Posted by: Tony Copperfield19 December 2012
My patient’s face looks decidedly un-festive. ‘OK, I realise being dragged in here for a medication review isn’t a bundle of laughs,’ I say, ‘but look on the bright side: you could be Christmas shopping.’
‘I know, doc,’ he replies. ‘It’s just that I can’t get enthusiastic about Christmas anymore.’ Bugger. What should be a quick box-ticking exercise is in danger of transmogrifying into an exploration of yuletide depressive symptoms, a scenario which carries a grave risk of suicidal ideation (in him) and caffeine withdrawal (in me).
But no. Turns out he simply hates Christmas. Ever since starting that statin for primary prevention, he’s cut out all the dietary pleasures in life – a chronic restriction with an acute exacerbation at this time of year. His yearning for a beer, some mince pies, the choccy Santa off the tree and so on is set in sharp relief by the orgy of consumption around him, and leaves him lacking goodwill to any men, or women.
I’m dumbfounded. What f**wit, when starting this treatment, failed to explain that this is supposed to be life enhancement rather than life sentence? That a healthy diet is a good idea but not a straitjacket, and makes little difference to cholesterol levels anyway? That you’ve still got to live a little, for Chrissakes?
I scroll back through the notes to reveal the guilty party. And, for the second time, bugger. It was me.
A salutary lesson, then: it seems I have been scribbling my signature nonchalantly on FP10s without realising that this is a potentially life-changing event for the recipient. All that focus on targets and the need to monitor LFTs or whatever has obviously distracted me from the bigger picture. When you consider how often I’ve started a statin in the last couple of years, that’s enough significant events for a whole revalidation cycle.
Next patient I start on a statin, I vow, I will not inadvertently shackle to a life of celery. I tell him the good news, admittedly a couple of years too late, and I feel a bit like Santa. Have yourself a Merry Little Christmas, I say, and we all have a warm glow as he leaves. Mind you, if he has an infarct in the New Year, I’m buggered. Again.