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When only expletives will do

Occasionally a GP needs something stronger than ‘no’, as Copperfield discovers.

Call it self justification but I’ve always insisted that GPs who achieve 100% satisfaction must be doing something wrong. Specifically, saying ‘Yes’ to patients all the time. Sometimes, you simply have to react to a punter’s request just as you would an offer of some Basildonian marching powder*. Just say no, in other words.

I have developed this capacity to say ‘No’ in a number of ways, and I don’t mean just ‘non, nein, ne, nagwa, na, nyet, nie, nde, nuddu and (my personal favourite), nannikwaw’ (emphatic Brazilian), though I do use all of these just to make it clear. No. What I mean is, there’s the autopilot ‘no’ to requests for amoxicillin, MRI scans, referrals and such like. There’s the ‘nice try no’ in response to a junkie’s plea for nutritional supplements which he wants so he doesn’t have to waste hard-nicked drug-money on food. And there’s the ‘reluctant no’ I give young mums requesting a stock of paracetamol elixir for their febrile, spluttering progeny – on the basis that I don’t encourage attendance for minor illness in children, plus I can’t actually remember the dose.

And, as I’ve discovered today, there’s the ‘No’ which emanates from deep within me, erupting volcanically with a spume of suppressed bilious rage I didn’t even realise was bubbling just beneath the surface.

‘I want a certificate,’ he said, like I’d just hand one over. Though, looking at him, some probably would. But a second glance revealed something beyond the tattoos, shaven head and absent neck: sunburn. In February. ‘I’ve just been on holiday to Tenerife and I got fried. I’m on long term sick because of my back, but I need another doctor’s note because I’ve got an interview on Monday,’ he said.

He mistook the curl of my lip for a smile. ‘Yeah, stupid, I know, I shouldn’t have fallen asleep in the sun.’ I’d love to be more specific about how he explained he needed this certificate to excuse him from a nice cosy chat with the police, or the DSS, or the job centre, or something, but how he couldn’t possibly attend on account of how uncomfortable the sunburn was, even though the interview wasn’t happening for a few days. But I can’t, because something about his insouciance, his sunburn, his holiday, his long term sick status and his apparent inability to detect any incongruities was causing strange things to well up inside me.

And before I knew it, I was deafened by a sound: the sound of my own voice making a strange, anguished, strangled noise. It was f*** off in emphatic Brazilian.

* I should make it absolutely clear that the Tony Copperfield blog does not advocate the use of illegal, mind altering substances, not even in the middle of Monday morning surgery.

‘Sick Notes’ by Dr Tony Copperfield is out now, available from Monday Books.

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