John knew the pain was wrong. Yet with his stoic Midwestern roots, it took a month of constant chest pain to express concern to me, his wife. He had lived with reflux for decades, but this was different. “Could you order a chest x-ray for me? Maybe I broke a rib.” Only a couple of orthopedic surgeons would put that first on the differential.
When I reviewed the chest film, a memory from my medicine rotation surfaced: a dark room in the bowels of Massachusetts General Hospital, meeting every week for the entire rotation with an elderly radiologist who reviewed stacks of chest films with our small group of third-year students. But fear blinds. “There’s something there,” I warned my husband. “You’re so run down you’ve probably got walking pneumonia! Let’s see what your internist says.” His internist didn’t share my blind spot. “Get a CT scan first thing tomorrow morning.”
Page AE. Stopping Time. JAMA. 2015;314(1):27-28. doi:10.1001/jama.2015.1674