As ward round ‘faux-pas’ go, this week’s was a bad one. The patient was a middle aged man with pneumonia – nothing out of the ordinary. Turning to the somewhat hirsute ‘adolescent’ sitting in the chair next to him I asked the question: ‘Are you his son?’, to which the indignant response: ‘No, I’m his wife!’ came as something of a shock. Things went from bad to worse when the house officer helpfully suggested that it was a sign of getting older when you can no longer distinguish the sex of the ‘younger generation’. Not that I needed reminding: I recently reached an interesting milestone, when I realised that that I had once babysat for one of our third year medical students (while she was still in nappies). Having said that, getting older has its compensations – it is now several years since any patient told be I look too young to be a doctor; what’s more, it won’t be long before I have an answer for those sceptics who ask if I will still be doing my job when I am fifty…
The first edition of 2005 brings another varied series of review articles. Mark O’Neill follows up his previous paper on bradycardia with a comprehensive account of the management of broad complex tachycardia. Guy Thwaites gives a practical approach to the assessment and treatment of PUO, while Lloyd and Garfield’s review of Non-invasive ventilation helps to demystify this complex subject. For many readers, ‘query urinary tract infection’ will probably stand alongside off legs’ and ‘collapse query cause’ in the ranking of ‘heartsink’ referrals on the medical take. However, if ‘prescribe trimethoprim’ would have been the only two words you would have been able to write on the subject I would commend to you Dr Chaudhuri’s comprehensive account of this topic.
A couple of new features appear in this edition. A picture quiz section provides a variation on the case-report theme – no prizes, I am afraid, but you can find the answers on p36. Future submissions of this type, in addition to the standard case report format, are encouraged. Practices in medical admissions units vary widely, and it is important that we share each others’ experiences, both positive and otherwise. To this end I am keen to encourage readers to submit papers describing their activity along the ‘How we do it here…’ theme. To launch this series, Dr Vincent Connolly, winner of the Hospital Doctor Acute Medicine Team of the Year award describes the evolution of his innovative unit in Middlesborough.
Finally, the more observant of you may have noticed a subtle change to the title of the journal, with the removal of the CPD Journal prefix to Acute Medicine. Although the educational themes of the journal remain unchanged, it is hoped that this will broaden its appeal beyond consultants and other ‘Points collectors’. I hope this does not detract from your enjoyment of the current and future editions, the reading of which can, as ever, be counted towards your ‘personal’ CPD.
Reference: Volume 4 Issue 1 Pages 2 - 2 (2005)