MrBallen’s Medical Mysteries - Ep. 23 | Gut Instinct/Into the Woods

Episode Date: March 12, 2024

“Gut Instinct”In the summer of 2021, a doctor celebrates his retirement with a rafting trip in the Grand Canyon. But shortly after he gets back, he begins experiencing debilitating stomach pain. Desperate to figure out what’s wrong with him, he tries to diagnose himself. He suspects the answer is a horrible disease that people rarely survive. “Into the Woods”After a camping trip in the summer of 2009, a woman develops a gruesome rash that covers her body with painful welts and makes her mouth bleed. Multiple doctors can’t figure out what is wrong with her – because the answer is something few physicians would ever suspect.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Hey Prime members, you can binge episodes 49 to 56 right now and ad-free on Amazon Music. Download the app today. In the summer of 2021, a 71-year-old retired doctor stared at his reflection in the bathroom mirror. He barely recognized himself. Since returning from a river rafting trip two weeks ago, he had lost 15 pounds, almost a pound every day. He looked 10 years older than he had just a few weeks ago, and he felt 10 years older. He picked up his toothbrush and squeezed some paste onto the bristles. Just then, intense fatigue washed over his entire body. Then he had an overwhelming urge

to vomit. Moments later, he was lying on the cold bathroom tiles, coughing and gagging as severe pain shot through his stomach like a knife. Until now, this retired doctor had tried to be his own doctor, taking endless notes about his symptoms and his condition and how it was going. But now he realized that he was not up to the task of figuring out what was wrong with him. Then he blacked out. From the team behind American History Tellers comes a new book, The Hidden History of the White House. Each chapter will bring you inside the fierce power struggles, intimate moments, and shocking scandals that shaped our nation.

From the War of 1812 to Watergate. Available now wherever you get your books. Hey, this is Nick. And this is Jack. And we just launched a brand new podcast called The Best Idea Yet. You may have heard of it. It's all about the untold origin stories of the products you're obsessed with. Listen to The Best Idea Yet on the Wondery app

or wherever you get your podcasts. From Ballin Studios and Wondery, I'm Mr. Ballin, and this is Mr. Ballin's Medical Mysteries, where every week we'll explore a new, baffling mystery originating from the one place we all can't escape, our own bodies. If you liked today's story, please add a scoop of dirt to the follow button's can of coffee grounds. Going into the wilderness can be good for your body and soul. But sometimes, things can get a bit rough out there. Maybe you sprain an ankle, or maybe you get sick from drinking unfiltered water. And then there are other times that something truly awful can happen to you out there. Something that you never see coming.

On this episode, we have two stories about people who come back from outdoor adventures with life-threatening conditions. Our first story is about a retired doctor who returns from a rafting trip with debilitating pain in his abdomen. Then the second story is about a woman who ends up fighting for her life after going camping in Vermont. Here is our first story called Gut Instinct. In early July of 2021, 71-year-old Thomas Trizona dragged a large inflatable raft across a sandy beach on the Colorado River. It was just before sunset and he was sweaty and tired, but happy. It was the last day of a two-week whitewater rafting trip in the Grand Canyon. And even though he desperately needed a hot shower, Thomas felt invigorated and youthful. Thomas was a retired surgical oncologist, which means he was a doctor who operated on people with cancer.

He loved being a doctor and had always been a total workaholic. But after retiring earlier this year, he finally had time for himself. And one of the first things he had done was take this adventurous vacation with his wife Amy. Whitewater rafting had been as thrilling as he had hoped it would be. They'd floated past Native American ruins and through canyons with cliff walls stretching nearly a mile over their heads. They had seen eagles, condors, and bighorn sheep. Now, on the last night of the trip, Thomas and Amy secured the raft and joined the rest of their tour group around the campfire. Thomas's stomach growled as he watched their guide grill another delicious meal for them. Thomas looked forward to dinner and then one more night of stories around the fire. Tomorrow it would be time to return home to Springfield, Oregon.

But for now, Thomas just gazed up at the setting sun, knowing he'd cherish these memories forever. On July 16th, so a few days after returning home to Oregon, Thomas sat at his dining room table feeling bloated and nauseous. His wife, Amy, had prepared a beautiful dinner, but Thomas only pushed the food around on his plate. He told Amy that his upper abdomen really hurt. He'd started to feel sick shortly after getting home from their rafting trip, and he was now starting to lose weight. And this morning, it seemed like the pain had gotten even worse. It was now coming on in these big waves. Amy suggested that maybe he ate or drank something weird on their trip.

You know, maybe he contracted a parasite. Thomas said he only drank the filtered water, and he didn't have diarrhea, which was a common symptom of parasite infections. And anyways, if he had picked up something on the trip, then Amy would probably have it too. But when he looked at Amy and asked her how she was feeling, she just kind of shook her head and said she didn't feel sick at all. Thomas knew that his wife was probably right and his pains were no big deal. But as a retired doctor, Thomas couldn't resist diagnosing himself. Just in case it did turn out to be something serious that required him to see his physician, Thomas began keeping a detailed journal to record all of his symptoms. He thought

that this journal would help him understand what was causing his pain. Thomas had seen some heart-wrenching cases in his long career as a cancer surgeon, and as he tracked his symptoms over the next few days, he started to get nervous. He wanted to stay open-minded about what was causing his symptoms, but he couldn't help gravitating toward the dreaded disease he knew so well, cancer. Thomas reminded Amy that his mother had died of pancreatic cancer when she was only 74. In his experience, a previously healthy 71-year-old man with persistent abdominal pain and unexplained weight loss could only mean one thing. Until he was proven wrong, Thomas was certain he had cancer too. Thomas picked up his cell phone and called his close friend, Jonathan Gonen. Dr. Gonen was

a gastroenterologist, a doctor who specialized in the stomach and intestinal tract. Thomas told his friend that he wanted a CT scan to figure out if he had a tumor in his abdomen. But unfortunately, the earliest appointment Dr. Gonan could get for Thomas was a few weeks away in August. Thomas hung up the phone feeling disappointed. There was nothing he could do except wait. A week later, Thomas stood in front of the bathroom mirror squeezing toothpaste onto his brush. And then he looked up and felt totally alarmed by his reflection. He was pale and gaunt. His weight was now down about 15 pounds since he'd returned from that rafting trip.

And now he could barely stand from the fatigue he felt, let alone brush his teeth. Just then, a bout of nausea swept over Thomas, and he rushed to the toilet. He dropped to his knees preparing to vomit, but nothing came out. All of a sudden, he felt these severe spasms in his stomach as he fell over sideways onto the floor. The tiles were freezing cold against his cheek as he lay there shivering in just his boxers. Then he called out to his wife and said he needed to go to the emergency room right now. Later that afternoon, Thomas sat next to Amy in the emergency room's crowded waiting room. His blood had been drawn by a nurse and he was waiting for the results.

Thomas' phone pinged. He grabbed it and opened a message to find the results of his blood tests. All were normal except for one. He had elevated levels of a type of white blood cell called eosinophils. That, Thomas knew, could indicate three things. An allergy, a parasitic infection, or cancer. Thomas had already decided that he didn't have a parasitic infection, and he didn't think he had an allergy either. So that left only one possibility, the one he most suspected, cancer. Thomas asked the nurse at the reception area if he could speak directly with the doctor about the results. She told him that they had a long list of patients that day

with serious problems that required immediate attention. Thomas could wait if he wanted, but it would likely be four or five hours until a doctor could see him. Thomas considered his options. He was pretty sure he did have cancer, but he knew he likely was not in any sort of immediate danger because of the cancer. And no matter what a doctor would say to him that day if he waited around to speak to one, it would still take way more testing to determine if he really had cancer or not. So Thomas stood up and told Amy they would just leave. He would deal with his cancer tomorrow. The next day, Thomas sat across the desk from his primary care physician.

The doctor looked at the results on his computer as Thomas tried to describe his symptoms. And then at some point, the doctor asked Thomas about his diet and routines. And then after hearing what Thomas had to say, the doctor glanced up from the screen and told Thomas that you know what, this is probably a dietary issue. And then he suggested Thomas try a grain-free diet. Thomas was stunned. He wanted to be screened for cancer. And now his primary physician was telling Thomas, a cancer specialist, to just try a grain-free diet? It seemed kind of asinine. And so Thomas just stood up and curtly thanked the doctor and then took back the test results and left the building. Four days later, Thomas was sitting at his dining room table with his laptop open in front of him

when he got the best news he had received in a very long time. The results of the CT scan he'd finally been allowed to take had just come back. And the results were normal. He did not have cancer. Thomas felt an enormous wave of relief, but now he was more puzzled than ever. The pain in his abdomen had not gone away. He had barely eaten in the past four days, and he had now lost 22 pounds since he had returned from that rafting trip. And so Thomas was back to trying to figure out what was going on with him himself. And so while sitting at the dining room table, he began scanning through his journal with

all of the symptoms he had recorded, while also going on his computer and looking up possible obscure disorders that might fit his symptoms. And as he clicked through these medical sites, he turned his attention to a chronic digestive disease in which white blood cells build up inside of the intestines, causing pain and bowel obstruction. Thomas knew that the condition, called eosinophilic gastroenteritis, was rare, but he was running out of ideas. He was growing desperate to know what was going on with him. He was in agony, both physically and mentally. And even though he was a doctor, he was completely stumped, and this made him feel so helpless.

So eventually, Thomas just picked up his phone and called his friend Dr gonan to see if maybe he could help him again a week later Dr gonan paced inside of his office he had just arranged to have Thomas have a tiny camera inserted down into his throat to look around inside of him to see if maybe he had a bowel obstruction. But like all of the other tests Thomas had undergone, this one too came back with normal results. Dr. Gonen was bewildered by his friend's case. He decided to order one more test to get a better look at Thomas's small intestine. The images on this specialized MRI would be much sharper than the CT scan,

which would allow doctors to see very small problem spots. Dr. Gonen hoped the added clarity and details of the imaging would finally reveal what was wrong with his friend. The day after the MRI, Thomas went to the radiologist's office to discuss the results. Looking over the images, Thomas was surprised to see a tiny abnormality in his upper left abdomen. This abnormality was about an inch long and very, very thin. The radiologist told Thomas that the shiny spot looked more fuzzy on the earlier CT scan, and he thought it was just a buildup of plaque on Thomas's artery wall, which is a common sign of aging. But with the specialized MRI, it made it clear to the

radiologist that he'd been wrong. Something strange was going on inside of Thomas's stomach. Then the radiologist had an idea. He was curious to see if this weird spot was stationary or moving around inside of Thomas, and so he offered to do another CT scan right then to find out. Thomas agreed and they performed the scan immediately. And sure enough, it showed that the weird spot had moved in just a few weeks between one CT scan and the next. But before the two men could decide what to do about this weird, moving, skinny spot inside of Thomas' stomach,

the radiologist noticed something else that required immediate attention. It might explain Thomas' chronic pain too. Thomas leaned in and saw on the image that there was another small spot. The doctor told Thomas that it was a gallstone, a hard mass that was growing in his gallbladder. Thomas and the radiologist stared at each other. Gallstones can cause severe pain and cause serious problems if left untreated. And so Thomas's inflamed gallbladder needed to be removed immediately. On September 13th, Thomas underwent surgery to remove his gallbladder.

In the last moments before the anesthesia knocked him out, Thomas prayed that he was about to be rid of the terrible stomach pains he had endured for two months. A few hours after the operation was over, Thomas lay in a hospital bed resting with Amy by his side. His surgeon entered the room, walked to Thomas' bedside, and stood there grinning. The surgeon said that he had successfully removed the gallstone and the inflamed gallbladder, but that was actually not what was making Thomas sick after all. The surgeon explained that while he had Thomas' abdomen open, he decided to investigate that tiny thin spot from the MRI scans. And he found something he had never seen before

in his entire career, something that totally explained all of Thomas's symptoms, his severe stomach pain, his nausea, his weight loss, and his constant fatigue. The surgeon pulled a small vial from his pocket and held it up for Thomas to see. It contained a small object about the size and shape of a needle. Thomas asked what it was, and the surgeon said he wasn't sure, but it was very sharp, and it was inside of Thomas's intestines. And so no wonder he was in so much pain. From the looks of it, it was almost like Thomas had unintentionally swallowed a needle. Thomas leaned back in his bed, staring at this little thing inside of the vial. He couldn't believe that such a small object had caused so much misery,

but he was obviously very relieved that the ordeal was now over. However, he knew he would not be able to rest easy until he figured out what this thing was that he swallowed and how he actually swallowed it. A few days later, Thomas took the object in the vial to a lab for analysis. The analysts found that it was a thin metal wire just under one inch long. What's more, they found a carbon pattern on the metal that exactly matched burned barbecue sauce. Thomas thought back to that last night on the Colorado River during the rafting trip and the delicious meal his guide had grilled for the whole group around the fire. That was the last grilled meat he had eaten before he started

getting sick. Now everything was clear. The black metal object found in Thomas' intestine was likely a metal bristle from the brush his guide had used to clean the grates of the grill on that magical final evening of their trip. Thomas chuckled. He always knew that he would keep his memory of the Colorado trip for the rest of his life, but he didn't realize that he had also swallowed a little souvenir that would force him to remember. In the Pacific Ocean, halfway between Peru and New Zealand, lies a tiny volcanic island. It's a little-known British territory called Pitcairn. And it harboured a deep, dark scandal. There wouldn't be a girl on Pitcairn once they reach the age of 10 that would still have urged it.

It just happens to all of us. I'm journalist Luke Jones, and for almost two years, I've been investigating a shocking story that has left deep scars on generations of women and girls from Pitcairn. When there's nobody watching, nobody going to report it, people will get away with what they can get away with. In the Pitcairn Trials, I'll be uncovering a story of abuse and the fight for justice that has brought a unique, lonely Pacific island to the brink of extinction. Listen to the Pitcairn Trials exclusively on

Wondery Plus. Join Wondery Plus in the Wondery app, Apple Podcasts, or Spotify. For more than two centuries, the White House has been the stage for some of the most dramatic scenes in American history. Inspired by the hit podcast American History Tellers, Wondery and William Morrow present the new book, The Hidden History of the White House and Winston Churchill as they make plans to defeat Nazi forces in 1941. And you'll be in the Situation Room when President Barack Obama approves the raid to bring down the most infamous terrorist in American history. Order The Hidden History of the White House now in hardcover or digital edition, wherever you get your books. Here is our second story called Into the Woods. On a Saturday morning in June of 2009, a 55-year-old woman named Elizabeth and her husband Ron pulled their RV into a campsite in western Vermont.

Elizabeth loved camping and took every chance she could to head for the wild, leaving behind her comfortable suburban life in Connecticut. But as she had gotten older, she had begun to enjoy the comfort of an RV. It was much nicer to sleep in a warm bed at night and not have to deal with the hassle of setting up a tent and then sleeping on the ground. The RV lifestyle was just so simple and so easy. Today, all the couple had to do was park their RV at the campsite, then put on some sunscreen, and then head out for their hike. And so that's what they did. The dense Vermont forest they were in was beautiful, but Elizabeth had to admit that the conditions today were kind of miserable. The whole area was buzzing with these black flies that were swarming all over Elizabeth's legs and neck. And of course, Elizabeth had forgotten any bug spray.

By the time she and Ron had got back to camp, every exposed part of her body was covered in bites. And over the next few hours, those bites turned into welts. Usually, whenever they went camping, Elizabeth and Ron really enjoyed lighting a campfire up at night and sitting out under the stars. But that evening, the black flies were so bad that they just stayed in the camper and played cards. Elizabeth and Ron were in good spirits, though. They'd camped in less-than-ideal conditions before, from freezing cold to pouring rain, and so they weren't about to let a few bug bites ruin their trip. But by the time Elizabeth changed for bed that night, her arms and legs were an unsightly mess. They didn't hurt, but all the red swollen welts looked terrible. So she took a

few ibuprofen to help with the swelling, and then she climbed into bed. The following day, Elizabeth and Ron got up and packed their bags and they headed home. And even though they had not enjoyed the black flies, they had had an overall nice time and felt energized from their weekend in the fresh mountain air. But for the rest of the week that they were home, Elizabeth battled this terrible on-again- off-again headache, and the welts from all those black fly bites were not going away. Elizabeth spent the following weekend at her niece's house in Long Island, New York. She was excited to catch up and spend some quality time with her family. But the whole time she was there, Elizabeth felt groggy, like she needed a strong cup of coffee. And then when she left and began driving back home, her headache came back full force to the point where it was just this constant,

horrible, throbbing pain against her temples. When she finally got home, she immediately took some ibuprofen to help with her headache, and then she drank as much water as her stomach would allow. She knew that black fly bites were not toxic, but her body seemed to be taking longer than usual to recover from them. That night, Elizabeth went to sleep early, hoping she'd wake up feeling better. But she didn't. She woke up in a cold sweat, and her stomach churned, and her head pounded. She knew right away that she had a fever. Her husband, Ron, grabbed a thermometer from the bathroom, and sure enough, when he took her temperature, it was 101 degrees Fahrenheit. At this point, Elizabeth was really starting to worry. She'd been sick now for more than a week and she really didn't know how much longer this was going to last. And next weekend, she and Ron were hoping to go camping again in Vermont. They were going to

meet up with Elizabeth's cousin and her cousin's husband. Elizabeth was really looking forward to the trip, but she was worried that her sickness, whatever it was, would force them to cancel. All week, Elizabeth tried to take care of herself. She stayed in bed, drank a lot of water, and ate well to help her body overcome this sickness. And finally, the morning before they were supposed to leave for Vermont, her fever broke. Throughout the day, she got better, and by that evening, she felt well enough to go camping. She was thrilled. For the first time in a week, Elizabeth got a good night's sleep, and the next morning, June 22nd, she and Ron loaded up the RV and headed back to Vermont.

When Elizabeth and Ron arrived at the Windhall Brook Camping Ground, it was absolutely downpouring, which made it difficult to find their campsite and hook up their RV, but luckily, Elizabeth's cousin was already there and could help them get set up. When Elizabeth's cousin made a joke about the great weather they were having, Elizabeth thought about her last camping trip in Vermont and decided that she actually preferred this monsoon over swarms of black flies. Elizabeth invited her cousin and her cousin's husband into their RV, planning to cook some dinner while they waited for the rain to subside. But several hours later, the rain still had not let up,

and so Elizabeth's cousin and her husband ran back to their own RV, and Elizabeth and Ron, they climbed into bed and they went to sleep, hoping that when they got up, the weather would clear and they could actually go outside and enjoy the outdoors. But the next morning when Elizabeth woke up, the rain was not remotely on her mind. Instead, she had this blinding headache, and she also knew immediately that her fever was back. Her skin was itching and her eyes felt red. Her mouth felt gritty, almost like it was covered in little bumps. Elizabeth was annoyed, knowing she was likely going to be sick all day and could not participate in anything they were going to do. Elizabeth rubbed her eyes and slowly made her

way to the bathroom to brush her teeth. She debated whether she should just ask Ron to take her home or if she could tough it out in the RV so he could at least still enjoy the vacation. Once in the bathroom, Elizabeth spit out the toothpaste into the sink and she noticed her spit was bright pink. And when she rinsed her mouth, she tasted blood. She opened her mouth and stuck her tongue out

and her eyes widened as she realized the bumps that she had felt inside of her mouth were these black blood blisters all along her tongue and on the inside of her cheek. Elizabeth started to feel panic rising in her chest, and so she hurried out of the bathroom and over to her cousin's RV. Luckily, her cousin's husband was actually a doctor, and so he had Elizabeth stand in their kitchenette while he looked around the inside of her mouth with a flashlight. And after a minute, he turned off the light and just shook his head. He said he had never seen a condition like this before, and he urged her to go to the hospital. Within minutes, the RV was packed up and Ron was sitting behind the wheel. Elizabeth needed to use the bathroom before they headed off, but when she urinated, it burned.

Now Elizabeth was truly worried. These were not flu symptoms. Elizabeth made her way to the passenger seat up front, sitting beside Ron. By this time, her headache was back and worse than ever. She popped an ibuprofen as they pulled out of the campground, but nothing took the edge off the pain in her head or the itching that had developed all over her body. It took two hours of driving down winding country roads to get to the nearest emergency room in Brattleboro, Vermont. To Elizabeth, every single time they hit a bump in the road, it made her nauseous with pain. By the time they arrived, Elizabeth was in pure agony. Ron parked the RV, then walked around to the passenger door to help Elizabeth get out.

When she saw him, she smiled at him, but she could see his eyes were full of fear. It wasn't until she herself looked in the rearview mirror and saw her reflection that she understood why. Her face was so swollen that she almost didn't recognize herself. About five hours later, Dr. Teresa Fitzharris walked into her office at Brattleboro Memorial Hospital, ready to start her overnight shift. She put her purse under her desk, then went to check on Elizabeth, who was her first patient of the night. When Dr. Fitzharris walked into Elizabeth's hospital room and looked at Elizabeth, the doctor tried to hide her shock. Elizabeth's throat, chest, torso, and entire back were covered in a bumpy red rash. Dr. Fitzharris played it cool, but she'd never seen a rash this bad before. Elizabeth also had a fever of 101.6. Her heartbeat was also

elevated and her eyes were so swollen she could barely see out of them. Dr. Pateras sat down next to Elizabeth and then Elizabeth began to recount the last two weeks of sickness and misery and all the symptoms she'd experienced since getting bit by all those black flies. Dr. Fitzharris pulled two rubber gloves out of a cardboard box in the storage cupboard. She put them on, then gently ran her hand down Elizabeth's arms and back. And as she did this, she frowned. She was confident that this was actually not the result of black fly bites. But Dr. Fitzharris couldn't think of any other condition that would cause a rash like this. And until she could figure it out, Elizabeth was very likely to continue to get worse. At a minimum, the rash could cause serious lasting damage to Elizabeth's skin, her eyes could be damaged as well, and there

was no telling what this mystery condition could be doing to the inside of Elizabeth's body. Dr. Fitzharris didn't really know where to start with Elizabeth, so she just ordered some x-rays and blood work and then went to go check on a few other patients while she waited for those things to happen. A little over an hour later, after Elizabeth had gotten the x-ray and done the blood work, Dr. Fitzharris looked over the results on the computer in her office, and to her surprise, Elizabeth's blood work and her x-rays had come back totally normal, and so Dr. Pateras was stumped. So she picked up the phone and called one of her colleagues, Dr. David Albright, the

infectious disease doctor who was on call that night. She walked Dr. Albright through Elizabeth's symptoms, and she could hear him scribbling notes down as she spoke. And then after Dr. Pateris was done talking, Dr. Albright let out a long sigh. He said that most sudden fevers like the one Elizabeth had were caused by viral or bacterial infections. And so the problem now was figuring out which one of those she'd contracted. Because Elizabeth had been spending so much time outdoors, Dr. Albright guessed that she might have an insect-borne illness like Lyme disease or Rocky Mountain Spotted Fever. Dr. Albright told Dr. Fitzharris that he'd be in the next morning, and he promised to make Elizabeth his first stop. In the meantime, Dr. Fitzharris decided to put Elizabeth on antibiotics just in case she did have an insect-borne illness. If left untreated, conditions like Lyme disease or ehrlichiosis

can cause organ failure. The doctor just hoped that she hadn't acted too late. Early the following morning, Elizabeth woke up to the sound of a knock at the door of her hospital room. She squinted through her swollen red eyes and saw the blurry outline of a person walking into the room. He then introduced himself as Dr. Albright and asked if the medicine that Dr. Fitzharris had prescribed was helping at all. Elizabeth groaned and shook her head no. She told Dr. Albright that she could barely see and her rash was more painful than ever, to the point where even a tiny shift in bed was extremely painful. He promised he would do everything he could to help her, and then he said he was very sorry, but he needed Elizabeth right now to sit up straight

so he could determine how much her rash had spread. And so Elizabeth tried not to scream as Dr. Albright helped her sit up. Even the slightest touch on her skin was agonizing. As Dr. Albright looked over Elizabeth's body, he could see that the rash had spread and it did not look like the medicine had helped at all. That meant his suspicion that it might be something like Lyme disease was incorrect. But unfortunately, he didn't really have any idea what else could be making her sick. Elizabeth clenched her teeth as Dr. Albright helped her lie back down. She knew the doctors were doing their best,

but the fact that basically nothing had worked so far was still extremely frustrating. She could barely open her eyes and her whole body felt like it was on fire. About an hour later, Dr. Albright reappeared in Elizabeth's doorway. This time, Elizabeth could make out a second figure standing next to Dr. Albright. Dr. Albright explained that he'd brought a colleague with him who was a dermatologist or a skin doctor, and his name was Dr. Jorge Crespo. Dr. Albright wanted Dr. Crespo to take a closer look at Elizabeth's rash. He hoped that if they could determine what kind of reaction this was, it might inform them what was actually making her sick. Elizabeth braced herself for pain as the doctors once again helped her sit up so Dr. Crespo could look at her. He spent a few

moments examining Elizabeth's rash, checking her eyes and the inside of her mouth. Then Elizabeth saw him nod to Dr. Albright, as if to confirm a suspicion. He told Elizabeth that she had a rare but severe kind of allergic reaction called Stevens-Johnson syndrome. Dr. Crespo explained that she'd ingested something that triggered an incredibly violent response from her immune system. Her body was so desperate to get the allergen out of her system, it attacked the deepest layers of her skin, causing the blistering rash that now covered her whole body.

Soon, he believed, the top layer of her skin would start peeling off. It would look worse before it felt better, almost like she'd suffered a severe burn. None of what the doctor was saying made any sense to Elizabeth. She assured Dr. Crespo that she hadn't ingested anything unusual over the past two weeks. She told him again about the black fly bites and wondered if maybe any of the flies could have been carrying some kind of bacteria or virus or fungus that could have infected her. But Dr. Crespo just shook his head no. What made Stevens-Johnson syndrome very unique was not only the reaction, but the thing that caused it. Medicine. For reasons doctors do not fully understand, medicines that normally improve people's health can sometimes trigger this life-threatening allergic reaction in certain patients.

In Elizabeth's case, Dr. Crespo was confident that the cause was one of the most common, easy-to-get, over-the-counter medicines on the entire planet – ibuprofen. Elizabeth's jaw dropped. She had been taking ibuprofen steadily for the last two weeks to reduce the swelling from all the black fly bites and to alleviate her headaches. Little did she know, the medicine was causing all of these problems. But something didn't make sense to her. She told Dr. Crespo that she'd been taking ibuprofen for as long as she could remember. If she was allergic to it, then why hadn't this happened before? Why didn't she have a big

reaction the first time she took it? Dr. Crespo shrugged. He admitted that he really didn't know why Elizabeth would develop this allergic reaction so late in life. Stevens-Johnson syndrome was so rare that the root cause of it was actually still unknown. But at least Elizabeth knew now that she could not take ibuprofen, and Dr. Crespo assured her that if she stopped taking it, that she would recover in about a week or maybe two. Elizabeth was given steroids to help reduce her symptoms, and a few weeks later, she had recovered enough to go home, just like Dr. Crespo promised. But because her allergic reaction had gone untreated for two weeks, some lasting damage had already been done. Elizabeth's eyes had swelled so badly

that her tear ducts were permanently damaged and no longer worked. Ever since, she's had to administer saline drops in her eyes every few minutes to keep them working properly. But Elizabeth likes to look on the bright side and has said at least she can still see. To be continued... sometimes because we don't know the names of the real people in the story. And also, in most cases, we can't know exactly what was said, but everything is based on a lot of research.

And a reminder, the content in this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. This episode was written by Michael Selditch and Aaron Lan. Our editor is Heather Dundas. Sound design is by Ryan Patesta. Coordinating producer is Sophia Martins. Our senior producer is Alex Benidon. Our associate producers and researchers are Sarah Vytak and Tasia Palaconda. Fact-checking was done by Sheila Patterson.

For Ballin Studios, our head of production is Zach Levitt. Script editing is by Scott Allen and Evan Allen. Our coordinating producer is Matub Zare. Executive producers are myself, Mr. Ballin, and Nick Witters. For Wondery, our head of sound is Marcelino Villapondo. Senior producers are Laura Donna Palavoda and Dave Schilling. Senior managing producer is Ryan Lohr. Our executive producers are Aaron O'Flaherty and Marshall Louis for Wondery.

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