confession time

With my 2 medical students in attendance, I see a patient with PMR (polymyalgia rheumatica). After she leaves, I ask what other imortant condtion is related to it and they correctly identify GCA (giant cell arteritis) When asked what the abbreviation stands for, one says "giant cell arthritis, and I gently point out how small mistakes like this can be seized on by a pedantic examiner and exploited to its limit.

Then we discuss the significance of the latter condition, where, if untreated, irretrievable blindness can result on the side affected (it's usually unilateral) And I go on to tell of one of my most catastrophic mistakes, when I missed a case of GCA (it was a slightly atypical presentation, to be fair) and the patient went blind in 1 eye. The slight problem was that he was already blind in the other eye following an industrial accident many years earlier, so I effectively blinded him completely. They look understandably horrified, as well they might..