Tired all the timeBMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7104.376 (Published 09 August 1997) Cite this as: BMJ 1997;315:376
- David Memel, general practitioner
The consultation had an inauspicious start. It was towards the end of a busy afternoon surgery and the young woman sat herself down. “I haven't been feeling well lately, I've made you a list.” The list was overwhelming for a 10 minute consultation late in the day, having 20 different symptoms. But I had known her for several years, including looking after her during her pregnancy, and she had never behaved like this before.
I looked closer at the list and a pattern appeared. Symptom number 2: puffy eyes most of the time; number 8: hands feel numb and swollen, especially while sleeping; number 9: dry skin on hands—sometimes chapped; number 15: generally feeling tired and worn out; number 16: always cold; number 17: hair gone darker and dry, more facial hair; number 20: lost my shout. By the time I …