BMJ 2003; 327 doi: (Published 24 July 2003) Cite this as: BMJ 2003;327:236
  1. Simon Stephenson, Western Infirmary (
  1. Glasgow

    At 12 years old, he'd already been unwell for a long time: congestive cardiac failure secondary to cardiomyopathy; a rare cause of this condition in my limited clinical practice but common in the population he came from. He'd been receiving maximal therapy for months now, his dutiful carers ensuring he took his furosemide and enalapril every day, going so far as to grind them up into his meals when he—as happened increasingly often—refused to take them.

    When they called me in to see him, I was shocked by just how bad he'd become. I'd known him his whole life, and in my mind he'd always remained as sprightly as the first time I saw him playing with his siblings. Things were different now. Even from the end of …

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