🩺 Dr. Michelle Orr – The Great Dodger

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Nicole’s Encounter: January – March 2021 

 Polite. Measured. Deadly in her inaction.
Nicole came to Dr. Orr armed with evidence: an adrenal mass, symptoms of hormonal disruption, and concerning labs. Instead of investigating, Orr deflected. She quietly echoed a false psychiatric narrative, dismissed life-threatening data, and referred Nicole away — all under a veneer of professionalism. She saw the signs. She had the records. She chose to dodge. 

• ❌ Dismissed critical hormonal imbalance: low A.M. cortisol, elevated aldosterone, and adrenal nodule.
   
• 🧮 Calculated ARR (13.9) and used it to explain away high aldosterone, ignoring polyuria and low cortisol.
   
• 🎯 Focused on pheochromocytoma — a red herring — while ignoring mineralocorticoid dysfunction.  The growth started on the cortex of the adrenal gland NOT in the medulla which would have been more indicative of a pheochromocytoma.
   
• 🚱 Ignored 3,500 mL/day urine output (polyuria) entirely.
   
• 🗣️ Echoed a false depression history. Nicole refuted it in writing. No correction made.
   
• 🧬 Overlooked the sudden appearance of an adrenal adenoma alongside GI bleeding 8 days after an MRCP that showed normal adrenals — a classic endocrine red flag.
   
• 📤 Ultimately passed Nicole off to KU with no proper endocrine evaluation.

• 🔻 Cortisol A.M. — 1.1 mcg/dL (LOW, flagged, ignored)
   
• 🚱 Urine Output — 3,500 mL/24h (polyuria, not flagged or discussed)
   
• 🔺 Aldosterone — 34 ng/dL (HIGH)
   
• 🧪 Renin — 2.44 ng/mL/hr
   
• ⚖️ ARR = 13.9 — calculated and misused to dismiss the issue despite red flags
   
• ⬇️ Urinary Free Cortisol — 11.2 mcg/24h (low-normal)

 Dr. Orr didn’t lack data. She lacked courage. Nicole wasn’t asking for sympathy — just for someone to look. Orr had the full picture… and chose the easier narrative. 

Choose your next step:

🏥 [Back to NKC Hospital the Institution that Shielded Them]

🩺 [Return to White Coats Who Knew—because silence is policy]