Intended for healthcare professionals


Doctor, help! My child has cancer

BMJ 2000; 320 doi: (Published 04 March 2000) Cite this as: BMJ 2000;320:644

Health professionals have the dilemma of how to get it right without getting it wrong

  1. Charles Essex, consultant neurodevelopmental paediatrician
  1. Gulson Hospital, Coventry CV1 2HR
  2. Alison Lea Medical Centre, East Kilbride G74 3BE
  3. Laurie Pike Health Centre, Birmingham B19 1LH
  4. Bracondale Medical Centre, Stockport SK2 6EQ
  5. 5 Ambassador Court, Century Close, London NW4 2EE

    EDITOR—The paired articles by the mother and general practitioner of Antony, a child who died of neuroblastoma, were both exasperating and encouraging.1 The story highlights a dilemma for health professionals: how to get it right without getting it wrong. Surely I am not alone in thinking that the general practitioner was damned if he did and damned if he didn't visit the family.

    Doctors are not mind readers. The general practitioner offered an open door to the family and yet was criticised for not being proactive, for not second guessing the family's needs and the frequency of those needs. Other parents would criticise their general practitioner for coming when they wanted privacy, or for interfering when he or she lacked knowledge of the condition. Antony's mother describes being on “an emotional roller coaster, feelings and tension are high.” The consequence is that every action (or lack of action) or phrase (or silence) can be given a meaning far beyond its intention.2

    We get the health service we pay for. The general practitioner has a list of, say, 2000 patients. Multiply that by the number of partners in the practice and add the welter of paperwork and administration that he or she faces as a general practitioner and a course organiser; anyone with any experience of general practice will realise that we don't live in Tannochbrae with Dr Finlay popping in for a chat. From the information given by both parties, the general practitioner has nothing to reproach himself for.

    The BMJis to be praised for publishing both sides of the story—something that I have long advocated, particularly when articles describe a specific incident or a person's course of treatment. Publishing one side of a story (the patient's side) with the author's name and address can cause immense …

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