
Man saves wife’s sight by 3D printing her brain tumor - zaaaaz
http://makezine.com/magazine/hands-on-health-care/
======
jpmattia
> _Balzer used Photoshop to layer the new DICOM files on top of the old
> images, and realized that the tumor hadn’t grown at all — the radiologist
> had just measured from a different point on the image._

Think about the some of the implications of that statement for a while.

It really is no wonder that the softer sciences have a reproducibility
problem.

~~~
nhstanley
> It really is no wonder that the softer sciences have a reproducibility
> problem.

Even Further, I think it's also indicative of medicine being full of people
that have a fatalistic, passive attitude towards their patients and medical
care. Medicine and health is really hard, and so many health professionals
essentially believe that the only thing they can do is wait until something
horrible happens before doing anything. And as the case with this woman, when
something bad does happen, they bin it in their per-organized mental filing
cabinet and you're fucked if they're wrong. Much like police officers, I think
many get so jaded by the job that they can't be bothered to give a shit when
they really should. And I really hope technology will save us from this.

~~~
jkokenge
It seems that health care professionals don't have a nuanced problem solving
attitude. They make a diagnosis, see how this diagnosis fits into a
preconceived treatment bin, then just solve from that position without
understanding what's different, what's unique to each case. And, in their
defense, they probably just don't have the time for that extra work. That's
where I see technology as most useful....how to automate and make more
efficient the redundant parts so professionals can concentrate on the
important, unique parts to each patient's diagnosis.

~~~
tsax
I come from a long line of docs, though I'm a software dev. Let me tell you
that the vast majority of patients can easily be sorted into these pre-formed
category bins. Rare conditions are rare by definition. Most of medicine is
dreary repetition.

~~~
AceJohnny2
This ought to be highlighted, before people start an echo chamber of "doctor's
don't know what they're doing!" that ultimately undermines everyone (guess
what argument the anti-vaxxers use).

A string of anecdotes of "I double-checked and it turned out the doctor was
wrong" remains less than a trickle compared to the flood of patients doctors
have to deal with, and a tiny fraction of the hypochondriacs they must deal
with. Our medical system is broken enough without adding doubts on the
competence of its medical professionals.

By all means, people should double-check what the doctors say, but realize the
much worse consequences of sowing doubt.

~~~
DanBC
There are some useful questions patients can ask.

"What happens if we do nothing? If we do watchful waiting?"

"What happens if I don't take these meds?"

"How likely is that bad event? Tell me in terms of numbers per 10,000 people
rather than percentages".

~~~
Normati
Another useful one is to ask him to explain his reasoning.

If he can't justify his decisions, then he's probably using instinct which is
unreliable in the case of rare diseases, or he doesn't know how to diagnose
known diseases which means he's incompetent.

Some people are offended when you challenge them for reasons for their advice,
but I think that's because they aren't confident in it themselves or feel
superior. Doctors shouldn't be in either of those positions and should be
willing to tell you how they came to their conclusions.

~~~
amedstudent1
Whilst on the whole I agree with you, the amount of doctors I know that would
react (quite strongly) negatively to that is quite high, so anyone who takes
your advice should be prepared. The most common response I've seen to your
question was the doctor reminding the patient "there is always something
called a second opinion", a couple of times though I noticed them taking the
time to explain it.

------
mcmancini
I coauthored a paper a few years ago on the intra-observer variability of
measurements of brain tumors when using the bidimensional product. An increase
of 25% in the BP is taken as an indicator of brain tumor progression. We found
that the intra-observer variability is so high, you can get that 25% increase
purely by chance. The first recommendation of the medical team, to wait and
see, is understandable.

~~~
pjungwir
Having been to three ultrasounds for my children, I'm amazed how casually they
use a 2D length to estimate the baby's age, and therefore delivery date, and
therefore when it is overdue and calls for a cesarean, etc. Your results seem
like they confirm my suspicions that this can't possibly be very accurate.

~~~
Florin_Andrei
Or maybe you're seeing just a slice of a procedure with a more complex theory
behind it that you're not aware of.

Remember, being good at computers does not imply being good at medicine. This
should be self-evident, but just a quick perusal of some comments here shows
the contrary.

~~~
pjungwir
Yes, I completely agree. It's not like I'd take action on my doubts. I'm sorry
if my original comment sounded critical---that wasn't my point. But it _is_
crude, isn't it? I believe even doctors concede that these estimates are not
very accurate (especially when taken mid/late in the pregnancy), and it is
sort of alarming to watch a nurse snap lines across the skull cross-section
freehand and use those.

I find that in general with medicine my intuition battles against what my
intellect knows must be the case. It's not like anything in the body is far
away. Cancer isn't even very small. Isn't it weird that it's so hard to treat?
Obviously it must be, but it feels like it should be easy. The patient is a
foot away. We are inscrutably powerless.

When every day you command computers and they obey, when you can summon
distant people and their image appears before you, when you can instantly
consult more lore than in the greatest library, when you see people casually
toting radiant tablets of spellbinding powers, progress in medicine feels so
slow, so analog---so carnal. I know it's wrong, and we live in a world of
medical miracles, with vaccines and antibiotics and DNA and everything else,
but sometimes I can't help but feel that nothing has happened since Galen.
It's not an argument, it's a feeling, but one with pathos that I'm sure many
share.

------
Shinkei
Wow... I really hope I didn't get to this thread too late that this just gets
buried.

This is a classic example of hyperbolic reporting to try and show physicians
as some kind of incompetent lot whereas this 'guy working in his basement with
passion and talent' figured out how to hack the entire field of Medicine.

The fact is, nearly all Meningiomas are treated this way because they are
overwhelmingly benign and the surgery to remove them is not. If the woman had
lost her sight getting this surgery, then our Monday morning quarterbacking
would've been entirely different... or not even reported. Also, surgeons in
general SHOULD NOT improvise new techniques unless it's specifically warranted
because their skill is in their muscle memory and if you upset what would
otherwise be a routine craniotomy and turn it into something experimental, you
are risking the chance of running into an unexpected complication.

Granted, Radiology can be imprecise at measuring progression of tumors but
this is mostly because of inter-observer reliability, sampling errors, etc.
that could easily be mitigated by a software-side solution. In fact, there's a
lot of research into measuring lung tumors this way. However, issues related
to the FDA needing to approve all the diagnostic technology involved are why
these are not implemented more quickly--some nifty program to measure the
volume of a tumor would probably be against the law to use in a diagnostic
setting (IANAL though, I am a physician).

Edit: Another case in point, there is a great technique of placing a new
Aortic (heart) valve in place using a catheter from a small puncture in an
artery in the leg. This technique (seemingly paradoxically) has a GREATER risk
of morbidity to the patient than the open heart surgery approach. There are
many hypothesized reasons for this, but it is also a fact that the surgeons
are simply better trained in the older open technique and its complications.

~~~
alphaoverlord
I absolutely agree with Shinkei. I had a few more thoughts, but summarizing, I
worry that this is a case of an 1) incidentally found, 2) benign, 3)
asymptomatic, 4) slow or non-growing mass was removed despite the
recommendations of multiple neurologists and after fishing for a neurosurgeon
who was willing to cut it out.

The story starts with an accidental, incidental finding. The wife recently
underwent thyroid surgery, and the husband pressures the wife to get an MRI of
a different anatomical location when the patient feels well and did not have
any symptoms. This mass is an incidentaloma — something found on a fishing
expedition and not by looking for a particular cause to a problem. The
problems with such an approach are well described in this old New York Times
article, however the synopsis is such: When we look for problems with very
precise tests, we can always find something to intervene upon and see
something wrong. This is a problem well known in the statistics of screening
tests in that even very good laboratory tests have significant harms when
applied indiscriminately to everyone and everything. For people not in
medicine, this can be analogous to not adjusting in frequentist statistics
when one does multiple hypothesis testing and simply using one p-value of 0.05
to make decisions.

The article describes the management of a meningioma, of which the vast
majority of cases are entirely non-malignant, either non-growing or slow
growing, and asymptomatic (often only found on autopsy or incidental imaging).
The wikipedia article on meningiomas says this:

In a retrospective study on 43 patients, 63% of patients were found to have no
growth on follow-up, and the 37% found to have growth at an average of 4 mm /
year.[23] … In another study, clinical outcomes were compared for 213 patients
undergoing surgery vs. 351 patients under watchful observation.[24] Only 6% of
the conservatively treated patients developed symptoms later, while among the
surgically treated patients, 5.6% developed persistent morbid condition, and
9.4% developed surgery-related morbid condition.

The very fact that the article mentions the surgeon thought that a partial
resection of the mass was a success suggests that there was little to no
concern for malignancy. One does not try to take out only part of a malignant
neoplasm (with the potential to grow significantly) without offering
chemotherapy or radiation as adjunct therapy. In fact, I would rather argue
that the husband’s big triumph was realizing that the two MRIs had shown the
meningioma had little to no interval growth — and such a conclusion would
recommend against rapid, aggressive surgery.

From all appearances, the article suggests the wife did not have any symptoms.
She could have had the meningioma since birth — a harmless birthmark that was
hidden until she underwent a superflous but expensive and highly sensitive
imaging test. While it is true the meningioma is close to her eye, I would be
surprised if a surgeon could intraoperatively tell the progression of the mass
more than multiple MRI imaging studies. While it is true that there is always
a small risk that a meningioma will grow, the slow progression on MRI suggests
to me that symptoms would only slowly occur and there is a low likelihood that
she would ever need emergent surgery. Finally, surgical resection causes
inflammatory changes in the area which could exacerbate mass effects at the
site and there is a high chance that it would come back (particularly with a
partial resection).

[https://medium.com/@davidouyang/providing-optimal-
care-576ab...](https://medium.com/@davidouyang/providing-optimal-
care-576ab231e121)

~~~
mzs
We do not have all the details from that article. It might have been causing
headaches or double vision for example. Partial resection was likely very good
here. It's generally very slow growing. If it had grown to cause trouble later
nuclear surgery could have been a more appropriate option at that point. The
craniotomy approaches are what have those percentages you outlined, loss of
vision, smell, or taste, as well as difficulty with speech can be
complications depending on the approach used. Basically the brain has to be
moved away and that causes trauma to nerves as well as which facial muscles
need to be cut depending on the approach.

This new approach is intriguing. Expected anatomy would have a wrinkle of the
dura near there which should lead to relatively small risk of CSF leak
following micro surgery. This could prove to be a very good and more common
approach in fifty years.

------
makmanalp
This is an amazing story - and pretty much my worst nightmare. Not necessarily
cancer itself, but the feeling and anxiety that you're not being treated and
taken care of properly and that someone might be missing something. That
doctors are (rightfully) unable to pay proper attention to everyone and
everything just due to the sheer number of patients they must see. I know I'm
prone to hypochondria, and it doesn't help to read things like this.

I can't wait for a world where we can constantly monitor the body easily, and
abnormalities can be detected quickly and unequivocally, and even have
software that can aid doctors in diagnosing.

I've read articles where doctors approach such ideas with skepticism, saying
that more data isn't necessarily better, which surprises me very much. How can
you look at two data points on a curve and guess what the curve looks like?

Anyone else feel similarly?

\----

edit: I see false positives and the cost of dealing with them brought up often
in the replies - I think this is an issue exactly /because/ we suck so much at
diagnosis.

The argument that what you see may be wrong, therefore you must close your
eyes just blows my mind. So you'd rather base timely detection of true
positives on random chance?

Maybe if we saw these false positives much more often then we could observe
the false positives properly and know how to identify them and improve
diagnostics. Or maybe we'd be able to know better when intervening would be
more harmful than not intervening. That an intervention would be harmful
should not affect the choice to monitor.

And then there is also the issue of the diagnosis itself being potentially
harmful (full-body CTs etc) which is equally terrifying and even more
conflicting. We can also improve there too.

In any case, this was supposed to be more about the nondiagnosis anxiety, but
I'm not unhappy with where this discussion went.

~~~
drzaiusapelord
>That doctors are (rightfully) unable to pay proper attention to everyone and
everything just due to the sheer number of patients they must see.

Why are we excusing this? This is an allocation and resource problem.

Frankly, I never understood why I need to schedule an appointment with a
doctor and also visit a pharmacy to get drugs like anti-acids, allergy
medicine, short doses of painkillers, antibiotics, short doses of anti-anxiety
drugs, anti-depressants, etc. My doctor spends, what I imagine, most of his
time on trivial issues and I sympathize with those who have non-trivial
issues. It doesn't seem fair to them that they get the same 30 minutes I get
for my minor issues.

I think society needs to ask itself if we need a full-fledged doctor for many
of these tasks. The politics of healthcare are really ugly. Sorry, but a lot
of this level 1 stuff could be done by a non-expert. I should be able to just
buy these things. Or, at worst, pharmacists should be able to prescribe this
stuff. The system as-is is designed to maximize labor, thus billable hours,
for doctors. Its a mess when it comes to actually providing care.

I understand there's potential for abuse here but I kinda don't care. In my
society you have the freedom to stuff your face with Big Macs 3x a day, smoke,
become an alcoholic, and soon smoke pot all day. Those all have major risks
and are completely legal and mainstream. Yet when I want to heal myself,
suddenly the regulators, rent-seekers, and moralists come out of the woodwork.

~~~
webXL
Devil's advocate: one man's cure is another's demise. The vast majority of
people know how to regulate their consumption of those not-so-bad things, but
regulating their consumption of healing technology without understanding the
potential downsides is what the powers at be are concerned about.

But I generally agree with you, it is an allocation problem, and the best way
to allocate resources is removing arbitrary barriers to trade and promoting
specialization. We're overly concerned about what might kill us and hardly
concerned about improving the overall quality of our lives. The latter makes
the former easier to deal with, but the need to feel safe and taken care of
trumps freedom, I guess.

~~~
drzaiusapelord
I've had stomach trouble my whole life. It was a Big Deal for my uninsured
parents to get me Zantac. It involved a script from a specialist and paying
out the inflated cost at the pharmacy. This was done for my safety, afterall,
the industry and doctors were worried about risk, right? I'm just a dumb
patient. What could I know compared to the experts, right?

Zantac can now be gotten OTC for next to nothing. Its completely safe. There
was no patient risk for this drug. Same when I had to ask a doctor for
Claritin. It also is safe as an OTC drug now. Meanwhile, we have research that
shows that even a slight overdose of acetaminophen can seriously damage your
liver.

The whole system is about maximizing profits for healthcare. It has very
little to do with outcomes or patient safety. This is why so many people
aren't getting the care they need. The industry is too busy creating "make
work" for profits.

------
jepper
Interesting article, glad the operation was successful.

The most interesting part of the article is not the advance in technology
(nothing new, we've been using 3d prints as models for complicated fractures /
bone tumours or even custom prostheses for years (academic centre)) but the
low use rate of this technology by most hospitals.

The trick with overlaying follow-up scans is called image fusion and is easy
and can be done by one-click applications (for example
[http://www.blackfordanalysis.com/](http://www.blackfordanalysis.com/)) but
outside of lung noduli i know of little clinical use. I've seen these types of
mistake made before and trying to introduce it locally. Image fusion is also
an awesome surgical procedure analysis tool (both for research and clinical
applications), complimentary to the standard PA examination.

The patient education part is enormously helpful in practice. Cost per patient
is however still high quite high for large models. For example a cardiac tumor
model was printed with transparent plastic for around 500e. Our bone models
luckily are a lot cheaper (non-clear plastic). When the price comes down i
hope acceptance will improve.

~~~
jarvic
>The trick with overlaying follow-up scans is called image fusion and is easy
and can be done by one-click applications

Just wanted to point out that image fusion is far from easy. The brain is
easier than most areas of the body because the skull provides a good basis for
performing a registration, but even then the brain has some small room to
shift and you can't get a perfect alignment with only rigid transformations,
especially when you're dealing with tumors.

For most other parts of the body you have complications like organs shifting
around, gas passing through the digestive system, patients being in slightly
different orientations, etc. In these cases you most definitely need to use
some kind of deformable registration, which is far from a solved problem,
especially when you have things like tumors changing shape/size or even
appearing from nowhere from one scan to the next.

~~~
jepper
Yes it was a bit of a generalization, but i mean the practical use of the
tool. The technology behind it is wonderful! For my specialty its relatively
easy (bone being a rigid body). But this type of software already works quite
well for lung, liver etc. With careful manual alignment it can work for soft
tissue sarcoma (muscle) and other types of more movable tissue, providing a
quick overview. Volume measurement is also an option. But as you say its
always complimentary to standard workflow.

~~~
jarvic
Yeah, I wasn't trying to be disagreeable, just pointing out that this is a
very active area of research still, and there is always room for improvement.
I work mostly with segmentation and shape analysis instead of registration,
but I am involved with a project on multi-modal image fusion, which is even
harder (and more interesting).

~~~
tjradcliffe
I've done a lot of work on multi-modal registration and would be interested in
talking to you about this. It's an amazingly hard problem and I see a lot of
wheels being reinvented whenever I look at what other people are doing.

My own work has been mostly commercial and so under NDA or otherwise
unpublishable, but is primarily based on applications of the pseudo-
correlation algorithm (Radcliffe, Rajapakshe, Shalev, Medical Physics, vol.
21, No. 6, pp. 761 769, June 1994.) I can be reached at tradcliffe at
predictivepatterns.com if you're interested.

------
cafebeen
Great story--I think one thing to highlight is 3D Slicer (the publicly-funded
open source medical imaging tool used for all this):

[http://www.slicer.org](http://www.slicer.org)

More doctors should be using tools like this. Hopefully stories like this will
help to overcome the inertia in adoption.

------
swederik
Seems like I should probably use this thread to plug my startup. We are
building a web interface for simple 3D modeling from CT and MRI data
([https://www.prevuemedical.com/](https://www.prevuemedical.com/)).

Medical modeling software (e.g. Mimics by Materialise, Slicer) is mainly built
for biomedical engineers, rather than radiologists. Our goal is to be
Tinkercad to their Autocad. 3D Systems also offers Bespoke Modelling
([http://www.3dsystems.com/ja/solutions/services/bespoke-
model...](http://www.3dsystems.com/ja/solutions/services/bespoke-modeling))
but their emphasis is on visually appealing color models rather than accurate
tissue segmentation and anatomical reproduction.

We're really at a turning point for physical reproductions of anatomy. One-off
cases are turning up all over the world for various surgical planning/training
cases but it's not quite clear whether or not they improve outcomes. Some labs
and hospitals are doing good work but we need large patient trials to see if
physical models actually help reduce operating room time or recovery time.
With positive findings hopefully we will see dedicated insurance
reimbursements for surgical planning models. Maxillofacial applications are
way ahead in this sense.

One thing that's interesting is that the FDA considers 3D printed anatomical
models similar to hard copies of X-rays, and so they are not specifically
regulated yet. I expect the regulations to become more onerous, though.

------
Gurkenmaster
This makes me doubt the reliability of cancer diagnosis:

>They were understandably terrified, but neurologists who read the radiology
report seemed unconcerned, explaining that such masses were common among
women, and suggested Scott have it checked again in a year.

Yet at the end of the article they say

>if she had waited six months, she would have had severe, and possibly
permanent, degradation of her sight.

~~~
alexholehouse
> explaining that such masses were common among women, and suggested Scott
> have it checked again in a year.

I know this sounds insane, but menigiomas (which I'd guess is what the
neurologist suspected it was) are almost always benign and shockingly common -
many post-mortems find these guys just kind of hanging out in/around the
brain. The corollary is that any kind of cranial surgery has enormous risks.
Point being, if a doctor sees what appears to be a (surprisingly) common event
on a chart, they're not going to necessarily recommend further action other
than observation UNLESS there's a change to the patient (which, as kitbrennan
pointed out, almost certainly accompanied the "get it checked again in a
year").

------
Gatsky
I can't be sure from just a photo, but the I suggest that the procedure wasn't
completely without side effects. Her left eye is not symmetrical with the
right, and the left eyebrow is elevated. This could represent some degree of
peri-orbital muscle dysfunction due to the procedure damaging the nerves that
supply those muscles. This could improve with time, not sure how long after
the surgery this photo was taken. Even if it doesn't, you could say it is a
minor side effect compared to losing your vision, but as Shinkei and others
have pointed out, it isn't clear whether the vision was really in danger.
Takes some of the shine off I suppose...

------
graeham
This is a cool application, but 3D reconstruction of DICOM images isn't that
new. For example, there is the Mimics commercial package that is on version
17, and similar things are actually quite commonly used by radiologists. (see
[http://en.wikipedia.org/wiki/Mimics](http://en.wikipedia.org/wiki/Mimics))

Patient-specific surgery, and computer analysis in diagnosis and treatment is
going to be very big (I'm betting four years of my life in doing a PhD in the
field). Its always interesting when there is patient or family led efforts in
the field, but this kind of thing was cutting edge in research probably 10-15
years ago (I 3D printed aortic aneurysms as an undergrad in ~2009 for a
surgery planning project, and it wasn't a new thing then - example
[http://link.springer.com/article/10.1007/s100160010054](http://link.springer.com/article/10.1007/s100160010054)).

Its curious then why 3D printing for surgery planning hasn't become the
standard-of-care yet. My instinct is that we'll see more improvements to 3D
rendering, planning, and simulation on the computer, but a physical model is
not that additionally helpful to surgeons for most cases. Especially
considering increased cost and time compared to a computer model.

------
stcredzero
_> Scott’s recent thyroid surgery had taught them that getting the best care
requires being proactive and extremely well informed._

So, if you go to a manufacturer or a printer, and you can just leave your
order and be assured you'll get excellent service, this has tremendous value.
This is first rate service. It saves your mental energy and it might even save
you money in the long term. Now, if you go to a manufacturer or a printer, and
you know that you have to be informed and stay on top of them, you should know
that you are getting crappy service. At the very least, you should be getting
a discount of some kind for the hassle.

Healthcare in the US often means paying a lot for crappy service. It's even
worse than dealing with mediocre manufacturers or printers, because of market
distortions and lack of transparency in the system.

If anyone wants to help this doctor out with spreading the above message, this
might be a way to show off your chops as a web designer or a marketer. He's
local to the bay area and his website is here:
[http://www.truecostofhealthcare.org/](http://www.truecostofhealthcare.org/)

(Disclosure: He's my former PCP)

EDIT: On the other hand, it is a credit to the doctors involved, that they
welcomed the husband's input and expertise.

------
gadders
In a similar vein, the chap in this article 3d printed his kidney stone to
help surgeons:

[http://www.bbc.co.uk/news/uk-england-
hampshire-30801273](http://www.bbc.co.uk/news/uk-england-hampshire-30801273)

Ironically, he passed out due to the pain from his kidney stone when
presenting to surgeons on the benefits of 3d printing.

------
jeffbarr
My recommendation: If you ever have a CT scan, ask the imaging facility for a
copy of the data. Make an archival backup for posterity and then download some
free tools and spend some time exploring and learning about your own body.

The DICOM format is widespread and you can find plenty of tools with a quick
search.

~~~
wwweston
Wish this was not only widespread practice for imaging but _any_ medical test
data.

------
mililani
I'm wondering. Does anyone know if the tumor was cancerous or benign? They say
that a lot of women have this, so I'm thinking it's benign like an adenoma,
but in which further growth can cause later complications.

------
Flott
Wow. Amazing story. Moral of the story : If you can, ask for a second opinion!

~~~
agumonkey
Beware, my mother, dissatisfied with the first answer[1] asked for a second
one, the next doctor told her exactly what she wanted to hear[2] but
underestimated the risks. Massive internal bleeding during the operation =>
emergency decision => remove the whole organ. Like precogs, we may need a 3rd
opinion as arbiter.

[1] situation is very complex, probably need to remove part of an organ [2]
the he could fix the issue without ablation

le: simplification

~~~
Flott
Thanks for the reply. You're making a very valid point!

First : Sorry to ear what happened to your mother.

Doctors telling what we want to ear is also a problem! Mostly, I believe,
because when something like a brain tumor is threatening your life, you might
not want (and know) what is best for yourself. Doctors can be influenced by
their patients.

As you stated, the second opinion can be wrong and it is very hard for the
patient to know who to believe. I wish everybody could have a little help from
a friend with some photoshop & 3d printing skills!

~~~
agumonkey
Luckily, if I may say so, it wasn't that crippling, the damages were more
emotional. Waking up to this kind of news unprepared (and they completely
dismissed their lack of judgement, ha the sacred doctor) is a pretty big blow.

------
ck2
I've been skeptical about 3d printing's real uses and how it might be toy but
this sold me.

Great solution and ending. Hope it helps others too.

------
iwince
It's reassuring of the human condition that these two stick with it through
thick and thin. Charting a course to success even when the medical expert(s)
said otherwise.

------
paulrademacher
Redundant/distributed/crowd-sourced diagnoses? Instead of a single
radiologist, fan it out to many.

------
harisamin
This is truly amazing. Someone needs to fund this guy :)

------
_almosnow
What's alarming is that a guy in his spare time can come up with a better
diagnose than a 'certified professional'...

~~~
zeidrich
He had spare time, the doctor didn't.

~~~
SilasX
The doctor had _work_ time, and ostensibly an entire eduction specifically for
this job. The doctor was still at an (extreme) advantage.

------
stefantalpalaru
Alternate title: Man encourages his wife to go through unnecessary surgery for
a benign and symptomless meningioma after she had an unnecessarily complicated
thyroid removal in order to avoid a 4cm scar on her neck. Oh, he also made a
shitty 3D model of her skull in the process.

~~~
Karunamon
Did we read the same article?

 _The neurosurgeon discovered that the tumor was starting to entangle her
optic nerves, and told her that if she had waited six months, she would have
had severe, and possibly permanent, degradation of her sight._

Because I'd really like to think you're being this insensitive out of
ignorance, rather than malice.

~~~
Gatsky
I have to say that MRI is usually very good at detecting optic nerve
impingement, so this 'crucial' point which is reported third hand deserves
some skepticism.

~~~
Karunamon
Skepticism, or casting aspersions? The first is smart, the second is just jerk
behavior.

