No Sh#* Sherlock

Published in the Huffington Post

No sh*#, Sherlock. How fun is this phrase? C’mon, you’ve used at least once in your life. You know . . . the answer or outcome is so completely obvious that you sit in awe of someone doesn’t know it.

I remember it being popular in middle and junior high school. Now that I am a mother, I am reminded why – kids do the darndest things!

Courtesy of Reddit, here are few examples:

“I put a stethoscope in my dog’s ears while he was sleeping and screamed into it. I had to get stitches on my neck and the bite marks narrowly missed my eye.”

Really? You didn’t see that coming?

“I wanted to see if my bike would stop if I put a stick in the spokes. It did.”

No . . . a wheel would never stop if you jam a wedge in it . . . .

“I made a Lego “cake”, put it in the oven, and switched it on.”

Of course! Everyone knows that plastic is made for baking.

Are you chuckling, shaking your head in disbelief, or recalling your own shameful story? They are all amusing. No one got hurt. So despite the lack of sense or judgment, we can laugh it off and forgive. Kids will be kids.

However, this can’t be the case in medicine. We can’t miss the obvious because the consequences can be tragic.

I read a story this week about a sixteen-year old girl named Gynna McMillen. She died in her sleep. The autopsy, through genetic testing, revealed that she had a heart condition called Long QT Syndrome. This is an electrical defect. It causes an irregular heartbeat (arrhythmia) that can lead to cardiac arrest.

No one at the Lincoln Village Juvenile Treatment and Detention Center knew about her heart condition.

They should have.

You see, two years earlier, Gynna’s father died unexpectedly in his sleep. This is the no sh@#, Sherlock moment.

It is well documented that the sudden and unexpected death of a family member under the age of fifty raises a red flag. The Preparticipation Physical Evaluationasks this specific question: “Has any family member or relative died of heart problems or had an unexpected or unexplained sudden death before age 50 (including drowning, unexplained car accident, or sudden infant death syndrome)?”

This document, and question, were drafted by five leading medical associations – the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American Medical Society for Sports Medicine (AMSSM), the American Orthopaedic Society for Sports Medicine (AOSSM), and the American Osteopathic Academy of Sports Medicine (AOASM). The document is used in a majority of states across this country when evaluating student athletes, and the question is part of many wellness checks.

Why didn’t anyone check Gynna McMillen’s heart after her father died suddenly and unexpectedly in his sleep? It is likely that an electrocardiogram would have revealed her Long QT Syndrome.

Didn’t all of the family physicians and pediatricians know this warning sign? Isn’t it so completely obvious that had to be the next step?

In 2005, my three-month old son died in his sleep. The initial prognosis was sudden infant death syndrome (SIDS). However, my pediatrician was wiser than most and told me to get my heart checked because “babies don’t just die.” As a result, I was diagnosed Long QT Syndrome, just like Gynna.

Apparently, my pediatrician knew the standard. She knew the warning sign. She may have even known about the research that shows up to 15% of all SIDS deaths is attributed to Long QT Syndrome.

Simon saved my life. I truly believe that.

Gynna’s dad tried to save her. Like Simon, he left a big clue. Unfortunately, Gynna needed Sherlock Holmes that day because her medical community failed her. Now, she is gone.

It shouldn’t be this way. We need to do better. We can’t afford to miss the obvious.