Tuesday, 10 July 2007


I aspirated a ganglion for the first time yesterday. I don't know why I'd left it this long, because I don't mind doing things with needles. I inject joints and aspirate effusions, but for some reason I'd never tackled a ganglion. Then the other day I read a comment on a mailing list to the effect that “we've all aspirated those” and determined to do something about it. Yesterday a victim walked into my surgery with a medium-sized ganglion on the back of his hand and agreed to let me treat it. I checked with my expert chum Neil who gave me good advice: use a white (wide bore) needle, a 10ml syringe to get plenty of suction, and squeeze the ganglion as you aspirate. I followed his instructions, and duly extracted 2ml of clear thick sticky fluid. We were all very pleased with the result.

Today I saw a lass of about my age whom I have known for many a long year. She is a great worrier, and from time to time she comes to share her worries with me. I was able to advise her again today, and at the end of the consultation she said “thank you for humouring me” which was a kind compliment. I told her the Voltaire quote (“medicine is the art of amusing the patient while nature cures the disease”) which she enjoyed. Although on reflection the word “humouring” is probably less to do with amusement and more with getting the four humours of the body into equilibrium. We try to remain sanguine in the face of these uncertainties.


Anonymous said...

Both senses of 'humor' you mention, as well as 'humor' in the sense of something amusing, come from the same origin word. And all, I would think, are medically appropriate.

The Shrink said...

Glad your patient did well with the aspiration. Reminds me of the law from the House of God, "There is no body cavity that can not be reached with a #14 needle and a good strong arm."
That's one side of A&E and GP land that I don't miss ;-)

I find myself oft times throwing quotes in to conversations with patients since invariably cleverer folk have said something far more effectively than I could, so I shamelessly nick their words!

We try to remain sanguine . . .

With this line (and when in good humour) another quote springs to mind :

"In seasons of cheerfulness, no temper could be more cheerful than hers, or possess, in a greater degree, that sanguine expectation of happiness which is happiness itself."
- Jane Austen

"That sanguine expectation of happiness which is happiness itself," I simply adore that :-)

Ms-Ellisa said...

A prof told us that if a procedure is written somewhere in the book, we are supposed to perform it if needed, whether we have been taught how or not... I think he was right, and he was probably trying to promote the whole perspective of "seek for your own education, learn by yourself as well, ask to be taught if people forgert to show you how etc etc"...
Your aspiration reminded me of that.

Dr Andrew Brown said...

The Shrink: Thank you for the Austen quote. I love literary quotes too, and in my youth I used to browse through the Oxford quotations dictionary. No doubt the authors would have been delighted that their work is still appreciated and used by us today.

Ms-Ellisa: Your Prof is quite right. There is so much to learn, and we can never be sure that we know everything that would be useful to us. Indeed, that is impossible. Ars longa vita brevis. One of the theoretical advantages of annual appraisal is that it encourages us to examine our "educational needs" and to fulfil them. The problem is that it may simply encourage a dutiful paper exercise in which one lists what one has learned and then conjures up the educational need post hoc. Not that I would ever do such a thing! What is really needed is a life-long spirit of enquiry which leads one to constantly re-evaluate one's performance and look for the lacunae. All clear? Off you go, then! :-)

Calavera said...

I like that quote, too.