Reflecting on the patients that have challenged me the most over my career, the ones who were difficult to get to know, and therefore understand, tend to stand out.

Putting the pieces of the puzzle together without the necessary background story can lead to mismanagement.

I remember identical twins I treated many years ago who proved this point. To a young and inexperienced doctor, they proved hard to know and so very challenging to manage.

I recall squirming under the steady gaze of Mrs Smith* during her routine reviews of her antihypertensive scripts and knowing, as she knew, that her identical twin Mrs Jones* was sitting patiently in the waiting room as my next appointment.