My colleague and I have completed several clinics with Dr. HPK now. The spectrum of disorders seen is simply mind-blowing. At least 80% of cases we encountered thus far I have never came across in a clinical setting. We saw a patient with Kennedy's disease, also known as spinobulbar muscular atrophy, a X-linked recessive lower motor neuron disease with a significantly better prognosis than other motor neuron conditions such as amyotrophic lateral sclerosis (ALS). For the first time in my medical training, I saw true fasciculations of the tongue - something I'll never forget. We also came across system sarcoidosis, Grave's disease, dermatomyositis (with classic appearances of Gottron's papules, periungual erythema, and a heliotrope rash), and possible systemic mastocytosis. If anyone ever asks me to recommend an elective/selective where they get to see the most rare and interesting diagnoses, I'd make sure to let them know about Dr. HPK's clinic. What's even more impressive is Dr. HPK's ability to make many diagnoses based simply on observation and physical exams. These clinics have truly been invigorating and I'm looking forward to seeing more interesting cases throughout the rest of the selective.
-Roy
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