The registrar on call had seen them only once before. In theory blocks we were told not to bother looking out for them because they are so rare.
My first reaction was to jump up-and-down with excitement. Fortunately I didn’t do so in front of the patient or her family. Her circumstances were not reason for excitement: a textbook-case of Systemic Lupus Erythematosus, fairly common in this part of the world. She was young and had signs of advanced renal failure.
The Janeway lesions were from a sterile endocarditis due to the serositis accompanying lupus.
It made me realise how excited we, in the medical community, become when we see a rare or textbook presentation.
A few days later I had a patient with advanced Huntington’s Disease. Something I’d never seen before. And I thought, “That’s too cool” – and then remembered again, it wasn’t.
It really, really isn’t.
Interesting, but by no means “cool”.