It is the phone call that every neurologist dreads. A colleague, diagnosed with motor neurone disease (MND), looking for a confirmatory opinion. From personal experience over the last 25 years, these calls have become all too regular. My early reactions were fear and apprehension. How could I possibly confirm such a life-changing diagnosis for a friend or fellow clinician and remain positive when we both know that the disease is universally fatal?

In 1970, WB Mathews opined in his medical classic Practical Neurology, that delivering a diagnosis of MND while maintaining a healthy level of pragmatism was the true test of a neurologist.¹ According to those who knew Mathews, this approach summed up his wisdom and humanity.² So, it was with some macabre relief that I began to recognise a pattern in these MND cases among colleagues and friends. It slowly became apparent that the cases shared a common trait. Not only were they self-diagnosed, but in almost every instance, the diagnosis was just plain wrong.

Life as a physician brings many rewards, particularly in terms of learning about the human existence. And although we are physicians, we …