The Lost Art Of Not Ordering A CAT Scan
She didn’t talk like a stroke victim. “I…I…I…k…kkk…can…can…can’t…t…t…t…talk.” She struggled with her words, struggling on early syllables, only to then spurt out full and correct words. “N…N…N…No.” Recognizing this unusual speech pattern, the neurologist Allan Ropper, author of Reaching Down the Rabbit Hole, expertly queried the patient and her loved ones, and determined she had just experienced a stressful break up with her boyfriend. “From the very first sounds out of her mouth,” Ropper writes, “I concluded that it is very unlikely that we are dealing with damage to her brain from a stroke, seizure, or any other acute problem.”
The residents [physicians-in-training] pushed for an emergency CT, also known as a CAT Scan. Ropper knew better and explained why they should slow down and rely on their clinical examination findings “but they feel the stroke issue has got time value,” Ropper writes. “They prevail, and she heads off to the floor to get a big dose of radiation.”
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