postplab
Credits:
707
My Scrapbook
|
PPUD syndrome published in bmj
|
03.18.06 (2 years ago)
#1
|
|
PPUD syndrome (post PLAB
unemployed doctor's syndrome)
In an effort to keep up an old medical tradition, I report a new syndrome, prevalent in the age group 25-35, but some cases are seen in the early 40s. Both sexes are equally affected. It is endemic in east London, but sporadic cases can be seen all over Britain. It is mostly found in immigrants from the Indian subcontinent and is characterised by the following features.
Depression—The hallmark of the syndrome, with 90% suffering from it at some time or other.
Insomnia—Patients are not able to sleep even though they stay in bed all night and even during the day at weekends, as they have nothing else to do and no money to spare.
Obsessive-compulsive disorder—Patients check their CV again and again, showing it to every person they meet; constantly check their telephone in order not to miss any interview call (which never comes); keep checking the mail again and again; and are resistant to any counselling from others.
Hallucinations—Visual and auditory hallucinations of a job that exists nowhere and interview calls that never come.
Somnambulism—Some patients can be seen sleepwalking to the post office to send an application for a job.
Omniphagia—Patients eat just about anything they can get and can be seen cooking strange recipes in the single pan they own. They lose weight.
Dissociative fugue—Patients are seen wandering aimlessly here and there, sometimes running amok in search of something elusive.
Musculoskeletal deformities—For example, 11th nerve palsy, resulting in drooping of the shoulders; seventh nerve palsy, resulting in expressionless face and inability to smile; disturbed gait; kyphosis, with inability to stand straight and keep their head high.
Cardiovascular manifestations—Palpitations and tachycardia are characteristic. Patients find it difficult to have a normal cardiac output with a broken heart.
Skin manifestations—Dry skin from exposure to the atmosphere (no money for moisturisers) and dry long hair (hair cut is expensive), and the females usually suffer from hirsutism (no money for bleaching and threading).
Eye changes—Epiphora and eyes always wet with vacant stare.
Prognosis—All patients lose money and weight, but those who do not lose their confidence and hope have better prognosis.
Treatment—Love and a healing touch. Patients should be encouraged to go back to their home country, as in Britain even local graduates find it difficult to get a job and nobody is bothered about someone with PPUD syndrome.
Surinder Sareen, unemployed doctor
|
|
|
Topic Tags: 
