Endocrine Abstracts

What does a clinical endocrinologist actually do? There are no angiogram, pacemaker, bronchoscopy, ERCP, kidney biopsy or joint injection lists to be done. Our only practical procedure is venepuncture, albeit multiple times and occasionally at odd times of day. Within a single clinic an endocrine physician will have to ‘key in’ very quickly to a variety of symptomatic issues that often go to the core of human identity. There may be two successive patients with secondary amenorrhoea, with final diagnoses of anorexia nervosa and Cushing’s syndrome; both of which are associated with deep-seated sensitivities about body image. The next two patients may complain, respectively, of hirsutism and failure of development of secondary sexual hair, with final diagnoses of an ovarian tumour or Kallman syndrome. In each case the endocrinologist must, within a few minutes, strike up a professional but simultaneously intimate relationship with a stranger and use a solid knowledge of physiology and biochemistry, together with sensitive phraseology to extract the relevant history, perform a honed physical examination and plan appropriate informative investigations. Separate to this there is a responsibility to train the next generation of doctors and to contribute towards the improvement of clinical standards and outcomes by a range of activities from local audit through recruitment into clinical trials to paradigm-changing translational research. In my talk I will present some clinical material that ‘goes somewhere’ - into a piece of clinical research; into a collective departmental effort to provide high quality clinical care for a group of patients previously under-provided for; or simply to illustrate a point of clinical and/or professional philosophy. In doing so I hope to be true to the spirit of this award which I am thrilled and honoured to receive.