows. Youll meet people who visit the doctor or show up in the hospital complaining of dizziness, fainting, paralysis, seizures, hazy vision, weight loss, ringing in the ears. Youll encounter a child who grows inattentive, a woman who develops inexplicable lesions on her face and scalp, and a man whose irritable personality escalates into something more troublesome. And you will run into those vague lumps and sore spots that can mean nothing, or everything.

The range of diagnoses that unravel from those symptoms is equally expansive, reflecting the incredible complexity of the human biological machine and the near-endless number of ways it can malfunction. As you would expect, many of the major maladies make an appearance here: diabetes, heart disease, multiple sclerosis, pneumonia, cancer. So do common forms of self-damage, such as the abuse of alcohol and recreational drugs.