The philosophy of the medical case

I once met a girl with six toes. Rather, she had five and a half toes— a toe-ette emerged innocuously from her otherwise normal hallux. Was I surprised by this medical curiosity? Certainly. Was I disturbed? Of course. Did I rush and document my finding in peer reviewed journals? Definitely not. To me such an activity seems, frankly, quite dull. Yet that is precisely what many doctors around the world regularly seem to do. The collection of case reports they produce is a who's who of the wild and the wacky in our wards today. What are these reports and why are they written?

Published case reports originate from the days when you described something; you got a disease named after you. Along the way, the authors may criticise the lesser mortals who preceded them, but lacked their superior skills of deduction. They then reveal their earth shattering diagnosis. “This patient has the first recorded case of Zollinger-Ellinson syndrome presenting as gallstone ileus impacting in a Meckel's diverticulum,” or …