Little Miss Diagnosed; A Surgeon's Guide to Breaking Bones and Bending Rules

In her memoir, Little Miss Diagnosed: A Surgeon’s Guide to Breaking Bones and Bending Rules, Dr. Erin Nance recounts gripping, "Netflix-worthy" experiences from her career as an orthopedic surgeon. From treating her brother—her first patient—to confronting systemic sexism and ethical challenges, Dr. Nance manages to keep her sense of humor while delivering a brutally honest look at our healthcare system at large.

  Dr. Nance’s memoir begins with a chilling account of her first day as an orthopedic surgeon. Against the backdrop of a bustling 4th of July weekend at Stony Brook Hospital, she receives an urgent call from family that her brother, injured after diving into a shallow pool, was being airlifted to her hospital with a neck injury and paralysis.

“And that was the moment I realized that he was paralyzed, and he had broken his neck. And was a quadriplegic. “I wasn't expecting my first day at work - where I'm supposed to be taking care of patients - for that patient to be my own family member,” said Dr. Nance. “Having that experience shaped how I became a doctor.”

Systemic Sexism in Healthcare

On her first day as chief resident, Dr. Erin Nance walked into a locker room at Stony Brook Hospital that was meant to be a shared space for all medical staff but was steeped in a blatantly male-chauvinistic atmosphere. The room was a stereotypical “boys’ club,” adorned with paraphernalia, calendars, and images that screamed exclusion, creating an environment where women, and anyone outside the dominant culture, felt unwelcome.

  “It was my first day as chief resident and I'm walking into our ortho resident lounge. And this is a lounge you can only imagine it more like a locker room; there are pictures of penises on the wall, there are sports calendars of women in bathing suits and bikinis, and there are maxi pads taped over people’s lockers. That’s the lounge we all shared every day.

  “I thought how awful to have to come into this room, this environment where it is, like, so clear that you are not accepted or welcomed.” And on that night, Dr.Nance recalled, “I said I'm taking all this sh*t down!” After taking down all the pictures, all the calendars, and all of the paraphernalia, she committed to making all who entered feel welcomed and safe.

   “I said, you know, this is going to be a place where everyone can feel like they are welcomed and included. I didn't have that ability until I was in the position of power,” Dr. Nance said, “until I became the chief resident, and I felt confident enough that I could make this decision and it's something that I hope is part of my legacy.”

Ethical Dilemmas in the ER

As Dr. Nance navigates her way through the hospital healthcare system as an Orthopedic Surgeon, she once again comes face to face with a dilemma, only this time it’s ethical.

   With the same bravery and unapologetic verve she’s demonstrated before, Dr. Nance puts herself in a position to save a homeless woman by going against normal protocols and taking matters into her own hands.

   Some 15 years ago, Dr. Nance recalled a case of a homeless woman who had come to the emergency room after suffering a broken arm after being attacked on the street.

   “What people may not understand about how the emergency room works, is it’s really only limited to emergency care. Are you dying or are you not, right?” Dr. Nance explained. “And if you're not dying, then you go home. So, it's a procedure that for her, although she broke her arm, it wasn't considered an emergency type of surgery. But I knew that if she was released no doctor was ever going to electively operate on her,” she continued, “and so, I made the decision to admit her.

   “I wouldn't necessarily say that I lied, but I would say that I emphasize a possible scenario where she could develop something called compartment syndrome. And I said I would like to observe her for compartment syndrome and operate as soon as possible. And when you go down that path, then you're able to actually do surgery under emergency circumstances. So, in that sense, I felt that it was worth taking things into my own hands for the benefit of this woman, this individual; she needed surgery that night.”

In Little Miss Diagnosed: A Surgeon’s Guide to Breaking Bones and Bending Rules, Dr. Erin Nance exposes the pervasive biases within the medical system through her journey as an orthopedic surgeon. Her memoir vividly highlights the discrimination based on gender, race, and socioeconomic status, offering a candid exploration of the systemic challenges she faced and challenged in her career.

   “Whether or not it's conscious or subconscious -you know. I don't think there's any doctor who is going around saying, ‘I don't want to operate on someone who has Medicaid,’ but certainly that's how our system is laid out,” Dr. Nance said. “You have physicians who are part of the public hospital system and then you have physicians who are out of network. And so, I think unfortunately we have a class system. When it comes to our healthcare, whether or not we want to admit that or not- after all not just anyone can go to the Mayo Clinic. Not just anyone can go to the hospital for special surgery. So, we as a society have to decide how we want our healthcare to be administered. And I think how we are judged as a society is how we treat the most vulnerable and so I think this is a larger conversation about how Healthcare is delivered, whether or not healthcare is considered a human right.”

The Medical Detectives

A Podcast For Patients

Dr. Nance first began exploring these stories and alike on her TikTok account which now hosts over 750k followers, and on her podcast show, The Medical Detectives, which allows call-ins to tell their story or explain life-long medical issues and mysterious symptoms.

   “So, what I started to do was share these stories on my TikTok account, which became the stories that I wrote about in this book. But soon snowballed, I was getting 10,000 messages a week from people asking me to share their story - so that one person wouldn't have to go through what they went through alone.

And that's partly what we do on the Medical Detectives podcast, she said, “It's not so much a medical podcast. It's more of a patient podcast platform.

   Describing the platform’s mission of helping people feel heard, understood, and possibly helped through Dr. Nance’s expertise and experience, she said, “At first, it's normal to feel anxious when no one can tell you what's wrong. It's normal to doubt yourself when everyone's telling you you're fine. It's just anxiety.

It's all in your head. It's normal to feel depressed when you're not getting any answer. So, I really want people to validate those feelings that these are a normal part of the process and then come up with some solutions to actually get you a diagnosis and avoid those later stages of depression and apathy.”

   Dr. Erin Nance founded Feelbetr.Health, a wellness platform launching on June 20, 2025. Supported by over 200 doctors, it provides answers to medical questions (e.g., "What is endometriosis?") and connects users with others experiencing similar symptoms for support and community. “If you have breast cancer, there's no one else to trust more than another woman who's been through breast cancer, right? said Dr. Nance. “And what I learned from our beta users is that if you're on the other side of things, there's nothing that brings you more joy than to help someone out who's going through it currently -and that they find so much value in -they felt like if someone heard their story, and it could help one person. That's all that matters.”

   To learn more about esteemed Orthopedic Surgeon Dr. Erin Nance visit www.TikTok.com/littlemissdiagnosed and for a copy of her book visit www.harpercollins.com, www.Amazon.com.