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Time-warp diagnosis

Time passes faster as you get older, right? Maybe that explains two hospital letters I received yesterday. Because both seem to involve a distortion of the time-space continuum.

Letter one was a paeds discharge note on a four month old with diarrhoea of three days. ‘GP to prescribe lactose free milk,’ it said. Yes, you might want a moment to digest that, assuming you have the necessary GI enzymes. Three days of diarrhoea. Lactose free milk. Hmm. Once, that would have been viewed as probable gastroenteritis. But in the modern era of time compression, they can diagnose lactose intolerance within 72 hours of symptom onset. Isn’t medical progress/the warping of space-time wonderful?

Letter two was from A&E. And I think it’s a record breaker. The prpresenting complaint? ‘Chest pain of one second’s duration.’ Can anyone beat that in terms of brevity of history? I did have a patient once complaining of a feeling of impending doom, but I’m not sure that counts. Here’s the punch line, though. Under 'Investigations’, there it was: ‘ECG and bloods normal.’ No kidding? Normal? Despite that one second of chest pain? It’ll have to remain a mystery, then.

There was a time when junior hospital doctors knew stuff and demonstrated common sense. It was probably ages ago, but it feels like only yesterday.

Dr Tony Copperfield is a GP in Essex. You can email him at