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‘I’m, um, having a few problems downstairs’

‘Those tablets, doc. They didn’t work.’

I sighed internally. I’d been expecting this. I looked across to Mr James, my patient. Why did I get the urge to bash my head against the computer screen every time he had an appointment?

Was it his lugubrious expression?
Or his Eeyore view on life, whereby everything was bound to go wrong? Or even that he seemed to enjoy telling me about the many therapeutic failures we had shared?

It all started several weeks ago when he’d turned up to complain about the side-effects of the blood pressure tablets I’d prescribed on his previous visit.

‘And there’s another thing…’

He looked shifty and moved around uncomfortably in his chair. I had
a feeling I knew what was coming next.

‘I’m, um, having a few problems.’

I raised my eyebrows in enquiry.

‘You know, downstairs.’ He paused to study the back of his hands.

‘Tell me more,’ I prompted, using the open questioning technique that I was always badgering trainees about.

‘Well, you know, things aren’t happening as they should.’

I nodded and tried my most sympathetic expression.

‘It’s been a problem for a while, but those blood pressure tablets seem to have made matters worse and my missus told me to mention this.’

‘Do you mean problems with erections?’ I thought I’d add some clarity.

‘Aye, yes.’ He looked relieved that I was on the same wavelength. ‘I don’t suppose you can do anything about it?’ Eeyore reared again. ‘I know I’m in my 70s, but we still enjoy… relations.’ This last word came after some careful thought.

‘Well, actually there are some new tablets that can be really helpful.’ I tried to sound positive against the doubtful look that was turned on me now.

‘There’ll be side-effects, I suppose.
I always get side-effects.’ Indeed,
Mr James even had problems taking paracetamol.

‘Well, apart from an occasional headache.’ My voice tailed off. I knew that he would scrutinise the fine print on the drug information leaflet and would have most of the adverse symptoms within minutes of his first dose.

‘I suppose I’ll give ‘em a try.’

And that brought us to today.

‘I’m sorry to hear that they weren’t helpful. Was there any effect?’

‘Just that headache you told me I’d get.’

I frowned. ‘Would you like to try
a different dose?’

‘No. I took matters into my own hands.’


‘Yes. The sex shop on Gillygate.’

I sat up. This was unexpected.

‘They were very helpful. They told me not to worry about tablets and sold me
a vacuum pump.’ He looked pleased.

‘And, was that helpful?’ I was struggling to keep a straight face.

‘It was. A lot better than those tablets you gave me. Mind you, there is something that I want to ask. When you use these pumps, are your ears supposed to go pop?’

By this point, I was biting my lip so hard it was bleeding. It was several minutes after he had left, before I could face my next patient.

Dr Chris Hirst is a GP in Strensall, York.

Pulse asked for talented GP writers to send us stories to inspire and amuse their colleagues, and we were bowled over by the quality of the entries submitted.

Nearly 30 GPs took the time to put pen to paper – or finger to keyboard – and entries varied from amusing tales from consultations to clinical dilemmas or political ideas about general practice or the NHS in general.


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