Idecided to apply for medicine at the end of my first year of A levels. Everything seemed to be going to plan, except for a niggling back pain I could not get rid of. Soon it was so bad that I couldn't sleep at night, fell asleep in lessons, lost my appetite, and dropped from an above average student to a straight D student. Four months later I was diagnosed with a Ewing's sarcoma of my right sacroiliac joint.

I left school to become a patient. The details of my time on the "other side of the sheets" wouldn't make interesting reading, but I had one year of chemotherapy and surgery and am now very well. What I am writing about here is some of the doctors I met during that time.

My first encounter with a consultant has yet to be matched. The orthopaedic surgeon was communicative, honest, compassionate, and had a great sense of humour. I have yet to meet a surgeon quite like him and, if you'll pardon the cliché, I quite literally owe my life to him. The second orthopaedic surgeon did not live up to the earlier precedent. We met when I sat nervously in his clinic waiting to discover how my tumour was to be "dealt with." He beckoned my exceptionally well informed and protective mother and me into his room. "So," he asked me, "what do you do?" I proudly explained that I was applying to medical school. "You mean you were," he barked. Our appointment continued and while he examined me, my mother asked questions about the nature of the planned surgery. "Are you a physio?" was his initial response before he turned to me and explained that in his opinion if the tumour was to be removed, then bone from somewhere else would need to be used to fill the defect. He planned to use my fibula. My face must have said it all and I wasn't exactly reassured when he said, "You don't need your fibula. God gave it to you so that I could take it out."

Another consultation involved a consultant radiologist. There wasn't nearly as much conversation in this meeting, but my feelings towards him were more hateful, particularly following a rather humiliating examination. When my mother, as ever at my side, asked about the side effects of the proposed six weeks of pelvic radiotherapy, he peered over his glasses and said, "Are you a physio?" When pressed for further details he patted me on the leg and said, "You'll probably have a bit of an upset tummy." Even at this stage in my training I realise that this brings a whole new meaning to the term "informed consent."

Perhaps the consultation to top all others was my most recent check up. After my annual reminder of what it is like to sit in a crowded, uncomfortable, and overheated waiting room for two and a half hours, I was ushered into a cubicle to see the specialist registrar. The doctor introduced himself (a first), but what followed was poor communication and a perfect demonstration that he did not have any idea why I was attending the clinic. He began talking about the importance of an annual review and chest radiograph, continuing with, "In the mean-time you must do your bit and examine yourself once a month." Clearly he thought I had the same diagnosis as his previous patient and was relying on consultation repetition, but I was annoyed by his neglect to read the last clinic letter in my file, or at the very least to inform himself of my original diagnosis. By the look on my mother's face, she felt the same and I was only glad he hadn't asked her if she was a physio. "I'm sorry," I said, the irritation becoming increasingly obvious, "but how the hell do you expect me to do an orthopaedic self examination?" "You're a medical student, it's obvious," was the condescending reply. By now I was starting to worry, thinking that for the past seven years I had been doing something fundamentally wrong and wondering why no one had shown me how to examine my own sacroiliac joints. My mother and I knew that the doctor in front of me had got something very wrong and for good measure my mother suggested that we should have an MRI scanner installed in the garage. I think the penny then dropped and he realised that I was not like his previous patient (who probably had an earlier breast malignancy) and quickly began flicking through my notes.

Overall, I cannot fault the quality of the care I received and clearly without it I would not be here today. I am fortunate to be able to look at these and a number of equally insensitive meetings and laugh. However, perhaps I (and others) have some simple lessons to learn. Perhaps the most important lessons are these: treat patients and their relatives as real people, always read the notes, and don't complain about communication skills exams and seminars-there will always be some students who benefit from them.