Speak clearly to the bogey man

doi:10.1136/bmj.331.7515.492

BMJ 2005;331:492 (3 September), doi:10.1136/bmj.331.7515.492

Filler

A patient who changed my practice

Speak clearly to the bogey man

When performing a cerebellar examination in multicultural Singaporesome years ago, I asked the patient to touch the tip of hisfinger to my fingertip and then to touch his nose. In Hokkien,the latter instruction translated to "Touch your nostril," whereuponthe patient touched my fingertip, then dug his finger into hisleft nostril, and finally touched my finger again. Too shockedto remonstrate (after all, he had complied with my instructions),I completed the examination, after which I surreptitiously wentoff to wash my hands.

Since then, I have always instructed my patients to touch thetips of their noses, after which they are to touch my fingertip.It was somewhat heartening to hear that a colleague (RCSS) hassince learnt the same lesson, to his chagrin (and my amusement).

Erle CH Lim, consultant neurologist

(mdcelch{at}nus,edu.sg), Raymond C S Seet registrar, Department of Medicine, National University Hospital, Singapore