Filler Memorable patients

Down but not out

BMJ 1998; 316 doi: (Published 13 June 1998) Cite this as: BMJ 1998;316:1785
  1. M K Thong, lecturer in paediatrics
  1. University of Malaya, Malaysia

    A decade ago my first house officer posting was in a paediatric ward in a Malaysian general hospital. One of my patients was a 2 year old Malay boy with Down's syndrome who had been referred for hypercyanotic spells. He was a scrawny looking kid with the deepest cyanosis I had ever seen. What made him stand out in the busy paediatric ward was his sunny smile for everyone who passed his cot. He had been referred 12 months earlier for cyanotic spells and when Tetralogy of Fallot was diagnosed he was sent home to a rural village to await a date for palliative surgical treatment. I discovered much later that the number of names on the paediatric cardiac surgery list was longer than anyone …

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