Minerva

doi:10.1136/bmj.332.7548.1042

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Many hospital patients are confused about whether to call their doctor “Doctor” or “Mister” (or “Miss”). Just when they start to get the hang of it, they're caught out again. Now they have physicians, dressed like surgeons, sticking a cardiac stent in them—and wanting to be called doctor. And the stent insertion is an intervention, rather than an operation, because it's not carried out by a card-carrying surgeon. In the US, of course, “Doctor” will do for every vet, dentist, osteopath, and podiatrist (Journal of the Royal Society of Medicine 2006;99: 164-5).

A 69 year old woman was referred by her general practitioner to the general ophthalmology outpatient clinic with bilateral eyelid irritation and loss of eyelashes on her left lower lid. A biopsy of the lower lid confirmed the presence of a basal cell carcinoma. She was referred to the oculoplastic service for surgical excision, after which tumour-free margins were confirmed. Infiltrating basal cell carcinomas may present in this seemingly trivial way, without evidence of a mass lesion. Clinical suspicion should be high if there is localised …