It can be challenging enough to diagnose a patient’s problem in the real world — just imagine how much more difficult it would be in a comic book world where magic, mutant abilities, aliens, advanced technology, and psychic powers all exist. Here are a handful of actual comic book medical cases -- are your diagnostic skills up to the task?
The patient is 13 year old girl who is very bright and generally does extremely well academically. For the past week she has been sent home repeatedly from school with bad headaches. There is no prior history of headaches. There are no associated symptoms. The headaches resolve with rest in a dark room; over-the-counter medication offers little relief. Of note, there is increased stress at home with her parents frequently discussing divorce.
This patient has:- Migraine headaches
- Tension headaches
- Chronic Daily Headaches
- Somatization related to stress avoidance
- The emergence of a mutant power
The patient is a fifty year-old man who complains of several minutes of "blacking out." He does not recall fainting or falling, but there are several minutes that he cannot remember. He denies any recent head trauma. He had a high stress job and smokes at least 2 packs of cigarettes per day. He has a known history of cardiovascular disease including a severe heart attack within the past few years.
The most likely cause of this patient’s complaint is:- Transient Ischemic Attack (a "mini-stroke")
- Heart arrhythmia
- Vasovagal response (a "fainting spell")
- Brief amnesia related to psychological stress
- Possession by a ghost
The patient is a 16 year-old male, previously healthy, who complains of sudden onset of severe hair loss. Examination of the scalp reveals smooth skin. No hairs, including broken hairs or exclamation point hairs, are seen. There is no scar tissue. He denies any tingling, numbness, or pain of the scalp. A KOH skin scraping is negative. The patient denies any family history of similar conditions.
The most likely cause of this patient’s condition is:- Alopecia areata
- Trichotillomania
- Exposure to chemical fumes
- Tinea capitis (scalp ringworm)
- Gamma radiation exposure
The patient is a ninety year-old male in surprisingly good health. He is a highly functioning member of society most of the time. However, he has been experiencing intermittent fits of rage characterized by aggressive behavior, violent acting out, and paranoid thinking. The physical exam is unremarkable except for an abnormally shaped pinna and bilateral malleolar protuberances. A psychological exam is normal, though it reveals a definite streak of narcissism. The MMSE is normal.
This patient has:- Alzheimer’s disease with sundowning
- Alien possession
- Antisocial Personality Disorder
- Bipolar Disorder
- Blood oxygen imbalance
The Patient is a twenty-five year-old athletic male in generally good condition. He complains of a headache that feels like his brain is “being twisted inside and out.” He describes the pain as burning; There is no radiation of the pain, though he also describes bilateral eye pain. He denies any aura or premonitions before the headache. There is no seizure-like activity. Cranial nerves II – XII are normal on exam. He reports that he had a similar problem roughly five years previous, but that it resolved spontaneously.
This patient’s diagnosis is:- Migraine headache
- Psychic attack
- Reemergence of a suppressed mutant ability
- Ruptured aneurysm
- Atypical Seizure
The patient is a six year-old girl with no significant past medical history. She is up to date on all her immunizations and previously had been an active and playful girl. Her parents found her unresponsive and she has not shown any sign of coming out of her coma since. Initial tests show a normal white cell count and no signs of infection or toxins. Of note, her parents are divorced and have a contentious relationship.
The most likely cause of this patient’s condition is:- Diabetic ketoacidosis with coma
- Head trauma (due to child abuse)
- Soul stolen by demon
- Psychic attack
- Inborn error of metabolism
The patient is a healthy male in his mid-30s who complains of the sudden onset of severe dizziness. He also reports that the dizziness is associated with visual disturbances: a swirling pattern of pastel colors. He denies any previous similar episodes. There is no history of cardiovascular or neurological problems. He exercises regularly, if not excessively, and reports that he has a very high stress job.
This patient has suffered:- A partial seizure
- A psychic attack
- Acute labyrinthitis
- Ocular migraine
- Teleportation to a distant planet
A 21 year-old female complains of a one-month history of increasing anxiety including episodes of poor memory recall. She complains of a severe generalized headache, pounding in nature, and increasing in intensity. She also complains of the sudden onset of hot flashes. She is unable to provide any family medical history as her mother died when she was an infant and she was raised by her stepfather.
This patient has:- Hyperthyroidism
- Anxiety disorder with panic attacks
- Exposure to mutagenic chemicals
- Early onset menopause
- Caught in the tail of a comet
The patient is a teenage female who complains of several days of fever, chills, fatigue, and congestion. She is generally very active and her past medical history is significant for migraine headaches which started a few months ago, but have since apparently resolved. She reports no recent travel.
This patient’s diagnosis is:- Severe allergies
- Viral upper respiratory infection (i.e. a “cold”)
- Spiritual possesion
- Pneumonia
- Exposure to alien spores
The patient is a male in his late thirties. Though generally healthy, he leads a sedentary lifestyle and has a high stress job. His face had a ruddy complexion and he admits to being a “social drinker.”
While out to dinner alone one night, he experiences the sudden onset of a severe weakness of the left arm. None of his other limbs are affected. There is no history of prior injury, and he denies any numbness, tingling, or pain in the involved extremity.
The correct diagnosis for this patient is:- A stroke
- Caught up in a science experiment gone wrong
- Multiple Sclerosis
- Victim of a magic spell
- Tetrodotoxin poisoning (i.e fugu, or puffer fish)
A tremendous thanks to all of Dr. Scott's intrepid teaching assitants including J. Aparo, J. Byrne, J. Carey, C. Claremont, D. Cockrum, F. Guardineer, b. Haney, F. Herron, L. Manco, A. Plastino, J. Siegel, and D. Sprang.
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