In general practice, 'always expect the unexpected'

Mr SF, aged 72 years, presented to a senior colleague complaining of a scalp sore which was failing to heal. The patient had injured his head while mustering cattle 4 years earlier. He consulted his local medical officer at that time and was reassured and sent on his way. Six weeks before presenting to our practice, Mr SF had split his head open again. Although he was not overly concerned about it at the time, it had been slow to heal and he had consulted a naturopath. The naturopath was packing the scalp sore with comfrey leaves and had advised Mr SF to eat curry to aid with its healing. He had been seeing this alternative practitioner each week for the preceding 6 weeks. Mr SF had become disillusioned with the poor results he was getting. At the behest of his wife he was seeking another opinion.