PROMPT DIAGNOSIS

A.I. is already helping physicians and patients. But there are side effects.

- BY DHRUV KHULLAR

In 2017, Matthew Williams, a thirty-something software engineer with an athletic build and a bald head, went for a long bike ride in the hills of San Francisco. Afterward, at dinner with some friends, he ordered a hamburger, fries, and a milkshake. Midway through the meal, he felt so full that he had to ask someone to drive him home. That night, Williams awoke with a sharp pain in his abdomen that he worried was appendicitis. He went to a nearby emergency clinic, where doctors told him that he was probably constipated. They gave him some laxatives and sent him on his way.

A few hours later, Williams's pain intensified. He vomited and felt as though his stomach might burst. A friend took him to a hospital, where a CT scan revealed cecal volvulus—a medical emergency in which part of the intestine twists in on itself, cutting off the digestive tract. The previous medical team had missed the condition, and may even have exacerbated it by giving him laxatives. Williams was rushed to the operating room, where surgeons removed about six feet of his intestines.

After recovering from surgery, Williams began to experience severe diarrhea almost every time he ate. Doctors told him that his bowel just needed time to heal. “It got to the point where I couldn't go out, because I would constantly eat something that would make me sick,” he said. During the next few years, Williams saw a series of nutritionists and gastroenterologists—eight clinicians in total—but none could pinpoint the reason for his symptoms. “Doctors are sometimes just, like, ‘Are you not dying? O.K., then come back another time,’” he said. Williams largely restricted his diet to eggs, rice, applesauce, and sourdough bread. “You don’t understand how much food is a part of life—socially, culturally—until you can’t eat it anymore,” he told me. “It’s awkward to be on a date and explain why you can't get the mozzarella sticks. When your food is bland, your life becomes bland, too.”