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At the heart of general practice since 1960

Patient power can prove to be a blunt tool

Rumpy-pumpy

Awkward positions arise when a GP takes on the involuntary role as sex counsellor

I've recently had a falling-out with my Kama Sutra coach. Unfortunately, this has left me in a very awkward position.

As a family GP, I think it is on the whole a good thing that my patients can come to me with a wide variety of problems. Many of them trust me with their most intimate dilemmas. But my involuntary role as sexual counsellor, which I did not think was part of my remit when I took on this job, makes me nervous on several levels.

One recent patient, a young , confident, professional woman, typifies my concerns. 'I'm all right in most positions doctor,' she confided, 'but doing it doggy style gives me a pain deep inside. What do you think? Do I need a scan?'

'You need a modesty transplant' I thought to myself, but of course I didn't say it. I shifted uncomfortably in my seat. 'What does your partner think?' I asked, stalling for time. 'Which one?' she replied, and damn it, incredibly, the consultation had just got even worse.

I'm just not equipped to deal with this kind of thing. Back in medical school I remember quite vividly the course of lectures on blood dyscrasias. I can recall embryology, and seminars on the limbic system. I feel sure that if we had had a series of lectures on rumpy-pumpy, it would have stuck in my mind.

Why are they asking me, for goodness sake? I'm a portly Hartlepudlian approaching middle-age, I've spent most of my life in the North-East, and consequently I only know two sexual positions ­ socks on and socks off. I am not, by any criteria you care to mention, Dr Ruth.

Another low point was when a hard-faced young female patient practically frogmarched her beetroot-complexioned boyfriend into my consulting room. 'There's something wrong with him, doctor, he can only last about eight minutes,' she informed me. 'Can you give him anything to make him last a bit longer?' His embarrassment at this juncture was crippling, but he needn't have worried about my reaction. 'A whole eight minutes?' I was thinking to myself. 'What's his secret?'

'Would you do me a favour and step out of the room for a minute?' I asked the young lady, and reluctantly she complied. The boyfriend and I eyed each other nervously. I would have offered him a cigarette, if this was the 1950s. 'What's all this about then?' I asked.

'Oh I dunno, doc. She's been watching

one of those DVDs from Cosmo magazine, and she wants me to bang away for hours, like Sting and his missus. She thinks everybody does it like that.' As we were

both normal men living in the real, non-Cosmo world, we shook our heads sadly.

'Listen,'I said, 'I'm no expert, but when you are approaching the, er, moment of fulfillment, why don't you try thinking of something unsexy?' I cast about for the most sexually offputting image I could conceive of. 'You could try imagining that you are in bed with Bobby Charlton.'

He looked doubtful. 'Well, I'll give it a try doc. But I'm not sure that that would help much.' It was only at this point that I noticed he was wearing a Manchester United shirt.

peverley@ supanet.com

Dr Phil Peverley is a GP in Sunderland

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