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Look who's not talking

Via a temporary inability to speak without bleeding everywhere, Phil accidentally hits on the novel idea of getting patients to say what is wrong with them.

Via a temporary inability to speak without bleeding everywhere, Phil accidentally hits on the novel idea of getting patients to say what is wrong with them.

I woke up this morning and my face was stuck to the pillow with blood. Gingerly, and with a faint tearing sound, I separated myself from the pillowcase and felt around the sore area. Somehow, during the night, I had acquired a swollen split lip.

I was pretty sure I hadn't been boxing before I went to bed. My wife was stirring. 'Did you punch me in the face while I was asleep last night?' I asked her (realising that, as an opening gambit, this was hardly the standard of: 'Good morning darling! You're looking lovely today!')

'Not on this occasion,' she said, as she studied my face with cool, professional detachment. 'If I had done it, I would have made sure you remembered.'

Ah, well. More than likely I'd done it myself during a vivid nightmare about Ruth Kelly or Harriet Harman. It wasn't really important. My major problem was that I had a day at work to face.

I managed to achieve haemostasis with a liberal application of Vaseline, but I had to admit that I looked like a particularly desperate, scarlet-lipped transvestite who'd gone overboard on the collagen injections. And I couldn't speak! Any attempt to move or stretch my lips resulted in a painful crack. Today, for a change, my patients were going to have to do the talking.

Utterly hopeless

I was schooled in the theory of the 'patient-led consultation', during which the patient expresses their agenda and we do our best to thwart them. I had genuinely believed I always let my patients set out their stall. Today I realised I must have been helping them all along. Because on their own, they're utterly hopeless.

'What it is, doctor, it's my arm.'

I can see it's his arm, he's sort of offering it to me (inside his donkey jacket).

The usual stream of questions rises to my lips (when, how, how often, did you hurt yourself?) but I can't manage any word that contains the letter 'e' or 'o'.

So we goggle at each other for a minute. He's obviously not going to add anything else, so I manage: 'Whurr durs urt hurt?'

'Come again?' he says.

'Where does it hurt?' I enunciate a little more clearly, and blood drips on the desk.

'Oh - there.' He points.

He either doesn't notice, or doesn't care, that I am bleeding.

My day proves to be full of unexpected silences. I don't get it. Why do they need me to play 20 questions? If I had spent 15 minutes waiting to see the doctor, I'd spend the time distilling my complaint into 20 pithy words, to save time.

The next one is a doozy. After 20 minutes to compose her opening gambit, she comes in, sits down, and says: 'It's terrible, doctor.'

And that's it!

Having got into my room and found the chair, she obviously feels she has done her bit and that now it is my job to extract, to tease out, the details of what, specifically, is terrible and exactly what it is she feels I may be able to do about it.

Today I can't do it. I've tried talking, and it's just not an option. I waggle my eyebrows in a friendly manner. She fidgets but doesn't say anything else.

I flick a rubber band across the room. She sniffs and looks at me pleadingly.

I try to express helplessness through the medium of mime. She crosses her legs.

It seems we are in it for the long haul.

Dr Phil Peverley is a GP in Sunderland

Phil Peverley, minus the split lip

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