The privilege of wisdom is to listen

doi:10.1136/bmj.329.7462.390-a

BMJ 2004;329:390 (14 August), doi:10.1136/bmj.329.7462.390-a

Filler

A memorable patient

The privilege of wisdom is to listen

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

A 64 year old patient was referred to the emergency departmentby an oncology nurse. He had metastatic bronchogenic carcinomaand was complaining of bilateral leg weakness of recent onset.The referral note mentioned the possibility of cord compressionsecondary to bone metastasis. The patient was seen first bythe emergency department doctor, who documented the leg weaknessand then forwarded the patient for an orthopaedic review. Theorthopaedic team agreed with the diagnosis and arranged hospitaladmission for urgent magnetic resonance imaging. They also discussedthe case over the telephone with me (the on-call physician)regarding palliative management.

Late that night, while reviewing another patient, I overheardone of the student nurses telling her colleague that she hadchecked the blood sugar levels of the patient admitted withspinal cord compression and that they were very high. Armedwith this new information, I reviewed the case history againand . . . [Full text of this article]

Mohammad Imran Khan, consultant in gastroenterology

Wanganui Hospital, New Zealand