Friday, November 02, 2012
the black cat
many years ago during an inter-school debate, i heard one student taunt his opponent : my esteemed friend over there is confused, like he's in a dark room, looking for a black cat (pause) which isn't there.
looking back, it was a cynical comment & it sounded authoritative yet lacked substance. it's one of those phrases you bandied about just to impress the judges. much like a pick-up line.
a semblance of that statement was taught in med school. searching for a cause of an intra-abdominal infection can be difficult, hence "pus somewhere, pus nowhere, pus under the diaphragm." it just means that if you suspect pus in the abdomen, but you can't seem to find it, try looking under the diaphragm.
and no, i didn't learn any pick-up lines in the lecture halls either, but i digress.
so today, a 30yr-old lady presented with a lump in the groin. a biopsy of the tissue had been done & the lab reported it as metastatic cancer, which means this swelling in the groin (aka secondary tumour) is a result of the spread of a primary tumour.
this lady had been subjected to a battery of investigations to locate the offending growth - tests like gastroscopy, colonoscopy, ultrasound, CT scan, MRI & even a PET scan. but zilch! it's nowhere to be found. i can emphatise with her - it's an unnerving feeling that you know something sinister is growing in you & yet it remained elusive.
like the black cat.
running out of places to scan, & as if to grasp at straws, we did a scraping of the uterus & cervix today. just in case, because already we're at wit's end.
let's hope it's truly darkest before the dawn.