As physicians, we’re all aware of the frustrating “medical mystery.” These are the cases that initially look straight-forward, but then veer from the expected path when laboratory and/or imaging results fail to show the anticipated results. We do more digging, we sort through our text books, we perform internet searches. We reassess the patient; we comb through the history for something we’ve missed. Often, with diligence, we’ll find a piece of the puzzle that points us in the direction of a solution.
But what happens when that piece of the puzzle remains elusive? Where do we go? Most of us have a game plan for those cases that don’t seem to have any answers no matter where we turn. And often, our patients are satisfied with our attempts - even if no answer is found.
But what about the medical mystery that isn’t our patient – but the child of a friend or an acquaintance? What’s the best response when that friend asks for advice or an opinion? How much effort have you (or would you) expend in such a circumstance? I think that we’ve all expended some informal efforts regarding kids – an otoscopic evaluation here (a neighbor calls on a Sunday afternoon and wonders if a trip to the ER is warranted), a concussion assessment there (you’re at the playground and watch a child fall off the slide) – but what’s your comfort level regarding something that doesn’t seem to have an answer?
As with the mysteries mentioned above there many not be one specific answer (and certainly not a “right” or “wrong” response!), but I am interested in knowing your opinions when faced with this issue.