Fillers A memorable patient

The benefits of a cross channel flight

BMJ 2004; 329 doi: (Published 26 August 2004) Cite this as: BMJ 2004;329:503
  1. Seamus J Murphy, research registrar in gastroenterology
  1. Queen's University, Belfast

    Florence was the sickest patient with primary biliary cirrhosis whom I had ever seen when I clerked her in that night. Her notes revealed that her liver disease had long been stable, but her deeply jaundiced condition proclaimed that something was now amiss. Then, as a post-membership senior house officer, I put liver cancer top of the list of possibilities. However, all scans were normal, and blood tests, apart from confirming that her liver enzymes were elevated, were unrevealing. Florence waited patiently each day for news of a diagnosis, but we held up our hands at the ward rounds and looked baffled. We contacted King's College …

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