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Message from the CEO

Embracing complexity

Where do you go when no one can figure out what’s wrong with you?

The Emory Special Diagnostic Services clinic is one of a handful of clinics in the country dedicated to working with patients harboring complex, vexing, and undiagnosed illnesses.

Christian Larsen

Christian Larsen
Dean, Emory School of Medicine
President, Emory Healthcare
Physicians Group

These medical mysteries are tackled by a broad team of experts, from pathologists to neurologists to geneticists, acting as “disease detectives.”

While Special Diagnostic Services was initially envisioned as a “rare disease clinic,” in practice most of the cases the team encounters are not rare at all, but common illnesses and conditions with atypical symptoms.

By the time patients arrive at the clinic, they have often been through several doctors and are discouraged. These complex cases can confound even the most experienced physicians. Clyde Partin, Emory’s own “Dr. House” who directs the special diagnostic team, calls the process “jousting with diagnostic demons.”

Part of what makes the clinic special is that, instead of traveling from one specialist to another over the course of months or even years, patients can come to one place where the focus is on them. “Our team devotes as much time as necessary to determine the source of the problem, although a conclusive diagnosis might remain elusive,” says Partin.

Clues emerge from spending time with the patients: asking detailed questions, listening closely, and observing carefully. Modern technology, such as advanced imaging and genomics, can augment the medical history and physical exam, but should never take its place. Asking about patients’ professions, families, where they grew up, what type of stress they have in their lives and how they handle it, is often as illuminating as any CT scan.

While brainstorming with colleagues can lead to creative problem solving, this isn’t something that happens only at Special Diagnostic Services.

Doctors and researchers across our enterprise are solving similar problems daily. They are uncovering rare genetic diseases, ferreting out tropical parasites, researching infectious diseases, helping athletes return to the field, and responding to unexpected trauma (such as pine tree impalement, as featured in this issue’s cover story) in heroic fashion.

Our patients, after all, aren’t “curious medical cases” to be solved but people with loved ones and busy lives to return to.

It is up to us to bring our collective knowledge, professional skills, and medical expertise to bear to help them do just that.

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