As a newly qualified doctor and with a first job as casualty officer I saw a boy of 14 with a tender swelling in his left groin. I diagnosed an inflamed lymph node and asked him if he had a sore wound or spot on his leg or foot. He said yes, on his knee. This seemed to be a good teaching point, and, flushed with the success of my apparent clinical acumen, I sent for the two student dressers. On examining the patient, one suggested a femoral hernia; the other wondered about a lymphosarcoma. I said I thought that it was simply an infected lymph node and asked them what questions they should put. There was no immediate response so I said that they should ask the boy if he had any sore spots or cuts on his leg. Anticipating gasps of appreciation I proceeded to roll up the patient's left trouser leg. Alas, as I began this manoeuvre the boy said, "The spot's on the other leg, Doctor." This was my first clinical "shock" and proved a salutary lesson that cured me of over confidence for life.
Desmond Farley, retired consultant surgeon, Winchester
COPYRIGHT 1999 British Medical Association
COPYRIGHT 2000 Gale Group
Contact
Home
A
Amyotrophic lateral...