A scene from Ozark*.  What is wrong with this image photographed from the TV video?

Janice Chandler of Ocean Grove is the winner saying that the Xray shows “dextrocardia” which is a congenital anomaly where the heart is positioned on the right side instead of the left.  It is an anatomic finding, but the heart works normally.

It is often diagnosed by a chest x-ray, but an old school physician, like me, might diagnose it on the physical exam, but doctors of this era, who sometimes don’t know which end of a stethoscope to put in their ears, would surely miss it without an imaging device.

However, the contest was to say what is wrong with the photo, and if the X-ray were a case of dextrocardia, it would look like that, but I wouldn’t call it something “wrong.”

But her answer is the closest.  My diagnosis is that some dopey junior TV producer hung a normal X-ray backwards.

So congratulations to Janice who is so brilliant because she is an RN who worked with me back in the day.

She wins a Jack Bredin print of “Flag Day” which is perfect because we are in a time when we need all the patriotism that we can get.

And:   Janice contacted us to say, “Wow! Good for me! Thank you Paul. I also suspected that the film was backwards, but thought you would get a kick out of the dextrocardia guess! In all my years in practice, I saw only a single case.”

This topic reminds me of when I saw a case of situs inversus where all the organs are reversed, such as the liver which is on the left instead of the right.  I was an intern, and a genius resident at Mt. Sinai told me how to diagnose situs inversus without laying a hand on the patient, but it only works on a genetic male. (XY)

You have the patient stand naked before you and you will notice that the lower testicle is the right one instead of the left.  You can impress your friends with that “pearl.”   In medicine, a pearl is a bit of knowledge.

*Ozark is a powerful series that was made in 2017 and is now available on Netflix.

Buena Vista Social Club:  “Veinte Anos”