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Medical Detectives: Inside the Mind of Great Physicians

MLL14002Wednesday evenings, October 16 – November 20
7:00 to 8:30 p.m., 513 Parnassus Avenue
Course Number:  MLL14002

General Public
1 Course: $75
2 Courses: $130
3 Courses: $185

$30 Special Registration for Students with a Valid ID



Ever want to be a detective and solve mysteries, conundrums, and enigmas?  This course will teach you how physicians at UCSF function as detectives, solving strange illnesses, rare diseases, new infections and unexpected poisonings using their knowledge, deductive reasoning, and data gathering. Climb inside the mind of a medical detective and see how it works - how they obtain clues, synthesize data to formulate a hypothesis, and select and interpret their tests based on these hypotheses.


Course Chairs:
Jeffrey A Tabas, MD, Professor of Emergency Medicine and Office of Continuing Medical Education

Malini Singh, MD, MPH, Assistant Professor of Emergency Medicine
Medical Director: San Francisco General Hospital Emergency Department


October 16
Genetic Mysteries: FOP, When Bodies Turn to Bone
Joseph A. Kitterman, MD, Professor Emeritus of Pediatrics and the Cardiovascular Research Institute

Overview: Fibrodysplasia Ossificans Progressiva (FOP), a genetic disease, is one of the rarest (incidence 1 in 2 million) and most horrific conditions that affect humans.  In FOP, skeletal muscle, tendons, and ligaments undergo endochondral ossification in episodes known as flare-ups that lead to progressive permanent loss of range motion in joints.  The onset is usually in the first decade of life.  Most people with FOP are initially given erroneous diagnoses, often leading to inappropriate treatment with permanent complications.  Currently, there is no effective treatment, but recent research suggests there will be a clinical trial of treatment in the relatively near future.

Genetic Mysteries: FOP, When Bodies Turn to Bone Handout


October 23
Inside the Mind of a Medical Detective
Jahan Fahimi, MD, MPH, Assistant Professor of Clinical Emergency Medicine

Overview:  The discipline and practice of medicine has a very unique way of approaching problems. Doctors use a mix of experience, intuition, evidence, and even chance to inform their clinical conclusions and decisions. In the emergency room, these decisions are being made rapidly, often with tremendous amounts of uncertainty when a lot is on the line. This lecture will explore the basis for those decisions, highlighting the sophisticated mechanisms that help doctors get it right, as well as the pitfalls and distractions that lead them astray. The lecture will explore real mystery presentations from the emergency room and the nuanced approach by clinician-detectives to solve the case when the stakes are high.


October 30
Neurologic Mysteries
Maulik Shah, MD, Assistant Professor, Department of Neurology

Overview: Learn how neurologists solve diagnostic dilemmas, including the evaluation of patients who are referred to us from the community for our expert opinion. Hear about the pitfalls we have made as well as the eureka moments. Learn the importance of thinking broadly about cases and deciphering which pieces of data are the most likely to lead you to a diagnosis– versus those that might be a red herring or irrelevant to the current problem. This course will highlight how the neurologic examination is a particularly vital tool to understanding which part of the nervous system is being affected and how this guides our diagnostic and therapeutic planning.

Neurologic Mysteries Handout


November 6
Mysteries from the Poison Control Center
Craig Smollin, MD, Assistant Professor of Emergency Medicine, San Francisco Poison Control Center, Toxicology Fellowship Co-Director


November 13
When Medical Illnesses Masquerade as Mental Ones
Paul Linde, MD, Professor of Psychiatry – Bio

Overview:  Not all episodes of disturbed or altered behavior can be attributed to purely psychiatric conditions.  Multiple different medical problems can present with predominantly behavioral symptoms.  To discover the root cause of these so-called “medical mimics”, one must start with an “index of suspicion” and continue the investigation with the clinician’s basic tools of history, mental status description, physical examination, and diagnostic testing to uncover the potential medical causes of psychiatric symptoms. The differential diagnosis runs the gamut from the everyday, such as alcohol and drug intoxication, to the esoteric, such as acute intermittent porphyria, but the approach to diagnosis remains the same.  Putting together the multiple pieces of a clinical puzzle, accomplished in part by creating and considering a differential list of possibilities, is one of the most satisfying tasks for the psychiatric sleuth.

When Medical Illnesses Masquerade as Mental Ones Handout



November 20
Public Health Outbreaks
Tomas J. Aragón, MD, DrPH Health Officer, City & County of San Francisco Director, Population Health Division (PHD) Bio
San Francisco Department of Public Health, Faculty, UC Berkeley School of Public Health

Health Outbreaks Handout



Solving a Medical Mystery Example




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