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Helping colleagues fallen on hard times

The case of Mrs Byrne (Features, September 6) was very well written and contained a few undercurrents that perhaps show the poor old GP in a better light. The three commentators took the self-flagellation route, blaming themselves for her behaviour after the consultation. I propose an alternative viewpoint.

First, it seems the GP has been supporting this woman very well through her illness and I really doubt very much if he has suddenly become unsympathetic.

Second, I smell 'victim' from this woman and I would be suspicious that the GP has perhaps been a little too supportive.

I speak as one whose default mode in the surgery is empathy and as one who has suffered serious illness himself.

I do have some worries about her obvious dependence on the ME group leader and we all know about how membership of such a support group can sometimes make recovery less likely.

Third, the patient obviously does not trust her GP. He has already checked her thyroid function and here she is waltzing in, in effect telling him that he lied to her or was totally incompetent or both!

She seems to think the ME group leader knows all there is to be known about TFTs in ME, despite his apparent absence of any relevant qualifications.

Fourth, mild iatrogenic hyperthyroidism is quite likely to make fatigued patients feel a bit more energetic – until they get tachyarrythmias or worse! And guess who will get the blame for that??

Fifth, could there be any other reason for the ME group leader's assertion about TFTs being unreliable in CFS? Well yes, there just might be. If he is about 25 years out of date with TFT methods and a generous extrapolator! He just might be thinking of the old protein bound iodine test that was affected by all sorts of illnesses. I don't remember which ones, it's too long ago.

So the woman has no doubt had her hopes raised to a totally unrealistic level by her support group and she thinks that all she needs is a script for thyroxine to end her troubles.

Then she finds this GP, who she clearly regards as a total doormat, suddenly won't do what he is told! Shock! Horror! I'll fix him, see if I don't. Exit muttering.

Well, anyone got a better explanation?

Dr Declan Fox


Co. Tyrone

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