A woman named Ethel Moore* arose one morning in the summer of 1999 and traveled 76 miles from her home in upstate New York to see a doctor in Manhattan. Moore was 74 years old, a stylish, humble woman who looked like someone’s mom. Once in the doctor’s office, she disrobed to reveal a secret that had both plagued and embarrassed her for two years and which she had kept hidden from friends and neighbors. A hairy tan-and-brown rash covered her body from the neck down. She had visited numerous doctors to rid herself of the affliction, but to no avail. The pathology lab of a prestigious Manhattan institution had examined biopsies of her lesions and pronounced them cancerous; her regular doctor had dutifully prescribed chemotherapy. To Moore, that felt like a death sentence. She wanted a second opinion.
Her new doctor, Thomas Bolte, thought that she was more than entitled to one. As he flipped through Moore’s voluminous medical files, he could see that something was destroying her immune system — but he did not know if it was cancer. As a young physician he had worked at a pathology lab, and he knew from experience that labs occasionally made regrettable errors. Under the microscope, a skin cell might look cancerous when it really wasn’t. Histopathology, the microscopic study of diseased tissue, is more art than science. If the lab had gotten the diagnosis wrong, chemo might kill this patient. Bolte had never seen anything like this rash in his life, but he was determined to save Moore from it.
Bolte, who today is still boyish at 45 and still working out of the small one-room office where he first examined Moore, is a doctor obsessed with mysteries. He calls himself an unusual symptoms investigator, his term for a doctor who picks up where other doctors fail. Patients find him on the Internet, and they appear in his consulting room like characters out of a foggy Sherlock Holmes story: The Case of the Migrainous Art Dealer. The Case of the Irritable College Grad. The Adventure of the Chemically Sensitive Sleeper. For fees that are astonishingly reasonable by New York standards, Bolte takes these patients under his wing and tries to ferret out the reasons for their illness. He usually succeeds.
“If a person calls our radio show and says they have a problem that no other doctor has been able to help them with, that they can’t crack the case, I refer them to Bolte,” says Jerry Hickey, a pharmacist and host of InVite Radio, a nutritionally oriented program aired on the New York City-based talk station WOR. “He’s sort of a medical detective. He looks at things out of the box, and he’s solved quite a few cases over the years.”
Like the cranky character played by actor Hugh Laurie on the Fox TV series House, Bolte is a master of the differential diagnosis — identifying patients’ ailments based on a careful analysis of their symptoms. At times cases have taken the doctor into the realm of the weird, as when a patient casually informed Bolte that her psychic told her she was suffering from a parasite, specifically Entamoeba histolytica. “I didn’t know psychics knew that much about parasites,” Bolte says, “but I am always willing to keep an open mind. I said, ‘That’s fine, but why don’t we do a stool test?’” The results proved the psychic correct. Bolte, a spiritual man who is also fascinated by Jungian theory and the workings of synchronicity, chalked that one up to the importance of staying open to whatever the universe slings in your direction. The patient, of course, was miffed that she paid for lab work for the doctor to learn what she already knew.
