In medical school and subsequent training, physicians are taught that taking a good clinical history is as vital as the knowledge needed for diagnosis—vital enough to set great doctors apart from good ones. Recently, that art of medical practice benefitted one particular patient, Maryjane, who presented to Konstantina Stankovic, MD, PhD, FACS, Chief of Otology and Neurotology at Massachusetts Eye and Ear (MEE), for unexplained hearing loss.
The patient, a mother of two from Indiana, was in town for her daughter’s audition, and had perused MEE specialists’ bios when prior physicians had been unable to correct her problem—which began with a summer swim five years ago. The patient felt a flutter in her ear, then a sudden diminishment of hearing after pressing on the ear. A parade of Indianapolis ear, nose, and throat (ENT) physicians had diagnosed sensorineural hearing loss, caused by nerve damage, but a melange of remedies failed to reach the problem—now accompanied by a relentless clicking in her ear.
With the Boston trip on the horizon, the bio of the lauded Dr. Konstantina Stankovic caught her eye. “Her résumé was unbelievable,” Maryjane says. “If anyone was going to know, she would.”
During her consultation, history-taking became key. Dr. Stankovic dug deeply into the day of Maryjane’s condition onset, and one key fact emerged: the fact that Maryjane had pressed on her wet ear to relieve the itching aligned with her hearing test, and an injury, not nerve-related, diagnosis. The creation of negative pressure as Maryjane moved her finger away, posited Dr. Stankovic, broke a bone in the eardrum. And the crunching sounds weren’t figments of her imagination, but rather bone fragments vibrating out of sync.
“All it took,” says Maryjane, who underwent surgery for the fracture, “was someone willing to listen to my history and figure it out.”
Read more in Boston Magazine.
Topics: Access to Care