Doctor and patientBMJ 2004; 329 doi: https://doi.org/10.1136/sbmj.0409335 (Published 01 September 2004) Cite this as: BMJ 2004;329:0409335
Five years ago I was an energetic medical student who had just returned from a life changing elective in South East Asia. I thought I was on the path to fulfilling my dreams. Instead, I inadvertently stumbled into dangerous uncharted territory--ill health.
At first I put my worsening myalgia and generalised joint pains down to a change in weather, diet, driving distances--anything really. But as the weeks progressed, immense fatigue set in. With a gradual loss of appetite and the subsequent weight loss (great at first) came eye problems and painful lumps on my legs. Then the dry cough became more and more persistent.
According to rheumatology, I had reactive arthritis and was started on anti-inflammatories. According to tropical medicine, I had one of three possible tropical diseases given my recent travel abroad. The dermatologists wanted a biopsy of my painful shin lesions. The ophthalmologist diagnosed anterior uveitis.
I read a general medicine textbook, trying desperately to put the pieces of the jigsaw together. I decided that I needed a chest x ray, something I had not had so far. My wonderful general practitioner kindly arranged for my medical student whim to be satisfied. It turned out that I had gross bilateral hilar lymphadenopathy. I was referred to hospital urgently for further tests and had to go …