A is for aphorism - is it true that 'a careful history will lead to the diagnosis 80% of the time'?
Medicine is an uncertain pursuit. As medical students and junior doctors, we often try to manage this by collecting golden rules as we progress through our education. And there are many occasions when a 'third voice' joins us during a consultation - the voice of a professor, clinical tutor or colleague, that enters our head spouting a pearl of wisdom, such as, 'a woman of childbearing age is pregnant until proven otherwise' or 'when you hear hoof beats, think horses not zebras'. (+info)
A is for aphorism - the power of silence.
'All you have to do is listen' is the title of Rob Kapilow's delightful book on classical music; but he could equally have been talking about general practice consultations. Listening requires several skills including attention, echoing and body language, but begins with silence. Well timed silences, used judiciously, can allow the patient adequate space to express symptoms and concerns, while allowing the general practitioner more time for attention, comprehension and synthesis. (+info)
Parental explicit heuristics in decision-making for children with life-threatening illnesses.
James Alexander Lindsay (1856-1931), and his clinical axioms and aphorisms.
John Alexander Lindsay was born at Fintona, county Tyrone in 1856, and at the age of 23 he graduated in medicine at the Royal University of Ireland. After two years in London and Europe he returned to Belfast to join the staff at the Royal Victoria Hospital and in 1899 he was appointed to the professorship of medicine. He was valued by the students for his clarity and by his colleagues for his many extracurricular contributions to the medical profession in the positions entrusted to him. He published monographs on Diseases of the Lungs, and the Climatic Treatment of Consumption, but his later Medical Axioms show his deep appreciation of studied clinical observation. Although practice was changing in the new century Lindsay displayed an ability to change with the new requirements, as evidenced by his lecture on electrocardiography as president of the section of medicine of the Royal Academy of Medicine in Ireland in 1915. He was impressed by the way the string galvanometer changed attention from stenosis and incompetence of the valves to the cardiac musculature, but rightly suspected that there was more to be told about the state of the myocardium than Einthoven's three leads revealed. His death occurred in Belfast in 1931. (+info)
A is for aphorism--'nothing is sometimes a good remedy'.
We live in a different era of medicine than that of the great Hippocrates. Our patients are better informed, with ready access to a plethora of medical information, and enter the consultation with expectations of being offered therapies for all their ailments. But is it still true, over 2000 years after Hippocrates, that 'nothing is sometimes a good remedy'? (+info)
A is for aphorism--'medicine is my lawful wife, and literature is my mistress. When I get [fed up with] one, I spend the night with the other.'.
'I feel more confident and more satisfied with myself when I reflect that I have two professions and not one. Medicine is my lawful wife, and literature is my mistress. When I get tired of one I spend the night with the other. Though it is irregular, it is less boring this way, and besides, neither of them loses anything through my infidelity.' (+info)
A is for aphorism - 'Wherever the art of medicine is loved there is also a love of humanity'.
He was an amazing diagnostician. He could listen to the history and then with this long, pointy, bony finger he'd say, "So, what do you think was significant in that bit of the history? What did you feel there as you examined the abdomen? Did you look at this here? Have you seen these?" But he was a very warm person too - just so caring. (+info)