One of my favourite things about medicine is that you can get your Sherlock on and deduce vast amounts of information without uttering a word. Look at the surroundings. Look at your patient. Do they look unwell? What have they got with them?
I was once asked by an incredibly charismatic neurosurgeon to examine a child who had had a large tumour removed from their occipital lobe, without asking the patient any questions. I plunged into the best neurological exam I could summon, trying desperately to remember the various aspects of tone, power, reflexes, sensation, and by the end of my seven minute performance I genuinely thought I had done a pretty good job.
“How old is your patient?”
What…
“I wasn’t allowed to ask – I don’t know”
“Look around”
The patient’s bay was full of birthday cards, presents, cakes and balloons all with the number 5 gleaming mockingly at me… I hadn’t seen a single one.
Open your eyes. Look around, there’s lots to see.
unicyclemedic 