My first patient

BMJ 2002; 325 doi: (Published 21 September 2002) Cite this as: BMJ 2002;325:651
  1. D W Smith, retired general practitioner
  1. Podington, Wellingborough

    I was 10 years old when I found that I had head lice. I lived with my aunt then and was too ashamed to tell her. I searched the medicine cabinet but found nothing promising. The oil lamp in the bathroom held a remedy, and I massaged my scalp with paraffin. The next problem was to get rid of the paraffin. A hot bath transferred the paraffin to the rest of my body and left a thin film over the bath. More soap and water got rid of it eventually. About a week later I developed swellings at the back of the neck. The doctor was called, and when he asked if I had been scratching my head my shame was complete.

    Eight years later, my non-medical roommate developed swellings in the neck and was not pleased with my provisional diagnosis of head lice. His displeasure turned to scorn when he was taken away to the fever hospital with rubella.

    I liked to think that this taught me the danger of hasty diagnosis.


    We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to.

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