The history

An unorthodox doctor once taught me a memorable lesson. The patient was a well-educated married woman who had spent much of her life as a missionary in the developing world. In her mid-fifties, her general health began to deteriorate. Fatigue, muscle pain and wretchedness caused loss of interest in her vocational work and limited her activities. She was forced to return to England. She gave the impression of being a resilient, uncomplaining, stoical individual.

Our hospital consultant staff included a very distinguished group of experienced clinicians. I requested each to see the patient. All were impressed with the organicity and genuineness of her complaints and were equally impressed by her resilient personality. Each initiated subtle, complicated tests to eliminate their ‘favourite’ illness. Thus, the professor of metabolic …