As well as sympathising with the patient, many respondents to this case commentary found themselves engaging in the difficulties faced by the general practitioner.1 Donald Schon, in Educating the Reflective Practitioner, described a “swampy lowland” wherein lie the problems of greatest human concern and where “messy, confusing problems defy technical solution.”2 Schon contrasts beautifully the technical and rational approaches of the theoretical high ground with the reflective approaches we often need in professional practice.

In interactive …