Transcription

• Speaker #0

  This is Case Encounters, a journey to the true medical mysteries solved by pathologists, like Devi Mansari, with a little problem that really got under her skin.

• Speaker #1

  Consider a woman, Devi Mansari, 43, healthy, active in her community. enjoys a glass of wine with friends at the local pub while rehashing old X-Files episodes or playing cricket on a Sunday afternoon. Somehow, amid all of her hobbies and outings, something unusual began happening to Debbie, something that would make her question the very fabric of her being.

• Speaker #2

  Good morning, Devi. What brings you in today?

• Speaker #3

  Well, Dr. Quinn, this thing does not want to vacate the premises. I tried the hot compress, finished the antibiotics. I even tried apple cider vinegar on it twice a day. Seems I have a permanent squatter at the back of my head.

• Speaker #2

  Hmm, a squatter, Okay, let's take a look. Tender still?

• Speaker #3

  Yep. Ow. I can't sleep on my back. and as you can see, my hair's a disaster. I'm named it Norman. I'm considering adding him as a dependent so I can get a tax break.

• Speaker #2

  Good plan. Although I've got two kids and it's not much of a break. Well, hmm, does feel firm. About the diameter of a quarter. And there's a small opening here. No draining fluid. Hmm, antibiotics should have helped if this was a bacterial infection.

• Speaker #3

  Right? Seriously? This thing is starting to take over my life. I swear, I heard it talking to me the other night.

• Speaker #2

  Okay. Well, I don't like how it looks or feels, Debbie. I think I'd like to remove it and have our pathologist take a closer look.

• Speaker #3

  Cut the thing out? Fine by me. Just promise me that if it's a tiny alien, I get to keep the specimen and on the movie nights.

• Speaker #2

  We'll see about that. You know, finders keepers and everything. All right. A nurse will call you with an appointment, okay?

• Speaker #3

  Thanks, Dr. Quinn. I'm going to plan this little things-going-away party.

• Speaker #1

  What's next for Debbie isn't just a simple removal, and it's not a simple answer for Dr. Quinn. What is next is a nagging question. What unknown entities seemingly resist the ordinary rules of medicine, and who uncovers their existence? Enter... Dr. Camille Ortiz, the pathologist. She's not who mends the body. She's the one who translates it. In her world, disease is a dialect, and every slide is a sentence waiting to be translated and understood. Ortiz reads them all, the tragic, the comic, and the absurd.

• Speaker #2

  Dr. Ortiz, nice to see you. I hope I brought you a mystery worthy of your attention.

• Speaker #1

  Ah, Dr. Quinn,

• Speaker #4

  always a pleasure. And yes, surgery sent the specimen over last night, and I've already been looking at it this morning. You know, we once had a patient who swore an alien had taken up residence in his sinuses. Said he could feel it moving when the moon was full.

• Speaker #2

  Really? And what did you find? Little green man dancing a boogie?

• Speaker #4

  Sadly, no. Just mold spores and a guy with a flair for storytelling. I'll tell you this, though. Sometimes the truth we find here in the lab is stranger than any of us imagine.

• Speaker #2

  Indeed. So what's Ms. Mansari's story? Please don't tell me it's really aliens this time. She actually said that to me before she left the clinic last week.

• Speaker #4

  Well, let's have a look at it on the big screen. You're going to love this one, I think. I have to say, this wasn't what I expected. given your concern for squamous cell carcinoma. Check it out. It's about the size of a grape. It's fibrous, fleshy, and kidney bean shaped with these thin black lines. And inside, this is organized tissue, smooth muscle, a digestive tract. This is definitely not a cyst. And like I said, not a tumor.

• Speaker #2

  Are you telling me this is a parasite?

• Speaker #4

  I sure am. Your Ms. Mansari wasn't exactly hosting an alien, but this is pretty close. Unlike my sinus alien guy, this time Mansari- He was kind of right.

• Speaker #2

  Wow, look at that thing. I wonder what it is. Dr. Kim at the microbiology lab will know. Let's get this over to her.

• Speaker #4

  Oh, yeah. Let's get our favorite parasitologist on this one. She'll definitely know what this little guy is.

• Speaker #1

  Under Ortiz's lens, the absurd had shed its mask. What masqueraded as a lump was a larva, not exactly an alien. But in fact, the alien squatter Miss Mansari had feared. But where had it come from? And how did it burrow itself into the scalp of our unsuspecting patient?

• Speaker #4

  Morning, Dr. Kim. Thanks for picking this up so quickly.

• Speaker #5

  After your email, I couldn't wait to have a look.

• Speaker #1

  And what did you find?

• Speaker #4

  I told you she'd love this one, Quinn. She's probably been waiting her whole career for a case like this.

• Speaker #5

  Love it. You guys aren't going to believe what I found. I mean, I've seen some weird stuff. This one is right up there. Come take a look. Okay, see these tiny holes at the back end here? They're called spiracles. Breathing holes. Nature's version of snorkeling gear. And these dark little hooks that look like backward-facing barbs along the body? Those are anchoring spines.

• Speaker #4

  So, when it wiggles... Those spines grip the surrounding tissue like fishhooks, so it can't easily be pulled out. This is real alien architecture stuff here.

• Speaker #5

  Exactly. And it also helps it burrow deeper as it grows.

• Speaker #2

  Wow. Okay, but what is it?

• Speaker #5

  Dermatobia hominis.

• Speaker #4

  The human botfly.

• Speaker #5

  Yes. Their larvae develop inside living tissue. They don't just invade. They settle in, grow, feed, and then they emerge. Ew, cool.

• Speaker #2

  But we don't have botflies here in the States.

• Speaker #5

  Correct. They're endemic to Central and South America. Panama, Peru, the Amazon Basin. Which means our little invader is, well, foreign.

• Speaker #2

  Well, I guess I better figure out where on earth Miss Mansari's been. She is going to love this. Or be mortified.

• Speaker #1

  Or both The alien had been unmasked, named for the record. But names only tell us what. The greater riddle is how. How an alien parasite, whose home is thousands of miles away in a different time zone and climate, found shelter in this woman's scalp without her knowing.

• Speaker #2

  Good morning, Debbie. How have you been feeling since we evicted Norman?

• Speaker #3

  So much better, Dr. Quinn. Sleep is back to normal, and I'm having the stitches removed today while I'm here.

• Speaker #2

  Super. I have the results from the biopsy, and they've caused quite a stir around here. The good news is that it is not cancer.

• Speaker #3

  Hallelujah So it's just a cyst then?

• Speaker #2

  Well, it also was not a cyst. Have you been traveling at all lately?

• Speaker #3

  Yeah, a few of us took an amazing camping tour to Machu Picchu. The vistas were incredible and the night sky...

• Speaker #2

  Ah, you were in Peru.

• Speaker #3

  Yes. Why? Oh no, did I bring a horrible disease home with me?

• Speaker #2

  Not exactly. What we thought was a cyst... was actually what's known as Dermatobia hominis. It's a bot fly larva, Debbie.

• Speaker #3

  I had bot fly larva embedded in my skull? How? Oh my god.

• Speaker #2

  What? You're totally fine now. There are no lasting effects. And if it makes you feel any better, it was likely dead when we removed it.

• Speaker #3

  No, that does not make me feel better. Holy cow, so it was an alien. I knew it.

• Speaker #1

  Can I have the specimen?

• Speaker #3

  I wanted for inspiration. I'm 100% making a podcast called Aliens on Earth.

• Speaker #2

  Yes, I can have it brought up from the lab. I think our parasitologist would like in on that project.

• Speaker #3

  I knew it. I'm wearing a hat from now on whenever I go camping.

• Speaker #1

  The mystery was solved. A parasite from Peru. an alien passenger hidden beneath the skin of an unsuspecting fellow traveler. But the story doesn't end. under the microscope or in the clinic. It lingers in the uneasy thought that perhaps alien is just a word for what we have yet to recognize. For Debbie Mansari, the invader has a name, Botfly Larva. For the rest of us, who's to say what other strangers share our spaces and whether they, too, are waiting to be named?

• Speaker #0

  you've been listening to case encounters this story is inspired by a true medical mystery solved through collaboration curiosity and a pathologist names and locations are fictitious until next time stay curious the voices you just heard are those real pathologists the people who work long days and even longer weeks to solve medical mysteries, big and small. To learn more about the work pathologists do for patients, visit yourpathologist.org. For a full list of the pathologists featured in this episode, and those who advised the creation of this story, please visit the show notes. Case Encounters is a production of the College of American Pathologists, Creative Support, Studio North. Produced and directed by Natalie Gregory. Sound design, editing, and original music by Jake Sorgum. Written by Paige Freeborn for Studio North.