Part 1 : The Sieve
- Disease and its Causes -
Let us begin with a scenario:
 
Oh dear.  That was a bit stupid.  Unlikely you say?  Something very similar to this happened to one intelligent student we know when he started out on the wards.  But where do you start when confronted with a condition you know nothing about?
 
The truth is that the problem solving skills of most medical students are never very well developed.  Though they generally have good brains, medical students are rarely ever taught how to put them to use.  
 
The aim of this system of medicine is to be a thinking clinician, and the first powerful tool in our armoury is ‘the sieve’.  If you have never heard of the sieve it is time for the first revolution in medical brain training.  If you already use a sieve, prepare to hone your skills.  Follow the menu on the left to proceed.
 
It is Monday morning and you are very nervous and excited – today you are on your first ward round ever as a medical student. You have been placed with Professor Grouch and his registrars. The Professor is particularly grumpy this morning after being held up in traffic. “The next patient is complaining of a painful ear,” says the senior registrar. “Oh? Let’s see him then,” responds Professor Grouch. The round approaches the next bed and everybody looks down at an elderly man. There is a knobbly crust obvious on the pinna of his right ear. The Professor prods and pokes at the crust. “Hmmm. Yes…yes. Rather interesting,” he mutters. Then you see a little grin spread across his face. You watch in dismay as he slowly turns his head and fixes his eyes on you. “Well? Student, what is it?” Oh no! You have never seen anything like it in your life! Your stomach ties in a knot, you feel nauseous, your knees knock together, beads of sweat break out on your forehead. You’re forced to contract your sphincters. Your mind races… If only you could remember that lecture on painful knobbly crusts on the right ears of elderly men. And then……. Blank! Oh no! You’ve been hit by… **stunned-mullet syndrome**. “Ummmm. Has he got h-h-heart failure?” you stammer. Oops! How could you have said something so stupid?! The Professor breaks out in a roaring laugh, echoed by everyone else on the ward. “No soul was ever saved after the first five minutes of any sermon” - Mark Twain -
There are only two sorts of doctors: those who practice with their brains, and those who practice with their tongues.