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A typical day

Clinic, mostly. Twelve to twenty patients: a new referral with joint pain and a strange blood test, a lupus patient whose kidneys need watching, someone starting a drug that suppresses the immune system and needs the risks explained properly. You examine joints by hand, read scans, adjust medication and write long letters back to family doctors. Some afternoons are injections or ultrasound. Hospital consultations arrive when an inpatient turns out to have an autoimmune disease nobody expected.