Intended for healthcare professionals

Student Reviews


BMJ 2005; 331 doi: (Published 01 October 2005) Cite this as: BMJ 2005;331:0510395
  1. Becky Hodgkinson, senior house officer in paediatrics1,
  2. Teresa Pun, second year medical student2
  1. 1Queen Elizabeth Hospital, Woolwich, London
  2. 2University of Toronto

Design flawed?

few weeks ago, consulting a patient with cystitis, I used one of the classics. I found myself explaining that her infection was due to a “design flaw.” Her urethra was too short allowing micro-organisms into her bladder. I heard myself and stopped, pondering the truth in this statement. Are we “design flawed?” Do we, as medical professionals, really spend our time correcting the inherent mistakes in the original construction of the human body?

The concept of the “clinical iceberg” is important in medicine, but we forget that the iceberg is surrounded by an enormous ocean made of people in perfect working order. As medics, we briefly learn the anatomy and physiology that underpin human biology, but with the perspective of working out how and when it will go wrong. Since we focus on the shortcomings in the system, we rarely pause long enough to ponder the incredible make-up of the bodies with which we work.

The body's largest organ, the skin, has an average surface area of about 2 in' and the epidermis is promptly renewed about every 30 days. Our gene regulators are so highly developed …

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