The white coated man's burden

doi:10.1136/bmj.329.7468.723

BMJ 2004;329:723 (25 September), doi:10.1136/bmj.329.7468.723

Filler

A memorable patient

The white coated man's burden

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

Mrs Jones was a truly delightful woman in her late 60s who struggledwith the problems posed by diabetes, hypertension, angina, asthma,peptic ulceration, gout, rheumatoid arthritis, and a modestdegree of renal impairment. Unsurprisingly, she was usuallymarkedly symptomatic from one or more of these conditions. Asa newly appointed medical registrar, I encountered her in myfirst outpatient clinic. I saw somebody who was clearly disabledtrying to make the best of it but obviously becoming prettylow spirited in consequence of the constant struggle. My role,I knew, was to relieve her plight and restore her to a pleasurableand fulfilling life, so I set about tackling her multiplicityof problems.

Over the weeks, I improved her joint pain and her angina, butthe drugs aggravated her ulcer and worsened her asthma. Theworrying level of hypertension could, of course, be treated—butthen the diabetes, gout, and . . . [Full text of this article]

John Moore-Gillon, consultant physician

Bart's and the London Trust, London (john.moore-gillon@bartsandthelondon.nhs.uk)