NEJM case: AI diagnoses woman's decade-long abdominal pain, physician prescribes largely on chatbot's advice
EricTopol · x · 2026-11-15
Eric Topol highlights a NEJM narrative article, "What the Robot Still Can't Do," by physician Shantanu Nundy.
The case
- A 37-year-old Ethiopian woman with nearly 10 years of abdominal discomfort: H. pylori negative, normal EGD, failed omeprazole trial. In 15 years of practice, the doctor had never seen the condition.
- He typed her full history into an LLM app, which instantly suggested functional dyspepsia (a gut-brain disorder affecting 10-12% of the US population) and noted the pain episodes triggered by her son's distress fit the picture. Next step: amitriptyline.
- "I diagnosed a patient with a condition I had never diagnosed before and started treatment largely on the basis of the output of a chatbot," he writes. Three weeks later she was markedly better and told him, "You are my brother. Sent from God."
His reflection
- AI played the chess: pattern recognition across a decade of data exceeded his own ability.
- But the humanistic core—reading the patient's face, earning trust, cross-language empathy—is what the robot still can't do. Let AI play chess while the physician remembers how to be a physician.
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