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Sack or sicknote? It's the sack I'm afraid

A patient turns on the waterworks in an effort to get a sicknote, but although he reaches for the tissues Geoff doesn't reach for the Med 3

A patient turns on the waterworks in an effort to get a sicknote, but although he reaches for the tissues Geoff doesn't reach for the Med 3

Then she burst into tears.

I hate it when this happens. Fortunately most of the surgeries I work in have a box of tissues near to hand. In fact most can be found strategically placed immediately adjacent to the monitor.

On this occasion I was lucky: it was a special "man-sized" box, and she was going to need it.

I was torn between sympathy, the need to get to the root of the problem, and growing mindfulness that the second hand was ticking. Ten minutes can be a bit of a brutal timetable in which to bare one's soul, lay out all of the troubles and pain, and then patch things up.

And who was the villain here? I'll let you decide.

Her opening line was a request for a doctor's note, backdated for the last three and half weeks.

This to me is like a red rag to a bull. Sometimes it's clean, neat and obvious: "Well, I was mauled by a lovelorn donkey in Cyprus and I've only just come out of traction." But on this occasion I smelled blood.

"Why do you need a note?"

"Well, my boss says I need one. In fact, she's written a letter..." which she then, perhaps foolishly, offered to me.

It only took a few seconds to read once, but then a few more to re-read because the implications were a bit odd. I then mentally chastised her for her lack of cunning and guile.

Again – don't mistake me: honesty is always the best policy. However, if you are going to angle for a "sickie", show a bit of creative flair. Thinking things through is a good first step.

Certainly don't come in following three weeks of unexplained absence and then produce a damning letter from your boss stating that unless a doctor said you had spent the last three weeks intubated on ITU you would be unceremoniously sacked.

"But it says here that your boss has repeatedly phoned you and even come to your house on a few occasions to see if you were OK. It also says you didn't respond. This also does not appear to be her first letter. What happened? Why didn't you reply?"

"Well, I was on holiday, staying with a friend."

Bad to worse, really. Several minutes in and not only have we failed to establish an even remotely medical reason why she can't work, but then, like a cold and dead fish, she slaps me with this.

I could see she was becoming more uncomfortable, but now I too needed some kind of closure. I pressed her one last time as to why she wasn't going to work.

She wailed: "The toilets there are so unclean!"

And then she burst into tears.

I didn't ask her what the toilets on Tenerife had been like. I just watched as she steadily made her way through a few more tissues.

Then I neatly folded the letter, passed it back to her, and said "You need to sort things out with your boss."

Geoff Tipper

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