Intended for healthcare professionals


Commentary: Wide angle thinking helps patients with distressing illness

BMJ 2006; 333 doi: (Published 13 July 2006) Cite this as: BMJ 2006;333:134
  1. Ed Peile, professor of medical education (
  1. 1 Institute of Clinical Education, Warwick Medical School, University of Warwick, Coventry CV4 7AL

    Kenneth Neville presents interesting problems for specialists and generalists alike.1 At the time of the case presentation, we were told about a young man with distressing symptoms of postprandial vomiting leading to weight loss and weakness. The local hospital had diagnosed gastro-oesophageal reflux disease, and a battery of other routine investigations had given negative results. We were presented with several possibly relevant psychological factors, and it was mentioned that his asthma had been difficult to control. Readers were invited to consider the differential diagnosis and to suggest the most helpful course of management for the family doctor to take when …

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