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A Village of Doctors

During a regular physical two years ago, my internist offhandedly commented that he’d heard lung sarcoidosis can recur. I smiled to myself as I thought how strange he should mention that, exactly fifty years since my own diagnosis with the disease. I remembered its onset as if it were yesterday—bronchitis, Bell’s palsy, the painful bumps of erythema nodosum, general respiratory symptoms, and a positive skin test.

Fast-forward to late 2019, when I started having familiar bronchial symptoms. A trip to urgent care was followed by referrals to a pulmonologist, an internist, and an otolaryngologist. All offered somewhat related diagnoses, none sarcoidosis. In the mix were laryngitis, tracheitis, allergy, asthma, respiratory infection, bronchospasm, and laryngopharyngeal reflux. The treatments varied as well, and I needed letters for my employer, a long-term care facility, indicating that I was in treatment and not contagious. It was close to nine months before I started to feel like myself, especially since I also had reactions to the various prescribed medications.

In fact, the cure felt worse than the disease, but I trusted my doctors and in time began feeling better—except for some left-sided pain. My never-ending cough seemed to be its primary cause, but neither the pulmonologist nor the internist could find any reason for worry. The internist suggested it might be due to a slight muscle tear and would likely heal on its own.

All during this time, a colleague and friend was on hospice care, dying of cancer and suffering significant pain in his ribs. He thought a fall had caused his bone pain, but ultimately tests indicated that his gastrointestinal cancer had metastasized.

This is when uncertainty surfaced for me. Was my own side pain due to empathy with my friend’s pain? Or did I also have bone cancer? Would the pain get worse, since it was clearly not getting better, even after weeks of home quarantine following what ultimately proved to be a false positive COVID-19 diagnosis?

The next stop, I concluded, needed to be a visit to another trusted doctor—the orthopedist who’d arranged for my successful spinal surgery two years earlier.  This referral had made an incredibly positive difference in my daily life. But could something have gone awry at the surgical site to cause rib pain? 

Bottom line: A bone scan showed three fractured and healing ribs not visible on the orthopedist’s X-rays.

My uncertainty turned to relief. Some might say that it sometimes takes “a village of doctors” to achieve healing.

Frances Smalkowski
Monroe, Connecticut

 

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