Fillers A memorable patient

Psychiatric problem dismissed

BMJ 1998; 316 doi: (Published 16 May 1998) Cite this as: BMJ 1998;316:1506
  1. Hillel Davis, psychiatrist
  1. Jerusalem

    I was a medical student in my first clinical rotation, assigned to a medical firm under a consultant renowned for his diagnostic skills and general medical approach in an ever specialising world of internal medicine. I first saw the patient in the senior house officer's (SHO) new patient clinic, and with my fellow students watched on impressed, as the highly motivated and extremely capable SHO took a painstakingly detailed history from a intelligent woman in general good health, who spoke animatedly about herself and her symptoms. She described recurrent episodes of apparent hypoglycaemia, which came on without warning, leaving her with an array of symptoms including tremor, confusion, tachycardia, and general malaise. The diagnostic possibilities were too much for us first time …

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