BMJ  2003;327:401 (16 August), doi:10.1136/bmj.327.7411.401

reviews

PERSONAL VIEW

Listen to the patient

The first 150 words of the full text of this article appear below.

The patient was a 79 year old woman with a history of ischaemic heart disease: two acute myocardial infarcts 10 years ago, followed by longstanding atrial fibrillation and worsening angina. Coronary artery bypass surgery six years ago had fully relieved the angina, and she had been free of symptoms (although still with atrial fibrillation) while taking digoxin, blockers, and warfarin, among other drugs. Now she reported two days of progressive shortness of breath with intermittent pain in the centre of her chest. She had obvious dyspnoea at rest, slight cyanosis, readily audible bilateral crepitations, a raised jugular venous pulse, marked dependent oedema of her arms and legs, and (I was pretty sure) a palpable tender liver.

We have lost something of the art of medicine in a headlong rush to embrace the science

It didn't seem the most difficult clinical problem—even for a public health physician without paid clinical responsibilities . . . [Full text of this article]

Public Health Group North East, Department of Health bill.kirkup@doh.gsi.gov.uk

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Rapid Responses:

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what happened to the GP?

kathrin j thomas
bmj.com, 15 Aug 2003 [Full text]

Communicate - don't just 'listen'

susanne McCabe
bmj.com, 19 Aug 2003 [Full text]

Far from unique

Mark Aszkenasy
bmj.com, 20 Aug 2003 [Full text]

Re: what happened to the GP?

Bill Kirkup
bmj.com, 23 Aug 2003 [Full text]

Any role for the GP?

Catherine A J Dixon
bmj.com, 29 Aug 2003 [Full text]

Listen to the patient

Valerie F Hartley-Brewer
bmj.com, 8 Sep 2003 [Full text]

Try to make, the patient understand what is his problem.

Ionescu Sebastian
bmj.com, 15 Sep 2003 [Full text]