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At the heart of general practice since 1960

I'll bloody shoot her

Phil's mad at a patient – he's never met anyone so impressed with herself for so little reason

Phil's mad at a patient – he's never met anyone so impressed with herself for so little reason

The charade begins before she even gets in the room. Her suppressed 'oof!' while opening the door is meant to express intense suffering, mastered with great self-restraint. She negotiates her way across the room and lowers herself gingerly into the chair, a masterpiece of overstated body language.

She gives me a brave tight-lipped smile, showing me that her indomitable spirit cannot be crushed. 'You know me, doctor. I'm never usually here.'Eight words, and already she's waist-deep in deceit. I want to leap to my feet and denounce her. 'You bloody liar! The computer says you've been here 14 times already this year!' But in her own mind, each of these attendances is an unusual circumstance forced on her by others.

As is this one.'I didn't want to come, but it was my daughter, Dawn. You know Dawn, she's got a cyst. She said "Mam, you can't put up with any more of this. You've got to go to the doctor's. You've got to stop thinking of us and think about yourself for a change. We're worried about you." Well, you know how it is, doctor. I can put up with a lot, but in the end I had to come; not for me but for them.'

If I'm perfectly honest, I want to shoot this bloody woman through the head. I don't mind her coming to see me with her arthritis; it's what I'm here for. What I can't stand is the overweening air of martyrdom, of suffering stoically borne – and the way every sentence she utters is designed to show her as a paragon of self-denying virtue. She puts the compliments into the mouths of others, but never have I met anyone so impressed with herself, and with so little reason.

'It was Lanzarote that did it. Shauna begged me to come with them; I didn't want to but I couldn't let them down. She said, "Doris, I know you're in pain but the kids won't enjoy it if you don't come". I couldn't refuse them. The bairns won't go anywhere without me, but I'm paying for it now.

''Did you have a nice holiday?''I made an effort, that's all I'm saying. It was agony, what with me joints, but I made sure they all had a good time. Aggie said: "Doris, I know how you suffer but you've done us proud." I've got nothing to be ashamed of, doctor.''

So what can I do for you today, then?' 'Well, you know how I don't like taking tablets?' This is news to me. I sign a prescription for her for 12 different drugs every month. How she must force them down! 'Well it's not for myself, but they can't do without me if I'm laid up. Kayley said to me just this morning: "Mam, if you weren't here to look after the girls I don't know what I'd do." So it's just to get me through this week, then I'll manage somehow.

''All right,' I tell her. 'I'll give you some more drugs. And would you like a signed certificate saying you are in constant agony but you won't let it show?

'Her face lights up. 'Ooh, could you?'

Dr Phil Peverley is a GP in Sunderland and Medical Journalists Association Columnist of the Year

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