This is a short but true story from the capital city of a good-sized country. Somewhere on the outskirts of this city, there lives a family with two little children, a boy and a girl. They have a huge garden to play in, and a two-seater electric toy car. Usually the girl drives -- because she is a year older.
Some weeks ago, the boy started coughing and his nose was running. When after two days the cough hadn't disappeared, the parents took him to emergency at the next hospital.
There, the staff took an x-ray. The emergency doctor saw "a small shadow," but she told the parents this was of no importance: "It's a cold. After some days it will be gone." The parents took the boy and a copy of the x-ray, and went home.
When after two days the cough had not disappeared the parents made a mistake. They wanted the best for their little boy; in this case they wanted the best pulmonologist in the country. They checked the list of "best doctors" and found a highly recommended expert professor; he even had a private office in their city, and they got an appointment for the next day.
The pulmonologist looked at the boy, then at the x-ray, and stated most likely the boy had a lung tumor. They should come back in some days for further examinations: a CT, an MRI, and perhaps a biopsy.
Torment for the parents
The next few days were pure hell for the parents. The nagging thought was that the little boy suffered from an incurable cancer; it would wreck all their hopes and plans for the family.
By the end of the week, the mother met a former neighbor, a retired female radiologist, at the supermarket. Crying, she told her the story of the little boy. The radiologist said: "That sounds strange to me. Lung cancer is extremely uncommon in children."
She accompanied the mother home and looked at the x-ray: "That's not a tumor. That's the thymus. The child has a cold, and the x-ray is normal."
She explained to the parents what a thymus is, and that because of its variability in shape, the interpretation of x-rays of young children requires years of experience. She didn't answer the question as to why the pulmonologist didn't come up with the correct diagnosis.
The cough receded after some days by itself. The parents slept well again, a heavy load taken off their minds. Perhaps they had learnt a lesson. The retired radiologist was happy she could help.
This story could be a fable like Aesop's; it's a tale that contains a message. However, I am not Aesop and you have to draw your own conclusions.
Dr. Peter Rinck, PhD, is a professor of diagnostic imaging and the president of the Council of the Round Table Foundation (TRTF) and European Magnetic Resonance Forum (EMRF).
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