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Jordan Safirstein, MD Headshot

It Smells Like A Duck

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tb2.jpg There are a few old adages that every doctor has heard a million times. Old clichés like Sutton's Law ("Go where the money is"), "Don't chase zebras," and the Duck Prophecy, i..e. "If it walks like a duck, and sounds like a duck..." - you get the point.

As contrived as they sound, these worn-out tidbits are quite applicable on the floors of the hospital as it is easy to lose track of the forest through the trees. Comorbid illnesses, errant lab values, incomplete medical histories, and a slew of other variables can all contribute to making a relatively obvious diagnosis much less obvious.

So it is often helpful to keep those idioms in the back of one's head as you ask yourself why an immunocompromised patient with chronic kidney failure, diabetes, congestive heart failure, a depressed white blood cell count and a crappy chest x-ray has 2 days of cough and low-grade fever. The differential for those symptoms could fill a book but the answer is most often the simplest (Occam's Razor).

It is this philosophy of sticking to the basics that enabled our staffers to correctly predict that Andrew Speaker would have his diagnosis reclassified, would not require surgery, and would make the federal authorities and a great number of my readers realize what an enormous overreaction this was to a truly benign incident.

Today, it was revealed that the Atlanta attorney who stirred up the ire of the non-TB-having American public has a less-severe form of the disease than originally diagnosed, according to his doctors.

We are not saying 'we told you so' to all of those adamant and aggressive StopPagingMe.com Huff Post readers that chastised us and berated us, but you know what? Chicken butt. Hah! We got you again.

Now Mr. Speaker will complete his course of medications, take off his mask, return to a normal life and have a positive PPD for at least the next 10 years or so.

"In the future I hope they realize the terribly chilling effect they can have when they come after someone and their family on a personal level,'' Speaker said in a statement. "They can, in a few days, destroy an entire family's reputation, ability to make a living and good name.''

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