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It seems I missed the all-important lecture on diagnosis and treatment of vague b*******

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Now I know I missed the odd lecture at medical school, but I think now I must have been a lot less diligent then I thought.  Recently I got to thinking I must have slept through a whole lecture series entitled ‘diagnosis and treatment of vague bollocks’, because some of the stuff patients present with I sure as hell can’t explain.

‘Doc I get this surging feeling in the big toe of my left foot along with an itchy sensation in my teeth, but it only occurs on Saturday nights in mid-spring after I’ve had a Chinese takeaway what do you think it could be?’

How loud does an inner scream have to be before it makes your ears bleed?

So you go back to basics, examine, blood tests and of course everything is normal. You tell them whatever it is, it’s nothing serious, but sensing their need for an explanation, against your better judgement, you do your best.

‘Well your tooth sensation could be due to the acidity of the food and it may be sitting down eating it on the sofa caused some pressure on the nerves in your leg which led to your toe numbness.’

They shoot your explanation down faster than a slow-flying grouse in front of a member of the royal family.

‘Well it can’t be acidity, because I test all my food with litmus paper and I never eat anything with a pH less than eight and my toe symptom can’t be due to sitting down because I never do, I relax by swinging vertically in a sling suspended from the ceiling and anyway it’s a “surging” feeling not a numbness.’

How loud does an inner scream have to be before it makes your ears bleed?

How did we get here? Patients thinking we are omniscient and if we haven’t given them an answer they are happy with then turning up every two weeks with the same symptoms will wear us down to the point where we give in and hand them the bottle of magic elixir from under our desk we’ve been hiding all along.

You would struggle to find a more paradoxical state of affairs. We live in a time when we are simultaneously seen by many to have all the answers, while at the same time the Government is constantly feeding the notion to the public that we are lazy, overpaid and could be easily replaced with a spotty youth on minimum wage and some user friendly software - no wonder so many retreat into the world of utter bollocks.

Dr David Turner is a GP in west London

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Readers' comments (12)

  • There is an interesting idea here - that a growing and excessive faith in "medicine" might coexist with a declining faith in actual medical practice.

    As in: "Medicine must have the answer - it's a shame all the doctors are too incompetent to find it."

    Yet medicine is in fact nothing but the aggregate actions of the doctors.

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  • It's so true. I personally don't try to explain this sort of rubbish too hard. A brief "I have examined you very carefuly and am happy to say that I found nothing at all concerning. Next." is more than enough.

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  • Just blame it on "the virus" or toxins in the water

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  • I tell them to come back in 50 years and my tricorder will tell them what's wrong.

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  • Surely, the very fact that the patient rejects all reassurances & keeps coming back with more & more apparently trivial complaints must tell the doctor that there is something wrong that a 10 minute consultation is not going to resolve ?

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  • Some patients have hidden agendas that need eliciting, good comm. skills will take care of that. Some are simply ill-informed about what a GP is there to do. That beast is now too big to be tamed by us GPs. No government will ever tell voters not to abuse the NHS. Collapse is the only option.

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  • Most customers are very clear about what they want. If they choose to hide their agendas- it's their choice, not mine. My choice is not to waste my time on the mental garbage they're trying to fill my head with. I need that part of me still functional in case a real patient appears.

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  • How about "my stools now look different when I dicect them. They've become more meaty, so it must be cancer. You're welcome to do dicecting with me, doctor".

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  • My favourite confounding question was a lady with isolated memory problems, just regarding misplaced car keys - after using all my empathy and compassion (she had a FHx of Alzheimers) to reassure her that her memory problems only affected one domain of her life, and she was still functioning at a high level at her workplace, she simply and earnestly stated her actual agenda: "so how can I find my car keys?". Needless to say, I didn't offer a house visit to help the search.

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  • A big 'surge ' of recognition from me. Its really hard and very wearing

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