Always take a careful history

BMJ 2010; 340 doi: (Published 31 March 2010) Cite this as: BMJ 2010;340:c418
  1. Alexander Fernandez, retired general practitioner, Lyme Regis
  1. alexfernandez33{at}

    Unusually for Lyme Regis, on England’s south coast, there had been a severe episode of heavy snow that lasted for several days. and I was snowbound at home. I lived a mile or so from the town centre, and my practice, at the top of a steep hill. Everything was at a standstill, and I could not get my car on the road.

    On the third day I was surprised to see that the milkman had arrived. He had managed to obtain chains to fix to the wheels of his van. He told me of the difficulties he had encountered on his round and mentioned that “poor old Mrs Jones has bad water trouble.” She was one of my patients, so I donned suitable clothing and boots, grabbed my medical case, and trudged and slithered the mile down hill in a blizzard to poor old Mrs Jones’s house.

    On my arrival, Mrs Jones welcomed me with great surprise: “Fancy you turning out on a day like this, doctor. Do come in from the cold.” I explained that the milkman had advised me of her water trouble. She nodded and pointed up to the ceiling, where a large patch of damp was to be seen. However, the plumber was on his way, so I commiserated, and we had a cup of tea and a chat. I then trudged back up the hill, treating some children on the way by joining in with a snowball fight.


    Cite this as: BMJ 2010;340:c418

    View Abstract

    Sign in

    Log in through your institution

    Free trial

    Register for a free trial to to receive unlimited access to all content on for 14 days.
    Sign up for a free trial