Please don't make a fuss, dearBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7115.1100a (Published 25 October 1997) Cite this as: BMJ 1997;315:1100
- Michael J Chamberlain, head of division of nuclear medicine
- Ottawa Civic Hospital
My mother reached 86 with her hearing, vision, and all her wits intact, living alone, and enjoying life. Then a neighbour found her semiconscious, bleeding from a head wound. She had struck her head on the sideboard and crawled to the telephone. The left hemiparesis was quickly evident and became dense.
She was admitted to the local general hospital where she had previously had a cardiac pacemaker inserted and been treated for mild hypertension and presumed angina. Unfortunately, no trace of the previous hospital records could be found. The paralysed limbs became oedematous, deep vein thrombosis was considered and rejected, a diuretic was prescribed.
Mother complained of dry mouth and urinary urgency. An antimicrobial was prescribed, although examination of the mouth did not reveal any thrush. Three weeks after admission my sister asked the consultant physician whether subdural haematoma had been considered. She was told that it had and had been excluded by computed tomography, but no scan had been performed.
By now Mother was being nursed in a stroke rehabilitation unit where the television was on at full volume distracting patients and visitors alike. It was kind of an aid to bring a cup of tea but not to leave it on a table on her left side to which she showed the anticipated inattention complete with the spilt food down her left side. The inattention to the left side led to a recurrent problem with her …