Hidden in plain sight.

  Patients do not come with diagnoses attached to their foreheads.  If only they did,  huge numbers of hospital visits and admissions could be avoided. To overcome the ever increasing number of potential diagnoses, and the rising tide of illness encountered by our ageing populations, we rely ever more heavily on investigations to guide us […]

Read More…

Look not for the fleck in your brother’s eye, but the gorilla in your own…

Teaching for medical graduates approaching clinical exams such as the MRCP PACES exam is an anxious time.  One is expected to ‘perform’ under pressure, wary of the need to elicit signs leading to potentially outlandish diagnoses.  The breadth of knowledge and skills required to confidently identify CMV retinitis at one station, followed by a complicated […]

Read More…

Three pipe chest pain…

Medicine is no longer quite so full of time to ponder as it once seems to have been.  Rumination and consideration have taken a back seat to efficiency.  Protocols and pathways seem to be the order of the day, and once a patient is on a pathway, it can be very difficult to get them […]

Read More…

What do all those numbers really mean doc?

  Go into hospital nowadays, and you will do well to escape without having a blood test of some sort.  Very often these are routine tests, which give doctors an overview of the state of play. There might be a few wayward figures here or there – but the doctors will ignore them, or explain […]

Read More…