Deep within all us persons, exists a kind and gentle fella,
Sitted above the “Renes” of urine, we’ve termed this gent, adrenal medulla.
We find him here in a rather calm, mild-mannered mien,
Fondling his friends, Epi and Norepi CAT-acholamine.

 
Now on rare occasions, this Mr. Nice Guy loses all cool and control,
And the Mr Hyde of our gland becomes a new friend called PHEO.
 
As a cause of high B-P, Mr. Pheo is at most one-half percent,
Yet he spares not age nor sex, much to our lament.
Why, in fact, if this monster, likes your fam-i-ly,
You may suddenly find you’re MEA II or II-B.

 
Upon his victims much and varied havoc doth he reek,
But, alas, among MD’s his diagnosis is not oft seeked.
 
Headache, tremor, palpitations and nervousness,
Pallor, weakness, nausea and even emesis,
Abdominal pain, dyspnea, parethesias and flushing,
Heat intolerance, postural dizziness and of course sweats-a-gushing.
Attacking Q two months or twenty-five times a day,
Pheo is an expert at keeping his prey at bay.

 
But these signs and symptoms may be so-o subtle and murky,
Than one may be tempted to think the victim, a Turkey.
However, the acute sleuth of physicians will often note,
That the paroxyms of Pheo, to his quarry are no joke.

 
Hypermetabolic, hyperglycemic, and hypertensive,
Should make most diagnosticians become quite pensive.
“Could it be?  No, surely not.  Yes, yes, tis true,
Pheo, the terrible, is the problem with you”
 

 
Now to find and prove this to his colleagues was the task,
For the presumptive diagnosis was made at long last.
 
Provocative testing(of which he was not fond)
Included tyramine, histamine, phentolamine, or glucagon.
 
 

 
Instead it was the inevitable biochemical measures,
This detective or ours, most dearly entreasured.
Cats, the excreta of Pheo, could be found to exist,
In bodily fluids, without very much risk.
And indeed, plasma and urinary CATS and their metabolites,
Were found to be reaching unbelievable new heights.
 
 

 
Together with the history, his diagnosis was made,
Now to find where the homestead of Pheo has been laid.
IVP’s, Angio’s, and Venography had been used in the past,
But a new method was found to be added to this cast.
CAT Scanning was its name by trade
By finding the impossible had its reputation been made.
 
With Eyes keener than the eagle the scan started its work
To discover where the demon, Pheo, in this victim doth lurk.
As suspected, hiding in camouflage beneath the small cortical zones,
This diabolical fiend was found crowding out the left steroid hormones.
 
 

 
Now, it is possible, to cease to pillage of our new found foe,
As was first done in ’27 by the immortal Dr. C. Mayo.
But a week of alpha blockade was first duly required
‘Fore the services of surgeons were sought to be hired.
Had signs of myocarditis been found to exist,
Then digitalis would also have been added to the list.
 
Carefully, the surgeons and the masters of gas,
Proceed to undertake this formidable task.
With saline, healing steel and adrenergic blockade
A successful battle on the surgical table was made.
 
 

 
A calm post-op recovery with fluids was readily assured
And we find that hypertension can INDEED be surgically cured.
 
Finally now that we have our patient fastly mending
This brings us to the conclusion and another happy ending.