Paraganglioma in the Organ of Zuckerkandl

Author(s)Richard M. Berlin, MD

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Key Takeaways

Comic Marx Brothers banter is used to offset the gravity of a catecholamine-secreting paraganglioma scenario.
Clinically, abdominal pain with extreme hypertension signals a dangerous endocrine etiology requiring high vigilance.
Radiographic conspicuity is emphasized through the “red” mass adjacent to the aorta at the Organ of Zuckerkandl.
Surgical management is framed as definitive and highly skilled, culminating in full patient recovery and return to normal life.
Authorship context notes a psychiatrist’s long-running medical-poetry practice, blending clinical observation with literary reference points.

"While studying the CAT scan, I picture Groucho Marx..."

-From the New England Journal of Medicine “Images in Clinical Medicine,”

While studying the CAT scan

I picture Groucho Marx

as Dr. Hugo Z. Hackenbush

offering a diagnosis to Emily Upjohn:

“I see you’ve got a Paraganglioma

in your Organ of Zuckerkandl,

and that’s a candle I’d like to light!”

Emily blushing, “Oh Hugo, you know

just how to set a girl’s heart on fire!”

Off screen, the scan is no joke:

a young man with belly pain

plus blood pressure numbers

so high even Hackenbush

would have thought to triple check them.

And though you might be someone

who has never tackled a CAT scan,

I guarantee you won’t miss the red

paraganglioma in the Organ of Zuckerkandl

beside the aorta, the way Doc Williams’

red wheelbarrow is glazed with rain

water beside the white chickens,

a silly line I recite to 10-year-olds

who laugh like I’m funnier than Groucho.

So let me light a cigar and honk

Harpo’s horn to celebrate

the surgical teams’ skill,

the miracle of CAT scans,

and a fully recovered patient

ready for another day at the races.

Dr Berlin has been writing a poem about his experience of being a doctor every month for the past 28 years in Psychiatric Times in a column called “Poetry of the Times.” He is an instructor in psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts. His latest book is Tender Fences.