I graduated MBChB (VU Manc) in 1950 and was very lucky in my first job to be appointed house physician to the great Dr Henry Howat at Ancoats Hospital. Dr Howat was the ultimate clinician, driven by an enquiring mind, an encyclopaedic knowledge, and a very high standard of ethics, and he expected a similar discipline of mind from me. Although my official title was house physician I soon discovered that I had many other duties, including administering anaesthetics for the gyny list once when the anaesthetist was ill, acting as medical admitting officer at least once a week, and doctor in charge of the casualty department also at least once a week. I shall remember for the rest of my life one particular night in November 1950 when I was on casualty duty. I had just X-rayed a patient’s arm in the X-ray department, developed and dried the film, confirmed a fractured ulna, and was setting the arm in plaster with the plaster sister, when a GP rang to ask me if I would see a patient with a fractured femur. ‘Of course. Just send him along’ , I said happily, and although I hadn’t the expertise to treat a fractured femur I thought I had better see the patient first before sending for the orthopaedic registrar on call. And I thought no more of it. Until the patient arrived. Then, my eyes almost popped out of my head. Covered with blankets, blue in the face and severely dyspnoeic, he walked with the ambulance driver’s help into the casualty department. He walked! Walked! He was supposed to have a fractured femur! Quickly I opened the letter from the GP hoping it would shed some light on the discrepancy but it simply read: ‘Thank you for seeing this patient.’ At …