ABSTRACT

Medical history: Recurrent ear infections. Type 1 diabetes (well controlled).

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THE PATIENT WITH A SORE THROAT Mrs Hughes was a 50-year-old woman, a known alcoholic and heavy smoker: a typical ‘heart sink’ patient. She was underweight and looked unwell. She was a frequent attendee who had sometimes been quite disruptive, turning up without an appointment and demanding to be seen. The receptionists and doctors were well used to her and felt they had reached the end of the road with her in terms of what they could do.