Tuesday, 10 August 2010

Crossing the legs

How I miss paper notes. Although computerised record keeping has many advantages, how I miss the ability to skim quickly through the notes. If well kept (ok not always the case)-so much information could be gleaned so quickly. But another disadvantage is the habit of spending as much time looking at the computer as looking at the patient.

Where you look when seeing a patient really does matter. A rather jovial patient of mine asked me to look at a skin lesion just beneath her axilla last week. After satisfying myself of it's benign nature I then went on to reassure her at some length. She smiled an said, "Do you realise you've been talking to my armpit for the last minute!"

Recently I saw a gentleman in his late sixties who had been vaguely off color for the past few months. Nothing all that specific, and indeed when i saw him a few months ago i wondered if depression was the problem. However I intently looked at him as his wife recounted her recent concerns. It was then that he crossed his legs.

It was as though it was in slow motion. And then I noticed the reduced facial movements, and then the fine right hand tremor. A prompt referral to the neurologist and a diagnosis I suspect forthcoming.

But it all started with looking.
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