Clinical narrative uncovers diagnostic delays and socioeconomic barriers in a symptomatic patient, highlighting the importance of patient voice in advancing clinical care.
The first two Clinical Connections pieces share a patient's narrative from two perspectives.The first is in the patient's voice, and the second is in the provider's.Both pieces highlight the intent of the Clinical Connections series-honoring what matters most to the patients whom we treat, seeing what advancing care looks like on the ground, and inspiring us to keep doing the work that we do.We hope that you enjoy them and consider submitting your own pieces in either your own voice or your patient's.Looking back, the signs were there long before I was diagnosed.For more than 6 months, I had been experiencing shortness of breath, on and off.I also had an itchy rash that started on my chest and then spread to other parts of my body.At the time, I thought my symptoms were due to gluten intolerance, based on what I found online, and interestingly, changing my diet seemed to lessen the itching.I visited urgent care multiple times for my skin and breathing and received different prescriptions, but each visit ended the same way: I was advised to go to the emergency department.Each time, I declined, hoping that my symptoms would go away.Fear played a role, but so did life and its everyday demands.As a single mother, I had spent years trying to build myself up.I lived below the poverty line, raising my daughter alone in an apartment where I could literally hear rats in the walls.Finally, after many years, I got a well-paying job, which was a big deal for me, and I immediately began the process of buying my first house.This was less than 5 months from my diagnosis.At first, I struggled to process the diagnosis.I laughed because it simply did not seem real.It only fully dawned on me when it was time to get my biopsy, and I cried for the first time.Right before
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Akpan et al. (2026) studied this question.
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