Patient: "So...what do you think is wrong with me?"

As a medical student I dread this question, I never answer the question with a direct diagnosis because its not my place to do so as a student. In fact, often I've got no idea anyway but we've all got some knowledge tucked up somewhere and usually have some idea, in our own little heads, what might be going on.

It's worst when its a textbook case of something sinister. Today for example I was asked the question by an elderly lady who'd given me an almost textbook history of a certain pathology with an extremely poor prognosis. She had no idea that what she'd described to me might be serious and she was the nicest of old ladies who offered drinks and biscuits despite being barely able to walk. She had no idea that I had a diagnosis running through my head, I just politely replied that I had no idea what was wrong and the doctor who would be seeing her later would be able to discuss the problem further. As far as I'm concerned this was the right thing to do and although we've had 'training' on breaking bad news, I'm not looking forward to the day when it's my turn to give some life changing information to a patient or their family.

I pray that I'm wrong, perhaps she didn't have anything wrong at all (although the GP did send her for urgent investigations.) In a few weeks I'll chase up her results and see for myself, in the meantime all I can do is hope that she is ok.