It's odd to be writing an Epistle in August for the front of the October issue; these months feel, clinically, very different. In a northern hemisphere August, acute paediatric services are quieter than the rest of the year, although enlivened by the rotation of junior doctors. However, halfway through October things change pretty quickly. The doctors who were new to paediatrics in August, and were even heard to mutter, quietly, around the start of September that ‘Paediatrics is OK, but it's not very busy' begin to wish that they could go back and have a few stern words with their slightly younger, more naive selves. The main reason for this is bronchiolitis, of which more later.

Some diagnoses seem to be of mostly historical interest. Recently, I read an account by a houseman who, in his first days as a paediatrician on call, removed a cast from the respiratory tree of a child with diphtheria. …