Fear of Shadows

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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!

chest x-ray with left pleural effusion (the L indicates the left side)

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.

normal chest x-ray

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


  1. Very nice post re: good shadows 🙂 I learned new medterms today: yucky + crap! 🙂 Worked in healthcare before. I also remember when my one-year old had to get his chest x-ray when he had pneumonia. He wasn’t crying until I had to let go of him and he was placed in a test-tube like kinda thing 😦 They had to hold his arms up as they placed him in there. Quite traumatic. He fixed his gaze upon me as I started walking away; he started crying, as if I had betrayed his trust. Man, that hurt! Glad he’s okay now. But oh boy does this post bring back memories.

    At least, it made me smile in the end, when I read about the “shadow”, albeit the good shadow 🙂 Thanks for sharing.


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