It’s nearing the end of a long and tiring ward round. My feet ache, I can hear my belly grumbling, and I’m barely listening to the case being presented in front of me. As another student summarises the history, the consultant turns his gaze on me. “What is your differential diagnosis?” I feel my heart race as I try to fabricate a list in my head. I decide the patient is most likely to have multiple myeloma. Before I can blurt this out I catch the eye of the patient, who is listening intently. The dread of disclosing an incorrect and worrying list of diseases in the company of the patient is too much. I stand speechless with discomfort, and the consultant looks at me disapprovingly.
Many medical students have experienced similar situations, but might not have questioned how it could affect the patient. Whether it’s discussing a diagnosis, delving