Personal Views

Resonant images from the United States

BMJ 1997; 315 doi: (Published 12 July 1997) Cite this as: BMJ 1997;315:133
  1. Gordon C S Smith, researcher
  1. Cornell University, New York

    The path to America is well trodden by middle grade medical staff from Britain. They return with fishermen's tales of the fabled inefficient, overinvestigating American healthcare system—“and they ordered whole body magnetic resonance imaging for an ingrowing toenail.” Such tales of the disaffected can get their authors in trouble, like the recent rebuke in the BMJ from the president of the American Society of Anesthesiologists over accusations from a visiting British registrar that American anaesthetists were dictated to by surgeons—perhaps the president of the American College of Surgeons told him to write the letter.

    Coming to Cornell University in Ithaca, New York, for three years of basic science research, I was quietly smug that such tedious anecdotes would not issue from me. And then my 5 year old daughter developed a fever of 100°F and the inability to bear weight on her right leg.

    Our first port of call was the local casualty department. No history or signs of trauma, both ankle joints clinically normal, tender over the distal tibia on …

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