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The things they say

Copperfield

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Ha ha ha ha ha ha ha ha ha. Don’t patients say the funniest things? Ha ha ha ha ha ha ha. Ha ha ha. Ha. Now, don’t get me wrong, I don’t want this blog to degenerate into that blog, ie, the one that resorts to relaying the funny things that patients say, because that’s like relating the funny things your kids say, which are funny to you but achingly tedious to the politely smiling person listening.

But it is funny, isn’t it, the things patients say? Like the woman who thought she had carnal tunnel syndrome. Ha ha ha. Ha ha. Ha. Etc.

Today, though, I had a variation on this theme in that it was a relative, not the patient, saying the funny thing. And it wasn’t so much funny as disturbing.

The patient is a full-on, frequent-attending, molar-eroding uber-heartsink. She always has lots wrong, her symptoms never make sense, she inevitably seems dissatisfied and so on. I’ve tried all the usual heartsink tricks. Nothing works. Our consultations typically end in frustrating and unsatisfying 0-0 draws.

An evil whisper in my ear makes me see a potential end to years of torture

Then she attends with her daughter. We do the usual, and we reach the point where I throw my hands up in a despairing kind of way. That’s when the daughter says it. And this is what she says: ‘She has such faith in you, doctor. If you said she should put her head in the oven, she’d do it.’

I cannot truly convey here the thought processes spinning vertiginously out of control in my head at this point, and for a considerable time after. Mainly, though, I am thinking, if I said she should put her head in the oven, she’d do it.

The daughter is looking at me expectantly and some time has passed. I’m trying to articulate something sensible but an internal dialogue keeps intruding.

‘Well, perhaps-’

(Really, faith in me?)

‘Maybe we could-’

(Head in a gas oven?)

‘It might be an idea to-’

(Does that even work these days though?)

And so on for quite a while until I find myself suddenly blurting, in a bid to end the torment, ‘Look, maybe we should just runs some blood tests.’

They seem OK with this and I’m feeling an odd mixture of relief and weirded-outness. I print off the form and hand it over.

Then, just as they’re leaving, with hand poised on door knob, the evil whisper in my ear becomes just too much as I see a potential end to years of torture simply by giving in to this overwhelming temptation. So I put up my hand decisively and say, ‘Wait!’

They pause.

‘I’m thinking about all these symptoms you’ve experienced for so many years. How much you’ve suffered. How I’ve done so little to help. And about what you said. You know. About ovens. Heads. And so on. And it does strike me that, you know, maybe in some way it would be a kindness, I mean, we have tried just about everything else. So…’

‘Yes?’ asks her daughter, a little breathlessly and with a strange look in her eyes. ‘What is it, doctor?’

I snap to, as if waking from a dream, but I haven’t been dreaming. I take a deep breath, then exhale. ‘Nothing.’ I say. ‘Same time next week.’

Dr Tony Copperfield is a jobbing GP in Essex

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Readers' comments (6)

  • David Banner

    When I started out last century I had a weekly elderly heartsink with unfathomable symptoms for which nothing worked and every investigation was normal. Feeling a failure I told him that I could no longer see the wood for the trees so he would be better off consulting with another GP in the practice with a fresh perspective. With tears in his eyes he left, and registered elsewhere. His daughter called me to say he was devastated that the only person who seemed to care (and actually listened) had turned his back on him. A sobering experience.

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  • I think many heart sinks get consolation through just downloading their various symptoms and problems, akin to going to a therapist. It is the process of downloading that is therapeutic. Unfortunately this has the opposite effect and affect for the clinicians involved. Heart sinks prefer to latch on to one favoured clinician. Modern General Practice with its lack of continuity of care does not give them the same positive outcome, but it may benefit the clinicians involved. In days gone past it used to be the local priest, their friends…

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  • AlanAlmond

    Funny and thought provoking in equal measure. Both comments above too. Thanks

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  • I think the daughter is extremely manipulative and is trying to get Copperfield to act as the instrument through which her own wishes are enacted.Subtext, people, the subtext.....

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  • Omg. Of course it’s obvious. If you feel rubbish after seeing the patient then that’s generally how much less they feel rubbish. The patient has just transferred that all over to you. Means you have done a good job. That’s what Balint groups are for.!!!!! Listening and validating are incrediably important and therapeutic gifts you can give to a patient. More then ever there are less other places to get this ( church/ family/ social worker).

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  • Dear All,
    As a trainee (yes that old) i was given the weekly attending heartsink to deal with. so after a while we got into a nice routine, he'd book an appointment for middway through the surgery, he'd slip into the kitchenette next to my room, brew me up a cup of tea and then bring it in when i called him. we'd chat, i'd drink my tea, once i even resorted to re-painting the walls in the room, 10 mins at a time with a brush and paint pot in the cupboard. that took about 10 appointments. 0 points for healthcare, 100% for doctor patient relationship.
    Regards
    Paul C

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