COLLECTING KEY CONCEPTS

• Every examination needs to be consistent with the patient's complaint.
• Every examination must follow every clue of physical change that may be consistent with the case.
• An examination is a hunt; an investigation of a crime scene. Rules guide; insight succeeds. Each, in its own way, is unique. Not allowing for subtlety, for variation, for what is not yet written, failure of persistence when the clues have not been tracked, are the main reasons for failure. In those examinations that require diligence and patience, there is no satisfaction like what comes from final success.
• The sands must continue to be sifted for physical evidence of the abnormal process.
• Improving the craft of medical examination is like every other. It is never fully learned.
• Preconception is the death of discovery.
• Any imaging procedure should be for the purpose of answering a reasoned question not answerable by physical examination. It should rarely be a prayer, a substitute for careful study.
• Principia Primum – Fundamental First
• Familiarity with the consistency and activities of injured tissues is as necessary to the clinician as the feel of steel to a machinist… the basic substance to any craftsman. The physician's examination table is, in all respects, his workbench. The trick is to realize that and learn accordingly.
• Add yours. ‘Build here and it will grow.'