Jeff recovered after a few days and
was able to return home, but the hal-
lucinations came back five months
later, while he was making breakfast.
He didn’t feel particularly unwell but
he suddenly stopped, stared into the
frying pan, and asked his wife: “Do you
see a chimpanzee face in the pan-
cake?” (She didn’t.) Jeff was hospital-
ized for a week.
Doctors now theorized that his brain
wasn’t infected, but rather was react-
ing to the recurrent fevers. Some-
times, when people are older or in
poor health, they become delirious
when they get sick because their fragile
brains can’t handle the extra burden.
Delirium is unusual in younger people,
however, and can sometimes signify an
underlying life-threatening condition.
One specialist suggested that Jeff
may have a rare genetic condition
called TRAPS disease that causes the
immune system to behave as though
an infection is present, triggering fre-
quent fevers. Jeff was referred to a
rheumatologist, Dr. Volodko Bakow-
sky, for investigation.
Bakowsky’s first impression of his
new patient wasn’t a good one. Jeff
arrived late after oversleeping. “I had
set aside extra time for him. I was
steaming!” says the doctor. Now, he
laughs at the memory. “Sometimes
there are clues that you don’t realize
are clues at the time. The fact that he
was late for his appointment was one
of the presenting symptoms.”
During a thorough physical exam,
Bakowsky noticed slight reductions in
Jeff ’s skin elasticity and joint flexibility.
Then, because Jeff had mentioned sinus
trouble, the doctor checked Jeff ’s ears—
not something he always includes in an
exam—and was dumbfounded. “His
ears were solid bone,” says Bakowsky. “I
was shocked. I’d never seen that before.”
Jeff had noticed his ears were sore
when he slept on his side, as though his
pillow was too hard, but he had no idea
that bone was gradually forming in
place of the cartilage that is normally
just under the skin of the outer ears.Bakowsky took a few days to research
the strange collection of symptoms.
“For each of the problems, you gen-
erate a list of possibilities, and then
where something intersects, maybe
it’s the diagnosis.” He adds that older
people might have several medical
conditions at once, but it’s different for
people around Jeff ’s age. “When you’re
younger, it’s more likely one thing
causing multiple symptoms.”
Most known causes of bony ears
relate to the endocrine system, whichWHEN JEFF’S DOCTOR
EXAMINED HIS EARS,
HE WAS SHOCKED TO
DISCOVER THEY WERE
SOLID BONE.rd.ca 27