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John is a 46 year old man, married with two children.

He initially complained of increasing weakness in his legs.  Always an anxious man, at first this was put down to stress.  When the weakness worsened, however, investigations and examination suggested motor neurone disease, and subsequent progression of the signs and symptoms has confirmed the diagnosis. He wanted to know the diagnosis and was told

Today he comes in to see you for the first time with his brother, Peter, with whom he is very close.  Peter soon starts to demand why his brother wasn't diagnosed earlier, and red-faced with anger starts to blame you for allowing John to get into this state.

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