We had the privledge today of meeting a former head of *insert specialty* surgery.  Dr Surgeon was a patient, and we were sent to give him a mini-mental state exam.

The MMSE is a series of questions designed to assess the mental capacity of a patient by looking at recall and cognition.  The test asks for recall of information like the date and location, a memory test, sentence construction, that kind of thing.

Dr Surgeon is a delightful gentleman of around 60, with a charming smile and a sharp wit.  In a short conversation, he seemed prefectly lucid.  However, only a few questions into the exam it became clear that his recall and cognition were markedly impaired.  This is why, I guess, we do standardised tests rather than simply judging someone by how they cope in a day-to-day conversation.  In the end, he failed the test. 

We left the room and went to discuss what we had found.  Our clinical coach pointed out that Dr Surgeon had been a man of supreme intellect, and although he was able to maintain a lucid conversation, something was badly affectinig his cognitive processing and his memory.  Then he told us what Dr Surgeon has - he has melanoma that has spread to his brain.

For goodness sake, wear your damn sunscreen.