THE DIARY Of A DOCTOR WHO TELLS

Evening Star, Issue 24226, 20 June 1942, Page 3

THE DIARY Of A DOCTOR WHO TELLS

EARLY TBBERGOLMfG Monday, June 15. We recently persuaded the hospital board that applicants for training in nursing shonitt he X-rayed. Young Elsa Harris, accompanied by an indignant mother, called this morning to discuss an adverse report. ‘‘ It’s all so silly,” said the mother. “ Elsa's been quite fit all her life. She’s never hud a cough in years. She’s a bundle of energy. How could she possibly have T.B. ? ” She flung the X-ray report on the table, 1 read that there was typical signs at the upper lobe of her right lung. Why not examine her yourself P ” asked the mother. "I'll examine her,” .1. said, “but I want you to understand clearly that no physical examination will reveal as much as an X-ray report on a lung. An X-ray can pick up trouble long before the ear can hear it.” 1 set to work and had to admit that the stethoscope revealed nothing at all. “There you are!” said the mother triumphantly. “ They've got the pictures mixed. I’ll go and get it taken again to satisfy them.” She picked up her things. “ I'd like to have a word with Elsa before you go,” I said. “ First, 1 want to know her weight and if she’s lost any lately.” “ Oh, she’s lost a bit.” said her mother, “ but she's been tearing round doing a lot of war work. She never gives herself time to eat a decent meal.” “ 1 don’t really feel hungry half the lime,” said Elsa. “ Do you get tired easily? ” 1 asked. “ Well, I make myself tired, 1 suppose, the way 1 rush round,” said Elsa. I looked at her eyelids and thought them anaemic. Here, then, was a significant quartet of symptoms—loss of weight, loss of appetite, tiredness, and slight anaemia. “ 1 don’t want to depress you,” I said to her mother, “ but the symptoms that Elsa owns up to are in every way compatible with her X-ray. 1 want to put her in hospital for a week and watch her.' Meanwhile, we’ll have another X-ray taken.” Mrs Harris nodded dejectedly. Then, as a thought struck her, she said in a hopeful voice: “But, doctor, the cough? There is no cough.” A cough can be a later symptom in tuberculosis,” 1 said. There is every chance for Elsa. Early tuberculosis is eminently curable. Many sufferers from early symptoms have been arrested, and, provided they are sensible, live a long and useful life. Courage, confidence, and caution are high C’s over which the patient rides to safety. The ear often cannot pick up taint sounds inside the body. So in the diagnosis of oarly tuberculosis X-ray is the'modern doctor’s third ear. Tuesday, June 16. The students at the hospital are excited over a new patient. He has “ narcolepsy.” In simpler terms he keeps falling asleep for no particular reason.

Whenever anyone mentions narcolepsy, the case of tbe Fat Boy- of Dickens is sure to be quoted. (“ JoeDamn that boy, he’s gone to sleep again!”) These people have their few seconds —or few minutes—sleep many times a dav, ’ and then take up life exactly where it stopped. These days it can often he kept in check by one of the new drugs. Narcolepsy isn’t sleeping sickness, which is an infective disease common in Africa, and caused by the tsetse fly. Wednesday, June 17.

Would you mind coming round after tea? ” said the voice of Mrs Jbkin on the phone late this afternoon. “ John’s got a bad leg.” “ What’s wrong with it? ” I asked. ‘‘ He came home early for a game of tennis and someone threw a stone at him from over tbe fence. It got him .right in the calf, and it must have injured something inside. He can’t walk at all.” John’s !cg showed no bruise. Crossexamination revealed that no one actually saw anyone throw a stone. Actually, John had injured a long, thin muscle of his leg called the plantaris muscle. It is injured so frequently in' strenuous tennis that a wag has christened it the “ playing tennis muscle.” 1 told John not to attempt to walk on it for a day or two, and that it would probably be better in a few days. He was advised not to play again until it felt quite bettor, probably in about a fortnight.”

Thursday, June 18. It’s no good, doctor,” said Mrs Wright firmly. “ Nancy just can’t take milk.” “ Does it make her sick? ” I asked. “ No,” replied the mother, “ but she makes such a fuss.” “ How is she on butter, fatty meats, cream, and chocolates? ” 1 asked. “ She’s fond of butter and chocolates.” replied Mrs Wright. “ She doesn’t like cream except with strawberries or blackberries and things like that. She prefers lean meat,” fs she the bilious sort? ” I asked. “ Yes and no,” said her mother. “She’s more inclined to sick headaches, if you know what 1 mean.” I nodded.

Don’t force her with fats,” I said. “ Give her plenty of fruit and green vegetables and lean meat. .She’ll take the milk better if you skim all tlie cream off it and add a little sugar. Give her junket, but don’t rush her with milk. She’ll probably grow out of her aversion to fats in time.”

If a child doesn’t like milk but can take fatty foods, it is possible that there is some psychological cause. Perhaps if the milk cairt be taken hot it can be taken iced. Or vice versa. Sometimes it is well taken as a “ chocolate drink,” a “ malted milk,” and so on.

A very few people seem to be definitely allergic to milk. In their case, until they get over it. they have to get their vitamins and minerals (like calcium) from other foods. Friday, June 19.

No doctor I have yet met likes appearing in a court of law. The legal profession knows very little medicine and the medical profession knows very little law. Jt seems to me it is undesirable for one legal side to call its medical exjm't and the other to do the same. While medicine is sometimes a matter of opinion, it would surely he better for the doctors concerned with tne case to submit a joint report wherever possible, which' report would he a dispassionate document rather than points for or against a particular .side." If further legal doubt existed, questions could again be submitted to the medical committee. Which is possibly very beautiful in theory.

These thoughts are prompted by my appearance in a compensation case

to-day. Wo had Ihe difficult task of assessing future working ability and adequate compensation for damage done. A Herculean task, my masters, when you think of men like President Roosevelt, who. with Mr Churchill, is saving the world to-day despite being the victim of severe' infantile para';, sis? There is the story of the man who demanded £SOO for the loss of his big toe. ‘ Good heavens! ” said the man who had run over it and cut it off. “Do you think I’m a millionaire? ” “No idea,” said the victim, “hut do you think I’m a centipede? ” Which, of course, is a point of view. Names in this Diary are fictitious. Copyright.