A Diagnostic Odyssey

The patient is lying sick in bed

The history we have not read

Nor laid a hand upon his head

Whatever shall we do?

Well, first we’ll order lots of tests.

STAT orders 24 x 7 to give it our best

Start with CBC, CRP, LFT and BMP

An ANA and hepatitis viruses A, B & C

Oh, what the heck, twice daily diffs and CMPs

And if the results don’t quite agree

We’ll blame the lab! Forget the fee!

We’ll start again with fiendish glee

And order them all repeatedly

We’ll culture urine, blood and stool.

Measure a lactate and the microbiome gene pool

Oops! Our patient is looking pale.

Why does he now appear so frail?

Have we made him too anemic?

Time to call blood bank for a hematinic

And if the patient shakes, gasps and cries.

A transfusion reaction workup would be wise

If he survives, then we should plan

To run a total body scan.

The report says there is a small lung mass

Surely, we cannot let that pass.

So, we’ll collect some fluid for cytology

And send more tissue to pathology

Then, to make our diagnosis more secure

A whole genome sequence we’ll procure

Now everyone can be completely sure

That the patient will respond to our million-dollar cure