Yesterday’s New York Times Magazine has an article, Full-Body Failure, about a young woman in New York who might have died if her doctors didn’t make a heroic effort to hunt down the right diagnosis for her.
Walerstein was a general internist, admired for his broad knowledge of medicine. If he didnâ€™t know the answer right off the bat, he was known to ask questions that would lead to the answer. And this young woman needed an answer, or she would die. Having examined the patient and her chart, Walerstein took a moment to step back and look for some kind of pattern buried in the chaotic assemblage of numbers and tests. Everyone else started with the bloody diarrhea. Maybe that was the wrong way to think about it. The fact that the patientâ€™s blood was not clotting made Walerstein think that her liver was no longer working â€” the liver makes most of the protein that causes blood to coagulate. So she had liver failure. And her red blood cells were being destroyed. That combination stirred something in his memory.
Eventually they found the diagnosis. But if they’d used SimulConsult’s decision support software tool, they would have found the answer easily, just from the information contained in the Times article.
I’m more impressed by a physician who uses appropriate technology to make a tough diagnosis in aÂ routine way rather than having to resort to heroics.June 18, 2007