A recent outpatient giving a contorted and unclear history provided a challenge in determining the benefit he might have from surgery. My boss smartly and simply suggested we follow that age old practice to “take a walk.”
I was reminded this Mother's Day how the simplest things can often tell us the answer to the question we should have asked.
Reel back four years to when I arrived at night to stay at my family house on an island. My parents, both in their 70s, had been working hard all day, one of them scaling trees, and unsurprisingly they looked tired. The next day I suggested a walk. Oddly it was met with a lack of enthusiasm. We started out along the flat coastal road, but 10 metres later, at the first hint of an incline, my normally fit mother stopped. In the sunlight her face was a sickeningly familiar shade of grey. In the ensuing discussion the history of severe chest pain the day before was revealed. Twenty minutes later the general practitioner's electrocardiograph confirmed the obvious, and one hour later we were in a helicopter. Too late for thrombolysis, the angiogram revealed there was nothing to be done.
How often would a short walk tell you something about a patient or a relative? How often do the complexities and availability of investigations distort us from the simplest course? Sometimes the more complex a problem the simpler the answer. Indeed the answer to the question may lie just a few strides away.