Every couple of months or so the surgery shuts for an afternoon and we have some sort of educational session. It’s an attempt to keep us up to date and make us better doctors. The most recent education afternoon was on the topic of sexual health. A lady with a colourful silk scarf and ethnic sandals was talking to us about the importance of sexual identity.
‘How often do you see your patients as sexual beings?’ she asked. ‘How often do you consider how the medications you prescribe might affect the sexuality of your patients?’
I had to admit that the answer to both of these questions was ‘never’. I knew that some medications could affect libido and erections, but I tended to avoid discussing it with patients if I could. This was all going to change from now on, though, I decided. The sex therapist lady was right. There was no point lowering a patient’s blood pressure if I was going to ruin his relationship because my drugs were inhibiting his erections.
The first chance to demonstrate my newfound sensitivity came the very next day. Brian had come in for a review of his blood pressure medication. I know it’s wrong to pigeonhole, but I had always felt like Brian looked like the perfect stereotype of a bus driver: mid-50s, with mutton-chop sideburns and an ever-expanding beer belly. His faded white shirt always had large yellow sweat patches in his armpits and was open at the neck to reveal a big gold chain that matched his sovereign rings. Brian was accompanied by his wife Deidre, and although they always came to see me together, I had the impression that their relationship was often strained. With my new approach, perhaps I could help?
‘Brian, some men find that beta-blocker medication like the one you’re taking for your blood pressure can affect their ability to have erections. Do you ever find this to be a problem?’
‘Well, funny you should say that, Doctor. Me and the wife here have been struggling to manage in the bedroom department for some time. When we’re alone together I just can’t seem to get the little fella to stand to attention these days.’
Wow, I think to myself. What a breakthrough. The nice sex therapist lady was right. We do need to talk more about sex with our patients. Perhaps I can make a real difference to Brian and Deidre’s relationship. Perhaps the sexual frustration is the reason why they’re always bickering.
‘Mind you, I do still get erections though, Doctor,’ Brian said, interrupting my thought process.
‘This young lass got on the bus last Tuesday. It was a right warm day if you remember and, cor blimey, Dr Daniels, you should have seen her. Gorgeous she was. Legs this long and a little top that didn’t leave much to the imagination if you catch my drift …’
Brian went on to explain in some detail each item of his young passenger’s clothing, and the relative part of her anatomy that was exposed as a result. ‘Rock solid I was, Doctor. Could barely keep the bus on the road! I could see her in my rear-view mirror and I had wood from the stop outside Boots on the high road all the way to the leisure centre past South Street. That’s five stops, and I got caught at the lights just before the bridge. I really don’t think it’s the blood pressure tablets that are the problem, Doctor. I think it might be Deidre. She’s not the woman she was. Just doesn’t really do it for me anymore.’
Deidre had been sitting quietly up until now, but I could sense her rising fury. ‘Don’t you worry, Dr Daniels, erection or no erection, Brian doesn’t do a great deal for me either these days. In fact, he never really did. Even when we were young I always had a lot more fun on my own, if you know what I mean.’
Brian and Deidre went on to describe each other’s inadequacies in the bedroom department in some detail. To make things even more awkward, they didn’t speak directly to each other but instead spoke to me as if the other wasn’t present.
I sank as deeply as I possibly could into my chair and cursed myself for turning what could have been a nice simple consultation into something so toe-curlingly awkward that I wished the ground would swallow me up. I tried to think of some useful interjections, but I was well out of my depth with this one, so instead I sat excruciatingly silent until Brian and Deidre decided that I had heard enough and left.
My brief attempt at viewing my patients as ‘sexual beings’ was well and truly over.
Dr Benjamin Daniels is the pseudonym of a doctor currently working for the NHS. He is author of the bestselling book Confessions of a GP and the recently released follow up, Further Confessions of a GP.