Constructivist science education typically presents a relativist image of scientific knowledge that is not shared by scientists. Truth and time are defined differently by scientists than by postmodern observers of science; a theoretical definition of truth is often applied to scientific knowledge within science education, whereas a practical definition, supported by evidence, is used within science. Similarly, time is sometimes taken out of context within science education when scientific concepts that have developed slowly and are well accepted by scientists are treated as though they were tentative.

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Patient: Female, 36Final Diagnosis: Thyroid hemorrhageSymptoms: Shortness of breathMedication: —Clinical Procedure: ThyroidectomySpecialty: SurgeryObjective:Rare diseaseBackground:Spontaneous goiter hemorrhage is a rare entity that can lead to life-threatening respiratory compromise. Goiter hemorrhages are usually due to effects of anticoagulation or neoplastic processes. The hormonal effects of pregnancy may also lead to such life-threatening goiter hemorrhages in the immediate postpartum period.Case Report:We report the case of a 36-year-old woman who complained of progressive neck swelling as well as eventual shortness of breath in the immediate postpartum period. Computed tomography scans and ultrasound of the neck revealed an enlarged and heterogenous thyroid with airway compression. The patient underwent an emergent subtotal thyroidectomy to alleviate the mass effect on the airway. Upon resection, the thyroid was noted to contain a goiter hemorrhage with no signs of neoplastic degeneration on pathology.Conclusions:Pregnancy is a known hormonal stressor that routinely increases the size of the thyroid and also predisposes patients to goiter formation. In rare cases, thyroid goiters may be predisposed to hemorrhage, causing airway obstruction and necessitating urgent surgical intervention.

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