I've often said that surprises in my line of work are usually bad. For example, I saw a 40-year old woman in my office some time back who was referred with a small painless breast lump. She had no family history or other risk factors for breast cancer, so I reassured her that is was likely a benign mass, but I recommended a biopsy nevertheless. SURPRISE! It was breast cancer. I did a mastectomy and she did very well. Fortunately, not all of my surprises are bad, and I do get some happy endings.
You may recall a patient of mine who was stabbed 20 times a few months ago. His girlfriend never left his side. She was with him when he was admitted, every time I went to see him on rounds, and during his follow-up visits to my office as well. Thankfully the young man did very well and I haven't had to see him since. But about a month ago I was walking through the emergency department waiting room and SURPRISE I saw his girlfriend sitting there alone, looking quite ill. She told me that she was the patient this time - she had been having flu-like symptoms for a week. I wished her and her boyfriend well and continued on my way to the trauma bay.
That was the first surprise.
The second was when she walked into my office earlier this week to pay her boyfriend's bill in full. SURPRISE! As you can imagine, this is a very rare occurrence, but it's one that I accept happily. I asked her if she had recovered from her recent illness, and she smiled sheepishly and said, "Not really."
"Oh? Is everything ok?" I asked.
"It will be," she replied with a big grin, "in about 27 weeks." SURPRISE! She's 13 weeks pregnant with their first child. The vomiting that brought her to the emergency department was morning sickness.
See? A happy ending for her boyfriend's saga with an even happier ending for the two of them.