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My 89-year old crystal meth user

Dr John Doe is taken aback when an 89 year old lady announces she's been getting crystal meth over the counter from her local pharmacy.

Dr John Doe is taken aback when an 89 year old lady announces she's been getting crystal meth over the counter from her local pharmacy.

"Doctor Jones usually just gives me an antibiotic"

14 minutes into my 1st consultation and I was getting nowhere. Mrs Vira L. Infection needed nothing more than to go home and take a couple of paracetamol but she was having none of it. I could make this easy and just give her an antibiotic or I could stick to my guns, explain why she didn't need one and risk my surgery running very late. This of course would result in a mad dash across the city to my afternoon session.

So I ran late, and after rushing out of one surgery, asking them to kindly post my cheque as I had no time to wait for one of the partners to sign it, I was still 10 minutes late for my next shift across town.

I went in search of the partner I would be working with (nowhere to be found), flicked through the locum pack, checking everything I would need was there, and then punched in all the passwords to start whichever computer programme it was this surgery used. On completion I had successfully added another 10 minutes to the waiting time.

My first patient of the afternoon was an identikit of Mrs Infection and as she was listing her cold symptoms with painful monotony my heart began to sink. This was proving to be a long day.

But then something quite unexpected happened. This petite 89 year old lady had moved on to listing her recent otc remedies when she proclaimed:

"I even tried crystal meth doctor but that didn't do anything for me"

"Crystal Meth?!" I replied "Where on earth did you get..... wait a minute, who gave you....Crystal Meth??!"

My immediate suspicion, that the local chemist was pushing class A drugs on the local octogenarians, proved unfounded. The patient had however been given mentholated crystals for her cold.

After explaining the difference between hard drugs and mild decongestants we both had a good laugh and came to the conclusion that her cold would pass in a day or two. No long explanations about antibiotics and bacterial versus viral infections needed.

The lack of continuity and the hit and run style of medicine that locums inevitably practice means gaining trust and developing relationships can often be extremely difficult. If a patient, already annoyed at not seeing their normal doctor, then learns they are seeing the locum, a successful consultation can be nigh on impossible.

I am viewed with curious pessimism, in their eyes not good enough for a "real job" and often sullied with a negative reputation, garnered after the last locum wouldn't give them an antibiotic for their "dreadful cough".

I look forward to the day I can create a reputation of my own, but until then I will take comfort in the small moments that only medicine can bring, picturing a small 89 year old lady smoking crystal meth with all her pals at the bingo.

The blog of Dr John Doe

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