Why do physicians continue to use words which the rest of the world do not understand?.It is peacockian and self-deceiving. Cryptic abbreviations and arcane acronyms are the latest fad and need to be rubbed out but obfuscation is an age old medical habit.

Most specialist journals are boring and increasingly difficult to read. It is as if unintelligibility is a virtue implying profundity.My advice is say extraordinary things using country simple words ( Bill Shankly taught me that).

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Brief silences, aside from when listening can sometimes be revealing, but sudden prolonged interludes indicate boredom or poor interviewing technique. The patient can tell immediately if you are interested.

Interest in a patient’s disease should never rule out a compassionate regard for her suffering and distress.#BrainspottingAdventuresinNeurology.

Im detecting physical signs as soon as the patient sits down and digesting the medical history during the neurological examination.#BrainspottingAdventuresinNeurology.

de Musset’s sign .Anyone else seen it?.@kailashbhatia @aditya_gan3500 . via @YouTube.

While I admired Pappworth’s courage in exposing cavalier, unethical research in the 60s the repercussions were by the late 1970s clinical science involving human volunteers, apart from in the area of drug development, was becoming very difficult to conduct.

‘The abc years’ .Never released in the UK never to be even heard without the northern soul scene.⁦@doufous⁩.#dopaminedanceparty #TheFourTops

I also prefer ‘the majority’ ‘a large number’ or ‘few’ to questionable percentages. There are no ‘100 per cents’ in clinical medicine.

I have never got round to the pseudoscientific notion of measuring physical sign severity with numbers. Much less pretentious and easier to picture are the descriptive terms ‘slight’ , ‘moderate’ and ‘marked’ .#BrainspottingAdventuresinNeurology #NeurologicalBirdsong.

Pappworth alerted us to head nodding as a very rare manifestation of severe aortic regurgitation.I’m still keeping it in mind however elusive it may now be @kailashbhatia.

‘Every physician should develop an accuracy of description, essential when using terms like ‘root pain’ .Such manifestations cannot be assessed mathematically but their correct description constitutes a discipline as scientific and as valuable as any laboratory test’. M.Pappworth.

Bar Italia this morning- haven of the old guard. The most famous clock in Soho .Put your hand on my shoulder on the jukebox.@RayGelato ⁦@TheBaristas⁩

Another Pappworth tattooed on my brain. ‘History recording should never be a stereotyped performance but should be evolved like a well written edited narrative with literary form and style’.

Pappworth from the Primer . ‘The symptoms of more than half the patients seen in general practice are functional and history taking is the chief diagnostic weapon,especially if the physician regards, as he should, psychological distress as a positive diagnosis’. @jonstoneneuro.

Guerir quelquefois.Soulager souvent .Consoler toujours.Mais nuire jamais . Such a privilege to be a physician. Ill never burn out.

Hyposkilliacs defend their position by blaming the inaccuracy of physical signs when the true problem is that they have not bothered to master the physical examination.# BrainspottingAdventuresinNeurology.@NottingHillEds.

I learned to leave my initial impressions fluid, open to revision and unrecorded. While examining patients i left what i had just heard to ferment with the physical signs .#BrainspottingAdventuresinNeurology @NottingHillEds @NYRB_Imprints.

And another two from Movement Disorders. Attempts by motor physiologists to subsume the visually distinctive athetosis under the blanket term of dystonia . Try to minimise the use of fudge terms like choreoathetosis - better to say I can see both chorea and athetosis.

Movement disorder messes.The sloppy use of dyskinesia instead of chorea or dystonia.The vagueness of bradykinesia - better to describe what you see .‘a delay in initiation followed by a progressive reduction of both speed and amplitude on finger tapping.