How medical mysteries can help us provide better healthcare

NOTE: This article is based on the interview between The Washington Post and Medical Reporter Sandra G.Boodman, which was posted on The Washington Post’s weekly Well+Being newsletter.

Everyone like good mysteries.

For 15 years, medical journalist Sandra G. Bodman has haunted the most bizarre, bizarre, and bizarre medical cases in her monthly medical series, Medical Mysteries. Recent news items have centered on a teen who was unable to wake up, a woman who was given the wrong diagnosis of ALS, and a family and visitor who were all sick with a peculiar flu-like sickness.

I contacted Sandra to learn more about her writing process and what we can take away from her.

Here is our edited conversation.

Q: How do you choose your ideas?

a: It must be something I didn’t write about. It should be a solved case. I need to know the final diagnosis. Although it is a solved case, there must be a mystery. And there must be a human story.

Q: Once you choose a case, how do you report it?

a: I ask for a chronology of events and medical records confirming the diagnosis. The medical records and chronology enabled me to see whether this was indeed a mystery and whether it was revealed in an exciting way. Would this be an interesting case?

Then I interview the patient, sometimes the parent, sometimes the spouse. The final step is to talk to the doctor who diagnosed you or your current treating doctor. At any step along the way, the process can fail.

Q: Do you write about unresolved issues?

a. No, it should be a solved case. So many people write to me and say, “I have this problem, can you help me?” Unfortunately, that’s not what I do. I once wrote about a Detroit lawyer who went into the Undiagnosed Diseases Program at the National Institutes of Health. He’s seen over 100 doctors and still doesn’t have an answer. But I thought his case was so unusual and interesting, I made an exception at that time.

Q: What are some of your most memorable medical mysteries?

a: I wrote about a family who kept suffering from frequent sore throats. They couldn’t figure it out. Share an adventurous vet. It turns out that their cat may have been the carrier. When they finally treated the cat, no one had streptococcus.

One of the strangest was a woman with severe kidney and heart problems. Turns out she was eating a lot of licorice. That was strange.

I still distinctly remember a State Department worker with a very itchy head at night. She even had a form of cancer. She has seen many dermatologists. Turns out she’s had head lice for a whole year. How did they miss that? That was really amazing.

Q: What did you learn about the medical system from writing about medical mysteries?

a. Medical care is becoming increasingly specialized. Doctors know a small part of what’s going on, but diagnosis is an inherently complex process. I also think time pressure is getting worse. It’s like: “You have 10 minutes. Go.” This will not work with a complex problem.

I also think patients are sometimes not very good at describing problems. Those who tend to perform the best are organized and can describe their symptoms in a way that is understandable to a physician.

Q: What is the best advice you would give patients for better medical care?

a. Primary care physicians can really help a patient. I often see people who go straight to the specialists. They may not have a primary care physician, or use urgent care when they are sick. It can be problematic. People really underestimate the role of a good primary care physician.

Conclusion

Through the interview with Medical Reporter Sandra G.Boodman, we know that medical mysteries can teach us more about getting better health care.

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