A 28-year-old slammed his MRI films on my desk, profusely sobbing away without my having the slightest clue of what was going on. He was lean, well-built and wore track pants and a tight-fitting white shirt. I waited patiently till the wailing ebbed and made way for intermittent snivels, which he wiped away with the tissue I’d handed him. His wife sat next to him with her hand on his back, gently patting it until his face was dry, his eyes remaining swollen and bloodshot.

“I have a 6-cm malignant brain tumour,” he lamented, his first words to me as he tried to come to terms with how his life had changed with a single scan of the head. “What prompted your doctor to get a scan?” I enquired in my “I’ve got his under control” voice, calmly guiding the conversation to become less dramatic. “I had headaches for a week, which weren’t getting any better, and then I started waking up with them,” he answered. “Any blurring of vision, nausea, vomiting, imbalance while walking?” I asked as a routine follow-up question, a yes to which might suggest raised intracranial pressure. “No!” he shook his head in disbelief, clearly thinking that at least a few of those symptoms should have been present if his headache was this serious. “They don’t have to be,” I replied, explaining, “Headaches don’t read textbooks. I’ve gone hoarse telling people that if a headache doesn’t settle down in a few weeks, it warrants a scan. Nine times out of ten it’ll be normal, but I can show you dozens of patients with brain tumours, and all they had was a dull aching headache!”