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At the heart of general practice since 1960

Dear patient: It's not you, it's me

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I was young and idealistic when we first met. Fresh out of medical school, my hope and enthusiasm for life was obvious to you. I’ve still kept all the thank-you cards you sent back then, and I look at them when I’m having a bad day.

But soon, all the late nights sitting on your hospital bed allaying your fears were taken for granted, and those cards started drying up. They were replaced by letters of complaint about failing to diagnose your appendicitis, which presented as gastroenteritis, or failing to prescribe you the pill when it was unsafe for you to take it. 

Yet I tried even harder to please you.

I booked you at the end of my surgery so I could spend an hour talking about your marital problems. I wrote letters of support so you could be rehoused and your kids could attend the school of your choice.

I expected nothing in return other than a little appreciation and respect, but got none.

The control started quite subtly, which is why I didn’t recognise it at first. You booked monthly appointments and consulted for half an hour, but became agitated if I ran late by more than 10 minutes. You started demanding same-day phone calls, which I made because I didn’t want to upset you. You began shouting when you didn’t get antibiotics or sleeping tablets, and because you threatened to harm yourself, I gave them to you. 

Then things got ugly. I developed a DNA policy because you were not attending 20% of your appointments. After you received a letter about this, you made slanderous comments about me on the NHS Choices website. When I was reluctant to continue prescribing your vast quantities of diazepam, you falsely reported me to the GMC for sexual inappropriateness, and I was suspended for nine months pending an inquiry. 

At group therapy I was amazed to see how many other GPs were in a similar situation. But I do not blame you because I also played a part. If I was not so keen to be adored by you, maybe I wouldn’t have let things go so far.

And if the Government was not fuelling your demands and the media was not indoctrinating you about how useless I was, maybe you wouldn’t have behaved the way you did. We both need to take personal responsibility.

I still love you, but I will not be abused. I will be there if you genuinely need me: if you are diagnosed with a life-changing illness, or need holistic care for your many co-morbidities, or if you have little time left in this world to enjoy. But I will also remember the words of Paulo Coelho, which formed part of our 12-step programme in therapy – ‘When you say “yes” to others, make sure you are not saying “no” to yourself’. 

And I will no longer say ‘no’ to myself.

Dr Shaba Nabi is a GP trainer in Bristol

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Readers' comments (29)

  • Beautifully put. That describes how are our job has changed perfectly.

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  • oh god im depressed now. patients arent like this in Canada.

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  • I like. The patient has become the customer in the biggest UK business.

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  • This is a beautifully written, and extremely perceptive Shaba. You could be writing my own life story. Keep up the good work!

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  • Brilliant

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  • Wow Shaba - well put!
    It is amazing how easy it is to be drawn into the 'pleasing' role and I'm sure that the majority of GPs have been there.
    As a newly qualified GP I hope to join a local Balint group. I hope (and have been assured) that these are very useful in this respect and discussion with peers may help to avoid being drawn into a manipulative co-dependent relationship with a (possibly personality disordered?) patient/ family.

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  • Una Coales

    Nicely written Shaba. What is the cure for helper syndrome?

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  • Legend. enough said

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  • Messiahs get crucified and quite rightly so.

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  • Quite simply, perfectly put

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