Langer-Syndrome

The Langer-Syndrome is a rare and poorly understood medical condition with unusual symptoms that pose a challenge for every experienced internist in terms of diagnosis and treatment.

Epidemiology

Prevalence: 1 in 7.5 billion

Gender: exclusively Caucasian males

Age of onset: between 30 and 35 years

Typical characteristic: white tennis socks in green surgical clogs

Natural behavior

The typical Langer moves in his habitat, the clinic, like a fish in water and considers the E1-doctor's office as their home. Often, one can find him at his beloved and preferred workplace at the front left computer in the emergency room. If this spot is occupied by another individual, potentially a doctor of a different medical specialty, it triggers inner discomfort and agitation in the Langer.

Furthermore, individuals with Langer-Syndrome are capable of getting through the entire workday without consuming food. This is particularly noticeable for a continuous period of 30 days during Ramadan when their significant other is fasting. Rarely do we witness the Langer indulging in culinary absurdities, notably the consumption of Schnitzel sandwiches (importantly, with both mayonnaise AND ketchup).

Social behavior

Another striking characteristic of the Langer-Syndrome is that those affected feel responsible for providing caffeine not only for themselves but also for their internist herd. This behavior is often evident at the kiosk checkout, where they swiftly whip out their debit card and don't hesitate to use physical force if needed. This behavior also extends to nocturnal bar visits, where they become an inexhaustible source of alcohol.

Despite being attributed with significant social competence, individuals with Langer-Syndrome develop competitive traits, particularly in Padel tennis. If they lose in such activities or during FIFA games, it leads to pronounced frustration and verbal outbursts (see also: verbal characteristics). This behavior is most pronounced when the triumphant opponents are male, usually younger family members.

Additional characteristics

Verbal characteristics:

Pathognomonic for the described syndrome is the Langer-Triad:

1. Maschine! (German - Machine!)
2. Ciao Leben! (German - Goodbye life!)
3. Halt's Maul! (German - Shut up!)

For the classic Langer context and appropriateness are secondary when using these expressions.

Work approach:

Example colors of possible highlighters

A classic Langer is characterized by perfectionism and diligence. As a result, it may occur that, in addition to cardiologic findings that are incomprehensibly complex for ordinary internists, he also identifies a "retention in the uterine cavity" and an "acute phimosis" during echocardiography.

To cope with the chaos of the clinic routine, he employs a unique strategy: the deliberate and structured use of three neon highlighters (pink, yellow, and green), which are accurately lined up and placed in the run down lab coat or overall pocket. This approach has allowed him to survive exceptionally long in the hostile E1-territory, unlike many of his successors.

Diagnosis

The gold-standard for diagnosis involves placing the urine of a person suspected of having Langer-Syndrome on the rooftop terrace of the clinic building. The test is considered positive and the diagnosis confirmed if the urine changes rainbow-like in color due to exposure to sunlight, matching the carried highlighter's hue.

Urine sample: positive result when UV-induced discolouration in highlighter color appears

Therapy

As Langer-Syndrome is a benign standard variant, it does not require specific therapy. However, periodic intervention by well-meaning friends and colleagues may be necessary to prevent burnout or bankruptcy in the Langer.

Prognosis

The syndrome has been observed in only one individual so far. Currently, it can only be confirmed that affected individuals reach the third decade. Expanding the study to include the integration of behavior-related patterns during nighttime bar visits could contribute to a more comprehensive understanding of this syndrome.