Hi everyone. We are so excited to launch a new segment on Core I Am called Gray Matters, especially since medicine is so rarely black and white.

We're hoping to create a space where people can bring cases that have been challenging,

whether it's from a management perspective or other pain points,

and really just give a space to talk about some of the nuances and give some deeper dives along the way.

So without further ado, I will leave you in the very trusted hands of Dr. Ali trainer and

Dr. Jason Freight.

Hey, Ali, I have been thinking, we spent so much time talking about diagnosis.

Which is wild because if I think of my week, maybe once a week I have a really perplexing differential

diagnosis, but mostly we're

spending our time making tough management decisions. So why don't we switch things up

this time? Welcome to Gray Matters, the podcast where we unpack how medical management is

rarely blacker way. I'm Jason Freed and I'm a hematologist at Beth Israel

Deaconess Medical Center and I'm Ali trainer and I'm a pulmonary and

critical care fellow at the Harvard Combined

program at Mass General and Beth Israel Deaconess.

So Ali, I know there's a case that's been weighing pretty heavily on you.

Yeah, I'm really grateful to be able to bring this case to gray matters and just to clarify before we start this is a pretty upsetting case and I did change some of the details

Yeah, so what happened? So we had this patient come in 64 year old old male, really not much in the way of

past medical history, just some hypertension in diabetes, and he came in because he

had leg swelling, fatigue, and anxiety. So we ordered an ultrasound in a CTA which showed he had both

dviette and a PE. But sure enough, his CT chest also caught the upper

portion of his liver which showed a mass. So he got a dedicated

...