The Role of a Lifetime - A true but inexplicable incident in
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Sachit Sogani
The Role of a Lifetime - A true but inexplicable incident in medical history !

The silent killer. That’s what doctors call an abdominal aortic aneurysm (AAA).

The extremely dangerous condition—in which the main blood vessel shuttling blood to the abdomen, pelvis, and legs enlarges—can balloon up for years without any symptoms. But if the aneurysm bursts, it is often fatal.

Pretending to have this silent killer was Jim Malloy’s assignment as a “medical actor” one day in February 2013. Over the years, Jim, then a 75-year-old retired engineer, had faked all manner of medical maladies so that students at the University of Virginia School of Medicine could practice diagnosing him. Really, it was just a fun part-time retirement job.

When Ryan Jones, a third-year medical student, walked into the room, Jim followed his script for an AAA: He complained of light-?headedness and stomach pain. But when Ryan pushed down on the center of Jim’s abdomen, he was shocked to feel a pulsing mass—it appeared to be an actual aneurysm.

“I stepped quickly back, confused,” Ryan says. “I tried to get Mr. Malloy to break character and tell me that he knew he had an aneurysm. But he wouldn’t.”

Ryan’s attending physician told Jim that he should see a cardiologist, but it was hard for Jim to take seriously. “I didn’t think I had any symptoms,” Jim says. He felt totally fine, and he had gotten a clean bill of health from his primary care doctor two weeks earlier.

When he did get an ultrasound, it showed that his AAA measured six centimeters—with the potential to rupture. Doctors immediately scheduled surgery and inserted a stent to deflate the aneurysm, saving his life. “I had no idea anything was going on, and I would have just gone about my business,” Jim says. “I’d probably be dead.”

Ryan, who will start his residency in radiation oncology this year, agrees. “It was an amazing coincidence that he was volunteering for that case. If he had been pretending to have anything else, I wouldn’t have done that part of the exam, and I wouldn’t have found it,” Ryan says. “He was in the right place at the right time.”

Perhaps no one is more aware of this lifesaving good fortune than Jim’s wife, Louise. “Soon after Jim’s surgery, I met two women whose husbands bled out and died from an AAA,” she says. “We are so grateful to Ryan.”


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