"Doctor, we're here about her foot. It's been really painful for the last couple of months," says the mother of an unassuming 14 year old girl. "Go on. Tell the doctor."

As an FY2 GP, you may also have similar experiences with aches and pains, nobbly bits, lumps and rashes that have conveniently disappeared. I've been told that occasionally it can be something really exciting and rare. Apparently.

"Well, it's been going on since my birthday. My left foot is really sore."

After a quick and unnecessary SOCRATES, it was identified that the foot pain was there when she was wearing the shoes… and wasn't there when she wasn't wearing the shoes. The shoes were a special birthday present. She wanted to wear them.

"YOU NEVER TOLD ME THAT!" exclaims the rather embarrassed and reddening mother. "She never tells me anything I swear!"

Perhaps I should've let her drag the child out. Perhaps not. I was nice, I examined the foot, I explained there may have been an underlying injury that has been exacerbated by the shoes. Of course there wasn't, but it's nice to hear you haven't wasted everyone's time.

"Diagnosis: Inappropriate footwear
Plan: Avoid exacerbating footwear for 2-3 months. Can try again if emotional attachment (birthday shoes)."

My time was not wasted. I had to be there anyway. That's what they pay me for.
Always the optimist.

[Image from flickr. CC license]