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CBird:  Do most doctors today send you cases they simply cannot diagnose or do they use you as a sort of diagnostic machine for everything?

FARRELLY:  Both, some for tough cases, others routinely.  I am much more challenged by the tough cases.  For example, I had to analyze a sample from a sixteen-year-old who'd had a history of chronic ear trouble.  In checking it, I first found it was bacterial so I began checking through the bacteria.  And I found tuberculosis.  This seems impossible since I'd never heard of tuberculosis in the ear.  But I relied on my analysis and sent it to the doctor.  He called me long distance to ask: "Have you lost your cotton-picking mind?  Whoever heard of TB in the ear?"  I told him I didn't know, but would stick with that diagnosis, no matter how far-fetched it might seem.

    The next day he called me back to say that he'd spoken to the patient's mother, a registered nurse, and told her that she should have a bacterial exam made but using, as I'd suggested in my report, an acid-fast stain to reveal TB.  The doctor was surprised that, instead of getting angry, the mother told him that her child had a swollen gland on the side of the neck at age six months.  The gland had been found to be tubercular.  But they never made a connection with TB and the running ear.