Medicine can be mischievous sometimes. There was this patient of mine who happened to present with long standing complaints of bleeding during micturation and high grade fever. He was initially admitted under the medicine team and as relentless as they are they got investigations on him worth fifty thousand rupees and still could reach no conclusive diagnosis. Thus the patient was handed over to the urology team. There he was re-evaluated and was advised further exploration under anesthesia. The plan was to get some tissue from his bladder and see if he had anything sinister. For this procedure protocol demands that he be seen by anesthesia team and declared fit for anesthesia. They got his X-ray chest and incidentally found out that the gentleman had dilatation of his aorta. Things got worse and a vascular surgery consult was sought. They asked for still further evaluation in form of CT scans of chest and abdomen to see the extent of the dilatation. After the tests the patient was told that he had a severe but stable dilatation of his major blood carrying vessel. Someone looked at his X-ray and said that he had some respiratory disease too. CT abdomen showed that he had a bladder tumor. He was finally taken to surgery room after investigations worth one hundred thousand rupees. Was operated upon for the removal of his tumor a simple 20 minute procedure. He remained in the hospital for another 3 days and then was discharged. Had to pay about one hundred thousand rupees to the hospital for its services. He went back home with blood in urine and fever!

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