‘Dear Dr Copperfield,
‘Your patient with carcinoma of the bowel has requested access to alternative therapies via our service. As he is undergoing chemotherapy, I need to seek your permission/consent for him to have reflexology.
‘Complementary practitioner, local hospice.’
I try hard to suppress the escalating feeling of tension working its way from neck and occiput down my arms and into a carpal spasm. But resistance is futile. It’s a Pavlovian reflexology response, and I can picture my reply ready-formed, without any conscious effort on my part:
‘Dear complementary practitioner
‘Thank you for inviting me to give permission/consent for our mutual patient to have reflexology. I am unable to do so for the following reasons:
‘1. I have no training in complementary or alternative medicine. I therefore have no useful input to offer into reflexology’s indications, contraindications or interactions. I have an opinion on it, but cannot articulate this until I update the dictionary on my word-recognition dictation software.
‘2. Being a complementary practitioner, I assume you do not suffer the limitations I have outlined in ‘1’, can make your own ‘professional’ decision, and therefore take the responsibility should the patient turn his toes up while you’re massaging them.
‘I do, however, give my consent/permission for you to stick your fingers in the plug socket, should you choose to do so.
So then I sit, in front of this letter, still feeling this strange tension of incredulity and rage. And I find myself agonising: this never ending barrage of nonsense, work dumping and responsibility shifting, and the responses we’re obliged to make, is there a limit to how much we can take, and is our ability to fend it all off a finite resource?
In which case, am I wasting valuable time, energy and will-to-live even dignifying bollocks like this with a response? Yet if I don’t respond, will I get another letter, then a complaint, then headlines in the local paper? And does shredding it suggest I’m losing the motivation to Actively Resist All Nonsense, which in recent years has become one of the few reasons I can find for keeping going?
On the other hand, should I just say, ‘Yes, fine,’ because what does it matter?
And I realise I’m agonising over agonising. This is what life has become: every interaction is stressful and wondering how to react appropriately becomes a stress in itself.
By this point, my body is rigid with tension. I’m going home to have an obscenely large G&T. I’m not seeking your permission/consent for this. There is no alternative.
Dr Tony Copperfield is a jobbing GP in Essex