Fear of Shadows

Are you afraid of your own shadow? Here’s a story for you.

Few days ago, a patient that I took care in the hospital last month, came for follow-up in our outpatient clinic.

She was hospitalized with pneumonia, and her course was complicated with fluid collection (pleural effusion) in the chest cavity around her lungs. I placed a chest tube to drain the fluid, and creamy, yucky (yucky? that’s a medical term!), purulent material came out, a condition called empyema. But even after a couple of days of hooking the chest tube to suction (like a vacuum cleaner), it did not drain completely. The fluid was so thick and was gel-like already. Thicker than condensed milk!

Finally, I consulted a thoracic surgeon, and our patient underwent surgery to evacuate the crap (crap? that’s another medical term!) and scrape clean the thoracic cavity, a surgery known as decortication. She made swift recovery thereafter and was eventually discharged home.

When I entered the examining room on her follow-up, I sensed anxiety on her face. I asked her if she still feels sick, but she denied it, and in fact she admits that she was really doing well. I told her that her chest x-ray, which was taken earlier that day, looks good and I was satisfied with her progress. To this she said: “But there’s still a large shadow in my chest. There must be still fluid there.”

Obviously she peeked on her chest x-ray, probably in the Radiology Department, prior to coming to our clinic. I was astounded by her remark, as I reviewed the x-ray myself. Are we looking at the same film? Does she know something that I don’t?

I then led her to the computer screen to review the digital film with her. She then pointed on the “shadow” in the middle of her chest x-ray, that was causing her concern.

I tried to contain my smile as I reassured her that the “shadow” was alright, because that shadow is her heart. “Then I am glad that shadow is there,” she declared, as she sheepishly laughed with relief.

We sometimes fear shadows, even our own, when we should be focusing in the light.

“No man sees his shadow who faces the sun.” – Danish proverb

* Chest x-rays were not from the actual patient