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At the heart of general practice since 1960

Sounds like a good wheeze

Copperfield has had enough of trying to listen to the chests of dysfunctional deep breathers and has unleashed his secret weapon - the iPod-o-scope.

Copperfield has had enough of trying to listen to the chests of dysfunctional deep breathers and has unleashed his secret weapon - the iPod-o-scope.



The only rational response to a typical Monday morning surgery is to bang your skull repeatedly against the consulting room wall until the punters, or your senses, evaporate.

So what keeps us going, apart from the warm glow we get from dishing out another prescription for statins? Those sweet little patient idiosyncracies, that's what.

Such as the way they can only reply to the question ‘How long have you had your symptoms?' with an answer so vague and rambling that it could go on – if you didn't stem the flow of drivel with threats of violence – well, for as long as they've had their symptoms. Which might be months, or years; you'll never know.

It's also amusing how you can always make a patient lying on the couch develop a spasm of rock-hard muscle tension with the simple command: ‘Relax.'

My favourite, though, is their response to the request: ‘Just take a few deep breaths.'

When I was young and naive, I imagined it would be straightforward persuading patients to shift enough oxygen for me to auscultate their lungs.

Not so. Many have perfected the art of appearing to breathe vigorously while achieving absolutely zero gas transfer. They do this by rocking their upper torso back and forth, or by pumping their arms like bellows, or both.

This would be amusing if it wasn't so bloody irritating.

But it's not as irritating as those who take a huge breath, then hold it for so long you could see the next patient while waiting for them to repeat the cycle.

Some stubbornly interpret the instruction ‘breathe in and out' as an invitation to hold their breath the whole time, which obviously means they're stupid – possibly on account of being hypoxic.

Others breathe so ridiculously deeply and rapidly they get dizzy and develop tetany, which gives us two more symptoms to explain.

My most memorable dysfunctional deep breather, though, was a young woman I encountered who, as I listened to her heaving chest, became so noisy and dramatic that she seemed to be reliving that scene in When Harry Met Sally. At least her request for a post-orgasmic fag gave me a chance for some opportunistic health promotion.

I mention all this because, the other day, a patient asked me – as I whipped out my stethoscope and he whipped up his shirt – ‘So what do you actually listen for, doctor?' By which he meant what sounds might I hear – but which I took as ‘What's the point?'.

Good question, I thought. I can't remember the last time listening to a patient's chest made any significant difference to the action I was going to take anyway.

Either I forget to concentrate or can hear bugger all – or the sounds don't correlate with what I've already decided is wrong so I ignore them.

That's why I've invented the ‘iPod-o-scope'. You can probably figure out the concept. Patient thinks I'm taking him seriously, while I get a dose of a recent download.

As long as I don't forget myself and start playing air-guitar, he's none the wiser – indeed he's happier for the therapeutic laying-on-of-stethoscope.

So what do I actually listen for, doctor? Anything by The Smiths, really.

Copperfield

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