Some doctors see pretty typical patients and carry out so many of the same procedures that it can seem boring. However, every once in a blue moon, they get the chance to happen upon very rare cases. Some are incredible, others are disturbing, but overall they can be pretty mind-boggling. These doctors share their most memorable cases on the job that made their patients truly one in a million.
All content has been edited for clarity.
"This was years ago. I saw a teenager (16 or 17) have a heart attack. This jacked athletic kid with eight-pack abs fell on the ground clutching his chest during basketball practice. Everyone in the pediatric ER thought it was a panic attack except for the adult ER resident who said, 'I’ve seen hundreds of heart attacks. He’s having a heart attack. Don’t ask me why, but that’s what this looks like.' And that’s what it was.
He had an inborn anomaly where one of coronary arteries coursed between the pulmonary artery and the aorta. During exercise, the aorta and pulmonary artery expand with the increased cardiac output and for whatever reason, that was the day that they squeezed a right coronary artery and caused a massive myocardial infarction.
It was bad news bears. The damage was so bad, the kid needed a heart transplant. He was transferred to a pediatric heart center. A left ventricular assist device (LVAD) was implanted because his heart function was so poor. A donor heart was found and as he was being prepared for surgery, his own heart decided to suddenly start working again. It turns out that hearts can heal after a massive heart attack (especially teenage hearts in athletic kids). This was only discovered after the advent of the LVAD because prior to that, nobody would live long enough to recover. At the time, I think this kid was like one of the first ten pediatric patients to get an LVAD at that hospital.
So the kid had to get his coronary artery re-implanted so that it wasn’t going to get squeezed like that again, but he got to keep his heart and I hear he recovered and returned to playing basketball."
"After a pretty uneventful pregnancy, a woman goes into labor, but it doesn't advance as quickly as it should so she gets a secondary Cesarean section. Standard procedure. The baby gets out and its eyeball is almost pressed out of the eye socket. Everybody is in shock, the parents start crying, we don't know what to do. It turns out the child had a huge tumor of the temporal lobe which pushed the eye out. We later analyzed the ultrasound pics and the tumor was already there so it just got overlooked. Brain tumors in neonates are even rarer than one in a million, it's actually 0.3 per million, so I hope I'll never see such a case again.
Unfortunately I don't know the outcome. The child was transferred to another hospital. But the prognosis is very bad due to multiple factors, such as small blood volume (even small bleeding during surgery can be fatal), difficulties with chemotherapy, and no possibility of radiotherapy. I don't know if there are any numbers though, since neonatal brain tumors are an extreme rarity."
"One of my patients nearly died of an amniotic embolism while she was in labor - it's so rare that the only way to diagnose it is by ruling pretty much everything else out first.
It's essentially when the amniotic fluid accidentally passes into the mom's blood stream. She went into cardiac arrest and we did CPR while doing an emergency c-section. She is slowly recovering, but has lost most of her brain function.
It is so incredibly rare, we ended up having a debrief conference at my hospital as a result to discuss the case. It was a little while ago, they aren't my patient anymore, but it's one of those cases that will stay with me for a long time."
"I'm not a doctor but a patient. I was born with a large vascular tumor in my right thigh around my right hip that caused my right femur to gradually die.
But my case wasn't one in a million but most likely one in 7 billion. Why? Being born with a tumor is very rare at about 0.3 in a million, plus it was vascular. It was very large at approximately 18x11x15cm (about 7.5 inches x 4.5 inches x 6 inches) and contained more than half my blood volume. Despite its size, it was not visible; there were no bulges, discoloration or any visible signs. This means it was embedded and striated in my muscles, and caused many lifetimes' worth of physical pain.
Fast forward to when I was 20 when they discovered I have osteonecrosis of my right femur. Essentially the blood supply to my femur got cut off and the bone started to die. I saw literally more than a hundred doctors and no one could figure out why I have it, why at such a young age, and what they struggled to understand was this never-before-seen co-morbidity. No scientific literature including case studies were available on cases even remotely like mine. My case was discussed by doctors worldwide and it was agreed upon to be most likely the first case in the world due to its sheer complexity.
In order to even begin treating the bone I had to have my tumor removed. I was scheduled for a surgery in mid 2017, was told it was 'just going to be a five-hour surgery' and that I'll be free from the tumor after this. They added that with any surgery some bleeding is to be expected which is frankly common sense, but that I didn't have to worry about it because they ran thorough blood tests on me and results did not indicate any abnormalities. I woke up four hours later and the surgeon told me they were not able to remove the tumor. After they cut me open and before they got anywhere close to my tumor, I started hemorrhaging and lost more than half my blood volume almost instantaneously. I just wouldn't clot at all and they didn't know why. I went into shock and almost died, at the age of 21.
Later I saw a hematologist to figure out what went wrong and she told me in her 30-year career she'd never seen a vascular tumor like this, AND such weird bleeding. She had to order a fairly rare blood test and it was determined that I have an extremely rare blood disorder found only in vascular tumors. Somehow the blood in my tumor spontaneously formed many clots (on a daily basis) and I ran out of clotting factors and platelets. Due to how isolated the tumor was they were not able to detect this abnormality with samples of blood taken from my flowing bloodstream.
I continued to deteriorate and there was no way to fix me. In January 2018, less than two weeks after my 22nd birthday, I was told I was dying and was given only a year to live. I had two options, one was to be content with the time I have left and do nothing, or risk everything entirely and opt for a surgery ASAP, but it involved a 90% mortality rate. Normally doctors won't operate if they know that there's a high chance the patient might die, but in my case not operating WILL kill me. They had to take any chances of survival no matter how slim. Got booked in for a surgery to try to remove the tumor. The nature of the surgery was the first of its kind, the first in my country with more than 10 surgeons involved. I was in there for 12 hours and was unconscious in the ICU for almost five days. Two muscles and 70% of the tumor were removed; now I have a huge dent in my right thigh, permanent nerve damage (I don't feel a thing) and other side effects from the surgery.
Despite everything, my doctor said that it's a miracle I'm alive. There are some aftereffects though. I suffer from severe PTSD, depression and anxiety, on top of my severe chronic pain. I have one last surgery for now, which is a total hip replacement (a common surgery but not at the age of 23) but with extra details like removing the dead part of my femur and dealing with my rare bleeding disorder. However due to the complexity of the case, my bleeding issues, and that the remaining 30% of the tumor that they were unable to remove happens to be the same part of the tumor that almost killed me, it's a tad bit different and I'll have more than three surgeons involved in the upcoming surgery."
"My father is an anesthetist. I remember his one in a million (way rarer actually) thing happen when I was like 13. He was knocking a patient out for the surgery, did the pre-op stuff, and the woman’s consultation showed no flags for anything major. She had a reaction, which can happen such as malignant hyperthermia, but this wasn’t that. Her reaction to the medication was where her own skin started to split and peel away from her body in large chunks, her own body was rejecting her skin.
The woman spent quite some time recovering. There was an investigation into the whole thing, but everything was done by the book and there was no reason for this to happen. The med company was contacted, and they had never heard or seen about this happening with any of the medicines. Multiple meds were taken and retested. This went on for a while. Turns out it was an allergic reaction to the medicine and it’s just the way it presented, it was so extremely rare no one had seen it with the medicine that has been in use for decades all over the world.
My father ended up writing a paper on it."
"I’m not a doctor but an RN. Before I was an RN, I was a patient care technician in the emergency department. I often worked closely with a specific doctor. She had a habit of thinking that there was always more to symptoms than there were, so no one ever took her seriously when she went digging. She especially paid close attention to pediatric patients, and ordered way more tests than any of the other ED physicians would have.
There was a 12-year-old boy who’s parents brought him in for suicidal and homicidal ideation. The child talked about how he hated himself, wanted to die, suddenly hated his parents and siblings and often thought of hurting them. He had no history before this of being mentally ill and it happened very suddenly (within a week his personality changed). His parents were absolutely certain that it was just him being a pre-teen, hormonal and unstable.
All the things he described were typical of a depressed and mentally disturbed pre-teen and none of us thought anything otherwise. We assumed he was suffering from mental illness. However, when the doctor spoke to him, he vaguely mentioned having frequent headaches and getting dizzy a lot. He and his parents also talked about how he had started complaining of nausea and would sometimes vomit for no apparent reason. She thought that he may have something organic and not just mental going on. She got a CT on his brain. I remember the nurses saying she was overreacting and that the kid should just have a psych consult and be hospitalized. I very distinctly remember people complaining about doing 'more work than necessary' on this child who was obviously just mentally disturbed.
It turns out, the kid actually had an atypical teratoid rhabdoid tumor (ATRT), which is INCREDIBLY rare — less than 1% of childhood brain tumors. The tumor had been there long enough to spread to his frontal lobe. On further questioning after he was diagnosed with the ATRT, the child had been complaining of dizziness, vomiting and headaches long before the personality changes, but it was attributed to him being overweight and having ADHD. It’s honestly amazing that the child lived long enough with this tumor for it to spreads so far, as it’s such an aggressive tumor and generally, children don’t live long with them, especially if they’re growing at that rate. It’s a rare brain tumor, and even more rare that a patient lives long enough for it to spread and cause personality changes.
I will never forget that a doctor always looked further into things than people thought 'necessary.' If any other doctor had been on that day, the kid would have been referred to psych, hospitalized in a psych institute and dead in weeks without his parents knowing it was all due to a tumor until after an autopsy. After a neuro consult, he was shipped to Boston’s Children for his brain surgery (one of the top places in the US for pediatric neurosurgeries), and he is alive to this day. He has to have therapies to help him learn how to live normally again, but if it weren’t for that specific doctor being on, he’d be dead right now. Eventually, he will live a normal and long, healthy life.
Later I found out that the doctor I spoke of had her reasons — in her residency, she missed two brain tumors on 'psych patients' because the attendings said it was just psych. That’s more than enough to make a difference and make someone say they need to look deeper on everyone.
That really taught me to respect a doctor’s knowledge more, especially if it seems like their intentions are good. Trust the physicians you work with and trust that they are ordering those extra tests not just to save their own rears, but because they want to save lives and are concerned about their patients."
"A coworker's son was born with hypoxic-ischemic encephalopathy. Basically the valve controlling blood flow to and from his mother while in utero failed, and he was born with 30% of the blood volume you're supposed to have. The EEG came back showing massive anomalies — little dude wasn't quite at the threshold of brain-death, but my coworker and his wife were told in no uncertain terms that he would never live off a ventilator, and it was pretty unlikely he'd ever open his eyes. The hospital persisted with treatment, though, and brought in a trauma team who worked on him for nearly a week, before three more weeks in the NICU trying to control the seizures and prop up his organ function.
Fast forward to yesterday, when the little dude made an appearance at a house party we threw. He's almost 2 years old, and is neurotypical — the guy walked up our treacherous back staircase by himself and was talking up a storm in a language no one knows. He was a big fan of our cat. His entire trauma team came to his first birthday party, because none of them would believe it without seeing it. His entire brain basically regenerated and rewired itself after he was on the verge of brain death. It's the most unbelievable thing I've ever seen. The guy basically won the Powerball a couple of times in the first two weeks of his life."
"I was told this by a doctor. Several doctors, actually. My brother suffered a TBI (traumatic brain injury) while in a terrible accident involving a Jeep that hit a curb, a tree, and flipped through a brick wall. He was life flighted, but fortunately this was in Houston, TX, which has one of the best medical centers in the world.
His entire face was crushed and crumbled beneath his skin. His skull fractured in many places and he bled profusely. After he was stabilized enough for emergency surgery, which was already a miracle in itself, he had his entire face reconstructed, as well as metal plates placed throughout his skull. He registered a < 3 on the Glasgow Scale, which is pretty much the worst possible score. It measures brain functionality after a brain injury or coma.
At first he couldn’t speak, and, after many many weeks, he finally began talking word salad. Stuff like, 'Triangle water.' Just nonsense words. Could not identify the names of his family or his girlfriend. While he was intubated there were many times his heart rate slowed to the point that we thought we would lose him and then raced to the same end; it was a rollercoaster. I would hold his hand and sing Beach Boys songs and things from our childhood while he was in a coma, and I could physically see the effect it would have on stabilizing him. That was like a miracle to me.
Flash forward a few years, he recovered to the point that he graduated with his masters degree in IO Psychology. He can walk, talk, laugh, read, study and has recovered so much that most people will never know about the brain injury he had a decade ago. He’s an even better musician now than he was before. The reconstructive surgeons did an amazing job with his face and his internal sinuses (which are mostly missing now). When new doctors see his chart for the first time, they all say the same thing — that they have never, in their many years of experience, seen a patient with such grave, life threatening injuries make such a significant recovery, much less the kind my brother made. One of the most decorated neurosurgeons in the field specifically told my brother that he was a walking miracle. He told me that he thinks about that still, every single day."
"I would say I have seen two cases of this. The first one was a dude who got stabbed in the chest. He arrived at the ER and had the knife moving with his heartbeat, but he was actually stable, in pain but stable. We got him to the OR, and to my surprise the knife went into the heart, but was about 1mm from going into the inner cavities, so he was saved by 1mm from probably dying.
The second one was a a young man who got shot in the back. He came in the ER with pain but very stable. He went to a CT scan, and the image was just incredible. It's not easy to explain without an image or if you're not used to seeing CT scans, but the bullet went in through his back. It missed the right kidney, liver, the spine, and ended between his aorta and cava. It was just the perfect trajectory to miss everything; 1 mm in every direction could have been fatal. I couldn't believe it."
"Not a doctor but an EMT. We had a wait and return with a patient for a CT scan at a local hospital. We picked him up at home, took him to his appointment, and then took him home. After we got him home, we had just put him in his hospital bed and his home phone rings. His wife makes no movement towards the phone but they have an older answering machine, one that you can hear the voicemail over the speaker as the person is leaving the message. At first I am not paying attention until I hear:
'This is Dr. [whatever his last name is], I just looked at his stat CT and it shows he as a 100% pneumothorax (collapsed lung) on his left side and a 40% pneumothorax on his right side. He needs to return to the hospital as soon as possible!'
I pick up the phone because his wife still hadn't made a move towards the phone and I answer introducing myself as 'Hi this is EMT [my name] with EMS. We just dropped him off from his appointment and we were about to leave until I heard this message.'
His doctors asks why EMS is there and I explain that we were the crew that took him to his appointment but we will load him back up and take him into the ER. I called my dispatch and informed them of the situation and that we are going back to the ER. My patient's oxygen saturation was at 96% (normal for him, I've transported him multiple times and this is his normal percentage), all vitals were almost text book. I tell my partner to get us to the hospital in a speedy manner, but don't hit the lights and sirens UNLESS I tell him otherwise. The hospital was only 7 miles away and we had just had snow and ice the night before, people don't seem to know how to drive and if we went lights and sirens we risk getting into an accident ourselves from sliding through an intersection, people hitting us, or people trying to stop near us and getting involved in an accident. My patient was calm and had good color and what people don't realize is when we hit those sirens, the patients in the back start to get more anxious, they breathe faster and in his case it may have exacerbated the problem. He was doing okay and I put him on O2 for precaution and we took him in.
In the five years I've worked EMS, I have never had a doc call while I was there with the patient saying they need to go in for something that was completely unrelated to the call that we had. I didn't listen to his lung sounds until I got the call because his vitals were normal, he sounded normal from every single time I've transported him in the past. This was a definitely a one in a million chance that our patient would have bilateral (both sides) Pneumothorax and we get the call while we are standing right there. I've never had a faster 911 call to, on scene time in my career.
We found out a couple weeks later when we went to transport him again for another doctors appointment that this is a chronic condition for him, that not even his home health nurses nor primary care physician knew anything about prior to that event. He is doing well and is stable. He is just monitored a little more closely now with respiratory."
"I inserted a urinary catheter into a female patient.
She complains of pain where the bladder is situated, and it was distended. There was no drainage per catheter.
When we pulled the catheter out, there it was - a worm which got stuck inside the tube.
HOW DID THE WORM ENTER THE BLADDER?"
"I’m an ultrasound tech.
I did a third trimester growth scan on a pregnant patient. The scan wasn’t necessarily indicated, but she had had a previous IUFD (baby died in the womb). The doctors wanted to give her peace of mind that everything was ok.
What I found was a baby with a belly full of fluid (hydrops). That’s very, very bad. The fluid was surrounding all the abdominal organs and the heart. There are a couple reasons why it can happen and the most likely one for this baby was a maternal infection. Our doctors sent the mother to MFM (maternal fetal medicine, specialists in high risk pregnancy care) and they gave the same diagnosis. Baby was not expected to survive.
The mother came back about two weeks later for a follow-up scan and the fluid around the baby was GONE. Totally normal scan. Normal looking baby. If the office had not happened to schedule this woman’s ultrasound for that day, we likely would never have known it had happened. None of the doctors or techs at my clinic have ever seen a case of hydrops spontaneously resolve like that."
"I was a paramedic and came to a scene where I had a patient who was talking to me, but he had NO blood pressure, and no detectable pulse. I couldn't even hear his heartbeat with a high quality stethoscope.
This patient was in bed, so I kept him completely horizontal and very gingerly transferred him to the gurney.
I really felt like an idiot calling the report into the ED. 'Patient is alert and oriented times three, BP is zero over zero, heart rate is zero... '
They dumped a few bags of fluid in him in the ED before they were barely able to get a BP on him.
He lived. I was worried he would code on the way to the ED, but apparently he was indestructible."