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A doctor can no more afford to ignore clues provided by his patient, than a homicide detective can fail to dust the crime scene for fingerprints. The best internists would undoubtedly make great detectives. When the body provides clues that something is not working properly, the doctor must follow the clues until he diagnoses the cause of the troubling symptom.

In fairness to physicians, the task is not always as easy as it might sound. Symptoms that can be caused by a passing bug, may also be caused by a serious illness. Doctors who truly fail their patients, though, usually ignore an alarming symptom, multiple suspicious symptoms, or recurrent or persistent symptoms. A case reported in this week’s Massachusetts Lawyers Weekly, illustrates the point. A patient died of metastatic colon cancer, despite complaining of blood in his stool for six years. By the time a colonoscopy was conducted, the tumor had become large and untreatable. Colon cancers are usually slow-growing, and eminently treatable if diagnosed soon enough. While colonoscopies for screening purposes are now called for only once every ten years, a prompt colonoscopy may be required if a patient presents to his doctor with unexplained symptoms that could be caused by a tumor in the colon.

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