My first impression was that he was ugly.  Remarkably ugly.  I wasn’t being mean spirited, just factual.  I’m trained to observe such things!  I had never seen him before, so I assumed he had always been ugly.  I need to keep reminding myself not to assume anything.

He had already self diagnosed a “carpal tunnel.”  Indeed he had numbness of the palm of the right hand, the index finger, the long finger, and half of the ring finger.  And it got worse when I tapped the palm side of his wrist, at the median nerve.  Classic.  But I was more impressed with his ugliness.  Even his hands were ugly, like this:

So, naturally, I asked him if he had developed tunnel vision.  He looked at me with a shock of surprise, but described how he could no longer see things off to either side.  It was becoming very hard for him to drive.  I told him that maybe he had a brain tumor.  He laughed and said, “No thanks, doc.  I think I just have a carpal tunnel, thank you very much.”  But his smile went away when I didn’t smile back.

I made note of his coarse facial features, and his Neanderthal eyebrows.  I asked him to take off his shoes and his feet looked like this:

Acromegaly this obvious is hard to miss.  We quickly confirmed a very elevated blood level of growth hormone.  Next, a CT scan confirmed the presence of the suspected pituitary gland tumor which was overproducing the growth hormone.  It looked like this:

He eventually had a successful resection of this tumor.  The neurosurgeon went up the nose and through the sphenoid sinus, like in the arrow above, to remove the tumor.  Slick!

He stopped getting uglier.  But his days as a leading man were over.  Fortunately, he got the part of Igor (Eye-gor) in the Broadway production of Young Frankenstein (Fronkensteen).  I’m a big fan!

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It’s a fictional story, Ted.  Fiction!  But you be the judge: