Many people like me who work in emergency medicine (or any acute medical practice) do so because we love doing things – whether it’s reducing a dislocated finger or resuscitating a person with sepsis.  

I’m no different. But what I have come to understand better than ever is that sometimes thinking, explaining and reassuring patients is still ‘doing’ but with fewer risks than practical procedures.  

This second approach to ‘doing’ used to be known as the ‘tincture of time’ because, as we all know, some syndromes take time to play out, while many benign and self-limiting conditions resolve without specific treatment.  

When I was a junior doctor, this ‘tincture of time’ was cynically called the ‘therapeutic waiting time’ and was used as a way of dismissing patients whose presentation was thought to be unnecessary – rather than as a way of avoiding unnecessary treatment, although the result was the same.