In October of 1989, 3 patients with severe myalgia and unexplained eosinophilia prompted a New Mexico physician to play medical detective and ultimately uncover the association of contaminated L-tryptophan with the development of the eosinophilia myalgia syndrome.
Indeed, some of the most profound influences on medicine have arisen from observations from practice: from the days of John Snow and the Broad Street pump (the point source of a cholera epidemic in London in 1854) to Curtis Hames’s groundbreaking research in cardiac disease. Many seldom sung heroes make such observations daily. It is in this spirit that The Journal Of Family Practice Presents the curious case of Dr McMichael: does unexplained itching warrant surveillance for a future skin malignancy? A careful review of the literature yields neither clear support nor refutation of this hypothesis (we invite you to correct us if you know otherwise). But I hope you will be as intrigued by the case as I was and will consider sending us your own Observations from Practice.
I am interested in neither the obscure presentation of common diseases nor rare “fascinomas.” Nor am I predisposed to publish a case series of 1000 sore throats, unless it holds important new implications for our colleagues. But I would be fascinated by those truly original or tantalizing provocative observations from daily family practice. Who knows, one of you might be the next John Snow!
