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So, here we go again. I came across another, random, person with a thyroid enlargement. And the endocrinologist in me would not let go!
I would not stay silent: What if the person does not know? What if they have a thyroid cancer hidden in that swelling?
This time, I was traveling.
In a previous post, last September, I talked about Doug, the medical student whom I taught few years ago, and during a simulated patient encounter I found a swelling in his thyroid.
Doug’s swelling turned out to be aggressive and metastatic thyroid cancer. Doug had no idea he had a thyroid swelling, although it was and grossly visible and so obvious to me.
Even his family were surprised. Doug’s explanation was that he never paid attention to his neck, though he would shave his beard regularly. And his family’s explanation was that Doug was so busy in his undergraduate program and then medical classes that they would not see him that often.
That is not unusual. People do not recognize gradual and subtle physical changes that occur before their eyes.
In the post I talked about the phenomenon of endocrinologists noticing people’s necks (their thyroid glands). Over the years, I have encountered multiple such examples. Here I was in a similar situation.
This time, I was returning home from the AACE annual meeting in Seattle. I was at Seattle airport, which was busy, likely because it is college graduation season.
As I was in the TSA long line, I noticed a thyroid swelling in the neck of a young woman who was four passengers behind me. When we U-turned into a new row, she and I would face each other. Her thyroid swelling stood out, and no endocrinologist would miss that!
I did not know what to do. Such a discussion would need time to explain, and I didn’t want to embarrass the young woman in line. I let it go, hoping that I could still catch her after we cleared security.
And it happened: We cleared security at the same time.
Before we departed the TSA area toward our gates, I stopped her. She was accompanied by a significant other, a man of a similar age, I guess they were in their mid-20s or so.
I talked to the man: “Folks, do you have a minute?”
They turned toward me. The man was a bit annoyed, and the women was surprised by my intrusion. The man said, “What do you want from us”?
I said, “I am sorry to bother, but I am a doctor, a thyroid specialist.”
At this time, both appeared a bit reassured and became more friendly.
I carried on, talking to the young woman: “I think you have a thyroid swelling. Are you aware of that?”
She smiled and said that she had had a goiter since childhood. Her doctor monitors it with regular ultrasounds and thyroid labs. She said she had no worrisome nodules or abnormal thyroid functions.
That was a relief for me!
They thanked me and made thumbs up signs, and we parted on our paths towards our different gates.
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