On-line version ISSN 2078-5135
SAMJ, S. Afr. med. j. vol.100 n.5 Cape Town May. 2010
Sudden death on an aeroplane
To the Editor: I was much interested in the report by Tiemensma et al.1 Considering the extent of the tension pneumothorax as seen in Fig. 1, one would have thought that the doctors on board should have diagnosed it - was the clinical examination done properly? Was the position of the trachea palpated, the thoracic cage percussed, auscultation of lung and heart sounds done?
With the wonderful and rapid progression of technology and sophisticated diagnostic facilities, it seems that the importance of a proper and detailed medical history, and the value of a complete, meticulous and careful physical examination, are no longer appreciated.
My impression is that the subject is neglected in present-day teaching of medical students. Too time consuming? Life too hurried?
I know of a case in which after a (normal) computed tomography brain scan in a stuporous patient, the correct diagnosis of diabetes was eventually made. I can cite several similar examples.
Patients also constantly complain that their doctors appear so busy that there is no time for questions or explanations.
My 'window of medical experience' over several decades convinces me that there is still a place for a basic down-to-earth clinical approach. Many doctors are going to work far from tertiary care centres.
J G Prinsloo
Emeritus Professor of Paediatrics
University of Pretoria
1. Tiemensma M, Buys P, Wadee SA. Sudden death on an aeroplane. S Afr Med J 2010; 100(3): 148-149. [ Links ]