Let’s say that you’re sick enough to be admitted to a hospital in the U.S.

You’d feel somewhat assured knowing that you were in the hands of experts, that no stone would be left unturned in trying to find out what’s wrong with you and how to make you feel better.

But what happens when medical experts disagree on things?

I recently posted about a friend of mine, who has a mysterious illness that seems to defy categorization. He’s fortunate enough to have had the opportunity to consult with some of the country’s leading experts (in no fewer than four different cities!) regarding his condition.

After nearly a week in a Boston hospital failed to cinch a diagnosis, he even turned to the Web to solicit input and ideas from colleagues, readers, medical types, and the lay public (probably House fans).

A blog account of his hospital travails turned up a few obscure references from the medical literature (including one from a Korean medical journal) that have definitely had bearing on his clinical situation and what steps he should consider next.

After all the consultations and data gathering were complete, he had a crucial decision to make: Some of the doctors (like me) recommended that he undergo liver surgery (a “partial hepatectomy,” removal of the right lobe of his liver) to remove a non-cancerous growth (“hemangioma”) that appeared to be causing his daily fevers, night sweats, weight loss, and systemic inflammation.

“Appears” is a key word, because we just do not know to a usual degree of comfort that the liver growth has caused the symptoms. Usually hemangiomas are asymptomatic. At this point, it has become a game of statistical probabilities: It’s more likely than not that his symptoms are being caused by the growth, yet it’s entirely possible that the exhaustive workup he has undergone either missed or has yet to turn up the real underlying cause.

Other experts with whom he’s consulted think it’s not worth taking the risks of such a big and invasive operation, since

  1. it will keep him out of commission a few weeks, and
  2. it may not actually solve the underlying problem.

My friend has weighed the alternatives again and again, and has decided to take action. Understanding the inherent risk of a big operation, he prefers doing “something” to standing pat and hoping things will get better on their own. He wants and needs to overcome the state of inertia that he’s fallen into.

I’m keeping my fingers crossed that his surgery goes well and his symptoms clear up soon afterward.