Wardround 29viii8

Why was a rheumatologist asked to see this patient?

The reading this week about the methods magicians use to distract their audience led to some discussion of distraction, its benefits and pitfalls in medicine, the importance of not interrupting the 'rituals' of medicine that doctors use to keep on track and recognising when we ourselves have been distracted from the path.

For next week I would like you to read Why are medical journals so dull by Richard Asher. Originally published in the BMJ in 23 August 1958. Tempted as I am to leave you to get hold of the paper using your own initiative there is a link here if you do not feel like taking up the challenge. The link works for me but if you are unsuccessful I can give you a paper copy (folded in the shape of a dunce's hat!)

As ever the original responses to a paper can be illuminating. It is well worth getting used to reading the letters written to the editor about papers you read.

I was sorry to have been called away before the end of the Gram talks. It sounds obvious but the information Gram pos/negative cocci/bacilli should prompt immediate thoughts: does the patient have features of systemic sepsis syndrome? what do I need to check to further identify the type of organism and the likely spectrum of antibiotic sensitivity. Be sceptical about any comment from someone who has not assessed the patient that an organism could be a just a contaminant. How about clicking the comment button and writing in one sentence about something particularly interesting you found in your reading on the subject.

The talks for next week will be Epilepsy.
I was not able to assign these so it will be first come first served. Click the comment and claim the subject you will take. On offer are:
Epidemiology
Classification
Investigation
What to tell a patient after their first seizure
Treatment

Interesting topics

Lofgren's syndrome (what I was called away to see)


MJM

How weary, stale, flat and unprofitable, seem to me all the uses of this world
Fie on't ah fie! 'tis an unweeded garden, that grows to seed ...
That it should come to this.