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Phil is incensed by an unnecessary house call to a shameless time-waster of a patient

Numbness of the senses

It was the patient's neighbour who phoned up. That's what put our receptionist off the scent; they are supposed to get a contact number so we can phone back, but in this case the caller said: 'No idea. She just gave me this mobile. I dunno the number. Does it matter?'

Well, yes, it does. It was the start of my evening surgery and the message was: 'I've gone numb all down one side. Can the doctor visit straight away?' Can the doctor, in the circumstances, do anything else? I can't really criticise this chap for not knowing the number of the phone he was holding. I don't know the number of mine. No doubt there is a series of buttons you can press to tell you your own phone number, but I don't know what they are. I've written my own number on the back of my phone in felt tip, but not everyone has my incisive organisational nous.

I checked the patient out on the computer. She had a history of a minor stroke, and a recent case

of shingles, an address that was flagrantly outside our practice area, and no phone number.

I asked the receptionists to do what they could with the patients I had waiting, and 20 minutes later I had crossed the River Wear and was at her door. 'Thank you for coming, doctor,' she said, as I eyed the car in the drive. She looked fine. 'Tell me how I can help you,' I replied.

'It's this rash I saw you with the other week,' she said. She hitched up her woolly cardigan to show me the shingles rash that had nearly disappeared. 'It feels funny. It seems a bit numb.'

I've not had a complaint about my clinical practice or manner in 10 years, and I'm not about to start now, so I resisted the impulse to slap her squarely in the mazzard.

'We talked about this last week,' I reminded her. 'For about 15 minutes. I told you it would probably feel a bit funny.'

'I don't remember' she said. It is a well-researched fact patients often don't remember much about their consultations, so I make full use of patient education leaflets.

'I gave you a leaflet all about shingles. There it is, look, right there!' She picked it up. 'Yes, I read this. It says I might get pain or pins and needles for months. It doesn't say anything about numbness.' And she was right, it didn't actually mention numbness. Altered sensation, yes. Numbness, no.

I counted to 10 and carefully explained her illness was following its usual course, and she had no cause for concern. But frustration was boiling over. 'Your car is sitting right outside the door. Why didn't you come down to the surgery?'

'I didn't want to get stuck in the snow,' she told me calmly. It is true that on that day much of the UK was crippled by a good inch-and-a-half of snow, but in Sunderland we had suffered not one single flake. Crocuses were poking cheekily out of the soil in her front garden. 'We haven't had any ruddy snow!'

'Sorry doctor, but I haven't felt well enough to go outside today'. Or indeed to look out of the window, the bloody stupid time-wasting idiot.

I don't mind stupid. Anyone who understands Gaussian distribution also understands that some people are utter pillocks and this is normal and unavoidable. What I do mind is her casual assumption that her own stupidity was nothing to be ashamed of, just a normal aspect of the way she ran her life, and that any consequences

of her moronic, self-centred behaviour were my problem

and not hers. No embarrassment, no apology.

What I mind even more is that she is right. Her terminal idiocy is indeed my problem; any aftermath of her thoughtless ignorance, whether it was at her house or back at the surgery where my patients were being redirected or cancelled, would be mine to deal with. There is no comeback. Having a brain made of mince is not a chucking-off-the-list offence. I went back to the surgery to sort out the mayhem as best I could. She switched on the telly and got back to watching Emmerdale.

Phil Peverley is a GP in Sunderland and PPA and MJA Columnist of the Year

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