The art, science, history, and process of differential diagnosis is fascinating to me. Although this blog is not meant to hone that skill per se, it reflects my interest in pattern-recognition, heuristics, and fun medical trivia. For those interested in a deeper methodological study of the DDX, there are many other textbooks, articles, and resources on this (I personally enjoyed reading Clinical Problem Solving by NEJM).
This project was inspired by one of my best teachers, Dr Andy Josephson of UCSF neurology who had a very similar set-up during our neuroscience block in the first year of medical school, about ten years ago. We all learn differently, and for me, it was a really sticky way of adhering the reams of knowledge we had to acquire to my brain. I began this blog as a way of active learning, to encourage myself to read UpToDate, collect images, and keep track of diseases I wanted to know more about. Indeed, over the last ten years, I've kept scraps of paper and email drafts containing lists of diseases, signs, symptoms, and syndromes that come up for patients I meet, lectures I attend, articles I read, and conversations I have. Some of the diseases still on the list that I wanted to write a Case of the Day on but didn't get to include: tinnitus, splenic vein thrombosis, percheron stroke, cavitary pulmonary nodules, CMV pneumonitis, IBS, isopropyl alcohol intoxication, MCA CVA (insular ribbon sign), basal ganglia CVA (comma sign), sterile pyuria, anaphylaxis, air embolism, compartment syndrome (abdominal and extremity), quinidine effect, bupropion overdose. I'm not sure where these come from; they're just culled over time.
I've learned an incredible amount from this blog, and I hope you have gained something too. I have such great appreciation for my readers. I've had about 350,000 pageviews, mostly from the U.S., but also Canada, France, India, Brazil, the UK, Ukraine, Australia, Algeria, and Israel. In these thousand medical mysteries, I procured 1127 pictures. My backup file of the entire blog contents is 1445 pages long (my answers document is 188 pages). I'm sure I spent at least several weeks of my life working on this project. It's been wild.
I've never been good at saying goodbye to things, but it's time for me to move onto other projects despite the time invested and momentum built here. I may go through the cases someday and make small adjustments or organizational changes. With time, some of the medical information here may become obsolete or change, but I hope it remains a useful resource for readers.
Thank you all for your time, your kind words, and your participation. It has meant a great deal to me. Please feel free to contact me (I will reply to any comments) and I wish you all the best in your futures.
Craig Chen MD