Every doctor will know the moment. The appointment is drawing to a close, the patient is gathering their things, their hand is practically on the door handle, and then they pause. They look at the floor. They clear their throat.
'While I'm here, Doctor...' they say. And that, in my experience, is when you hear what they actually came to say.
There is even a name for it in medical circles: the door-knob diagnosis. It is the symptom mentioned in passing, seemingly as an afterthought, though it's probably been preying on their mind for months.
Blood in the toilet. A change in bowel habits. Unexplained bleeding. A lump somewhere they have been too mortified to describe to another person.
Sometimes it is the very reason they made the appointment in the first place, buried under safer, less awkward topics until the last moment.
And the reason they waited to tell you? Not ignorance, but embarrassment.
The death last week from bowel cancer of Mel Schilling, the relationship expert from Married at First Sight, has prompted an outpouring of grief from viewers who felt they truly knew her. At 54, she was vibrant, warm and, by all accounts, a woman who poured herself into helping other people navigate the complexities of their emotional lives.
As so many of us do, when she first began feeling symptoms, she explained them away, hoping they would pass.
She had been experiencing severe stomach cramps on set in Australia and initially put them down to the demands of a punishing travel and work schedule.
The death this week from bowel cancer of Mel Schilling, the relationship expert from Married at First Sight, has prompted an outpouring of grief from viewers who felt they truly knew her
She had been experiencing severe stomach cramps on set in Australia and initially put them down to the demands of a punishing travel and work schedule
Her GP said it was constipation, handing her a box of laxatives and sending her on her way. To her enormous credit, she was not satisfied with that. When she returned to the UK, she pushed for a scan, and it was that scan which revealed a tumour the size of a lemon in her colon. By the time it was discovered, it had almost certainly been growing for some time.
The cancer eventually spread to her lungs and then to her brain and, despite extraordinary courage through 16 rounds of chemotherapy, tragically she could not be saved.
This story is not unusual - it is heartbreakingly ordinary. While Mel was not satisfied with the GP's course of action, many would be. And many more would be too shy to see their doctor in the first place.
I think often about what gets in the way of people coming forward sooner.
If you needed an excuse to reach for the hummus, consider this. Research has linked a daily portion of chickpeas to a meaningful reduction in cholesterol levels. They're high in fibre and protein too. As snacks go, you could do much worse
Sometimes it's fear. People say they're terrified of what they might be told, so simply choose not to find out and there's a peculiar but entirely human logic to that.
Not knowing, at least temporarily, feels like safety.
But embarrassment plays an enormous role too, and I think it is badly underestimated.
Bowel symptoms are, in our culture, considered deeply unseemly. We are conditioned from childhood to regard anything related to that part of the body as shameful or comic. When something goes wrong down there, the very awkwardness of raising it can become a barrier to care that proves, in some cases, fatal.
Dame Deborah James did extraordinary work in dismantling that shame. She spoke about her bowel cancer with a frankness and good humour that did so much to shift the conversation. The data from Bowel Cancer UK bears that out: awareness of symptoms has improved considerably.
But the deaths of women such as Mel Schilling remind us there is still much further to go. For the truth is, the numbers are stark.
Bowel cancer is the fourth most common cancer in the UK and kills more than 16,000 people every year. Crucially, however, when it is caught early, the survival rate is much higher.
More than nine in ten people diagnosed at the earliest stage will survive for five years or more. Caught late, that figure drops catastrophically.
So what should you be watching for? A persistent change in your bowel habits is the most commonly overlooked early sign.
I mean anything that lasts more than three weeks: going more frequently, looser stools or a feeling that you have not fully emptied your bowels. These symptoms can come on gradually and feel trivial, so people tend to normalise them, tell themselves it is stress or something they ate, and wait. Please do not wait.
Blood in or on your stool should always prompt a same-week GP appointment. It can be bright red or darker, mixed in or on the surface. Yes, it is often haemorrhoids. But it needs to be checked, not assumed.
Unexplained weight loss, persistent bloating, abdominal pain that keeps returning and a fatigue that feels out of proportion to your life are all worthy of investigation too.
I am aware that even just laying out these symptoms in print can provoke anxiety in those already prone to worrying, and I am not trying to frighten anyone. What I am saying, as plainly as I can, is that your doctor has heard it all before.
There is nothing you can tell them about your body that will shock, disgust or amuse them.
The consulting room is one of the few places in life where frankness about the workings of your body is not only acceptable but essential. Mel Schilling's first GP was wrong to dismiss her symptoms. And Mel was right to push further.
Her parting gift to us is a reminder to do exactly that.
End this strike madness
Just when you thought the endless cycle of NHS strikes might finally be behind us, resident doctors have announced a six-day walkout beginning on April 7 - the 15th round of industrial action since 2023.
After howling for years in opposition about the Conservatives' handling of the dispute, Health Secretary Wes Streeting promised that a Labour government would end it. He has not. Strikes took place in July 2025, then October, then December. And now here we are again.
I do have genuine sympathy for resident doctors, whose pay has been badly eroded. But it's the patients who are really suffering, lying awake wondering whether their cancelled procedure will be rescheduled before their condition deteriorates further.
Both sides need to feel the weight of that responsibility. Enough is enough. Sort it out.
A landmark study led by University College London has found that hormone patches identical to those worn by menopausal women can treat locally advanced prostate cancer just as well as standard injections.
In a trial involving 1,360 men, the patches were equally effective at controlling the disease while causing fewer of the debilitating side-effects, including hot flushes and bone thinning, associated with existing treatments. Very encouraging news indeed.
Dr Max prescribes:
This short memoir by an American neurosurgeon diagnosed with terminal lung cancer in his 30s might sound bleak and depressing, but it is actually one of the most uplifting books I've ever read about what it means to face death and find meaning in life. Keep the tissues handy.