Apparent diagnostic triumphs may be mere shadows masking the reality of human tragedy, as Professor Sir John Scott relates.
A strange set of circumstances
I was a junior registrar, my chief was a very famous physician. He phoned me one day from his rooms.
‘I have a case I wish to admit. Things aren’t quite right here. I have some ideas but I would like you to start this largely on your own,’ he said.
The patient was in her late 40s, a demure, slightly built farmer’s wife and mother of three children, who lived in a small country town. She had presented to her GP because of recurring attacks of cyanosis. My chief had concluded that these were very unusual. He had taken, in his meticulous way, a very full history and realised that there was something quite strange in the overall circumstances.