Wrong Diagnosis.

“I choose to begin with I am wrong because it is the hardest of the phrases to say and genuinely mean”. Richard DeVos starts his book Ten Powerful Phrases this way.  

I was reading this book today; he narrates some of his life experiences and lessons that he has learnt. The  phrase “I am wrong” is simple to write but difficult to say. To admit when you are truly mistaken is equally difficult.

I took care of a patient recently. He presented with right upper quadrant pain. His liver function panel was slightly abnormal but his pancreatic enzymes were quite erratic. I obtained a CT scan of the abdomen and a HIDA scan. Considering the clinical picture I was quite confident that this patient has pancreatitis due to gallstones, without common bile duct obstruction.

One of our gastroenterologist and a surgeon were on the case. The GI suggested an ERCP (study to evaluate pancreas and billiary duct), I was confident that ERCP was not needed and urged the surgeon to proceed with laproscopic removal of gall bladder.

During the surgery when surgeon performed a cholanagiogram she realized that there is indeed an obstruction of the billiary duct. Patient ultimately had to go through an ERCP the next day.

I saw the GI doctor the other day, initially I almost considered saying that it could have gone either way but instead I said “I was wrong!”. It takes an effort to accept you are mistaken.

On the other hand it is better to know when you are wrong rather than being wrong and not knowing about it.   

About the picture: I entered my room one day and found my daughters trying on my jackets.