Mr. Joe Walken's Case Study: Pleural Effusion And Fluid

Pleural effusion/fluid 1 The next started as a classic and in the end taught so much more including that Peters was possibly a prestidigitator: 1.1 A lady had come to the ER with new shortness of breath, pleuritic pains in her right chest, some haemoptosis and a slight fever. 1.2 Previously she had been a well lady with seeming good health, weight steady, no hospitalizations, on no medications etc. 1.3 She had sat in a bus on a trip back from for Florida and likely for too long without getting up and moving around and 1.4 she then developed swelling and tenderness in her left leg and so a blood clot must have formed in a vein in that leg! 1.5 and then the new shortness of breath, pleuritic pains in her right chest, some haemoptosis
Joe Walken's case)! 3 Mary knew this would be a zinger for Peters and indeed starting with 1.1 through 1.7, he yawned, hummed, swore a little and final cried out: “The same old same old – always the same!” (i.e. pulmonary emboli from sitting around too much!) 4 Mary then jumped up and showed Peters the hand-written report from cytology saying that malignant cells had been found in that lady's pleural fluid!” 5 And without a word of lie and just after a short minute of reading the report, Peters said to the house staffers: “The report is wrong! Call the cytology department on the phone and tell them that they are wrong! And do it right now!” 6 Mary was shocked: a report was wrong and it seemed so obvious to the Chief! 7 and then, and again without a word of a lie, and while Mary was reaching for the phone, it rang. Mary picked up the receiver and it was the head of cytology and he wanted to talk to someone about this very case and the report on the pleural
9 Chief John Peters then stood up and asked if anyone had ever seen pleural fluid under a microscope and since no one had, he said that that was a shame and explained that the cells in pleural fluids are all very abnormal looking: many/most of them look just like cancer cells, but they aren't and so don't look at your own pleural fluid or that of any close friends &/or relatives because it can be quite scary! 10 Mark was there and he quoted the other Mark: Professor Mark M Ravitch and who had said: “A diagnosis may be based on the x-ray or the tissue section, but not on the