In anticipation of episode number 33 on oncologic emergencies, we have with us Dr. John Foote,

who's going to tell us his best case ever when it comes to oncologic emergencies.

Dr. Foot, let it rip.

Thank you, Anton.

My best case is something actually a case that I actually have a bit embarrassed about

because I

missed the diagnosis and somebody else made the diagnosis when this patient returned to a neighboring

emergency department. So the case in question was somebody I saw in my first year in practice

and in a busy community emergency hospital. The patient in question was a 35-year-old who came from home via ambulance with the chief

complaint of back pain and fatigue.

So I was already set up by the nurses and the paramedics who brought her in to sort of

be a bit cynical with this whole presentation.

Apparently this woman called the ambulance service

because of acute on chronic fatigue,

which was felt to be due to her fibromyalgia.

And she called the ambulance and actually walked down two flights of stairs

to open the door for the paramedics

and promptly got in the ambulance and was driven essentially

like a taxi to the emergency department. She had normal vital signs, a febrile, and looked a bit

thin, but there was nothing really remarkable about her. So when I went to see her and read all this

on the paramedics and nurses, I was already ready. They said, it was a real doozy for you.

So I went in there with a bit of a bias, that this was a bit of a waste of my time,

...