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A shared wave is a clinical test of health—and humanity

BMJ 2014; 348 doi: (Published 17 January 2014) Cite this as: BMJ 2014;348:g281
  1. J Edward Fitzgerald, general surgery registrar, Association of Surgeons in Training, Royal College of Surgeons of England, London WC2A 3PE, UK
  1. edwardfitzgerald{at}

The exchange of waved hands between doctor and patient can reveal much more than you might think, writes J Edward Fitzgerald

It was Saturday night as the general surgery registrar on call, and I was halfway through a three shift weekend stretch. In our emergency department the psychological darkness of the busy early hours was punctuated by the piercing call of a crash bleep. Switchboard’s disembodied voice rose from my pager and repeated itself loudly and firmly, summoning me to the surgical ward. Clerking interrupted, abrupt apologies given, notes abandoned, and three flights of stairs climbed, culminating in a breathless, anxious arrival.

The medical and anaesthetic team was already there and made it clear that the immediate crisis did not require operating. Instead, I stood there, watching the battle unfold, wondering how I could help. Standing at the foot of the bed I looked down at the elderly patient, who was dyspnoeic and audibly wheezy. He looked back at me as the acute medical team took charge. Now was not the time to push in for a social chat. He was too ill, with too much happening, too many people, and too …

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