The archive

Cases

Everything published so far. Cases that include clinical imagery are marked, and the images stay hidden until you open them.

MC-020Wilderness medicine

He stayed at Camp 4 to help another climber

Grade 4 frostbite, treatment 66 hours late, and he lost half of two toes.

MC-019Paediatric surgery

The operation removes the hairball, not the habit

Hair cannot be digested and cannot be pushed along, so it stays and builds for a year in silence.

MC-018Infectious disease

It does not eat flesh. It cuts off the blood.

Her IV antifungals were not working. The answer was to stop relying on the bloodstream entirely.

MC-017Dermatology

It looked like a virus. It was the medication.

He was taking lamotrigine. Much of the risk with that drug is in how fast the dose goes up.

MC-016Neurosurgery

The abscesses in his brain came from his teeth

The veins of the face have no valves. Nothing stops infection travelling the wrong way.

MC-015Paediatrics

The wound was cleaned. She still got tetanus.

She reached a hospital the same day. The one injection that would have prevented it was never given.

MC-014Hepatology

A vein that closed at birth, reopened fifty years later

Caput medusae is the visible detour. The one that kills is in the oesophagus.

MC-013Orthopaedics

A knee replacement does not replace the knee

About a centimetre comes off each surface. The rest of the operation follows from that.

MC-012Dermatology

Purple ears: the adulterant, not the drug

A net-shaped rash, collapsing neutrophils, and antibodies pointing two ways at once.

MC-011Transplant surgery

Twenty operations rebuilt his jaw. None gave him a face.

Reconstruction restores structure. A face is not structure. What the transplant cost him came seven years later.

MC-010Hand surgery

Replanting an arm: the clock, and the harder question

Six hours of viability, and a decision about whether to reattach a limb the patient removed himself.

MC-009Ophthalmic oncology

Retinoblastoma: the cancer a photo can catch

Over 95% survive when it is found early, around 40% when it is not. The tumour is the same.

MC-008Paediatric surgery

Parasitic twin: the twin with no heart

A second head with eyes and lips, and no circulation of its own. Waiting would have made her weaker, not safer.

MC-007Plastic surgery

Keloid vs hypertrophic scar: fifteen years untreated

Minor cuts to the jaw, no treatment available, and fifteen years for a scar to become a disability.

MC-006Contains imagery

Wooden foreign body on CT: the scan said gas

Wood reads as air on a scan. The clue that overturned the report was an infection that would not settle.

MC-005Emergency medicine

Viper bite coagulopathy: the scan that showed nothing

Three hours after the bite his blood could no longer clot. A normal ultrasound is what kept him out of theatre.

MC-004Urology, historical

Bladder stone surgery in 1824: the nail-and-hammer myth

No nail, no hammer. A blind operation inside a conscious man's bladder, and the first minimally invasive surgery.

MC-003Reconstructive surgery

Burn scar contracture: face healed to the chest

Ten months without a surgeon turned a survivable burn into a disfigurement that took twelve operations to reverse.