Often my medical work is little different from my UK practice, except that most of my patients are a lot poorer than the population of affluent St Albans.  I live and work in a big city at high altitude that doesn’t suffer the same degree of tropical disease as more remote and lower places. However sometimes things come my way that take me by surprise. Here are three short examples from my work today that my medical readers in particular will appreciate. it’s interesting to reflect on what might happen were these situations to arise in the UK. One in particular would make national headlines.