Dinosaurs. Found only in the Natural History Museum and Steven Spielberg’s imagination, right?
Wrong. Remember the coelacanth? A prehistoric fish, thought to be long gone, which was hauled up, alive and flapping, off the coast of South Africa? Well, I’ve found my coelacanth. Or, rather, it has found me.
‘My private specialist wants me to have this,’ said my patient, thrusting a handwritten note under my nose.
‘My private specialist’ was a neurologist she’d paid to see, who hadn’t worried about courtesies like a referral from her GP.
‘Me’ was a lady with a long history of headaches, fibromyalgia and dissatisfaction.
And ‘this’ was a list of drugs comprising two types of antidepressant, a sleeping pill, an anti-convulsant, calcium supplements and vitamins. All of which replaced her current treatment regime, which was precisely nothing.
‘Does he?’ I replied. ‘Well, he can prescribe them, then.’
There followed a lengthy discussion during which I explained that generally my philosophy is to avoid polypharmacy, especially when initiating treatment, and that specifically I would adopt a step-wise approach in her condition rather than leaping straight to the Nuclear Option.
Predictably, she flounced out and, equally predictably, I received a proper letter from her private consultant. ‘Dear Dr Copperfield,’ it began, ‘I understand this charming lady is having problems obtaining her prescription from you. I can’t see why she shouldn’t have her treatment under the NHS, and I would be obliged if you would do this for her.’
Hmm, I thought, as you do when you’re punching a wall, this bloke’s a genuine dinosaur. Probably uglier and more stupid than a coelacanth, though. I won’t bore you with the detail of my response but, to paraphrase, it said, ‘Dear Jurassic Prat, piss off. Yours sincerely, Dr C. PS Charming? Hilarious.’
A fortnight later, I received another, longer, letter from the pinstriped pin-pricker. It sighed at my obduracy, tut-tutted over my lack of co-operation and wagged a fat finger at my ‘attitude’.
He went on to explain, as if to a retard, that medicine is ‘as much art as science’, and that some of my patient’s problems were linked to loneliness. This, he suggested, might be resolved by a monthly house-call from her GP.
So, despite the fact that my knuckles were bleeding by now, I replied again, expanding on my previous themes: ‘Dear Dino Doc, piss off, you pompous twat’.
Oddly, though, this episode did leave a warm glow, and not just because I’d catharted a whole gallbladder’s worth of bile. It made me think that this is what a GP’s life must have been like back in the day: self-important consultant pillocks with obsequious patients, treating GPs as their lackeys.
True, our job can be as much fun as eating shards of glass, but, nowadays, at least our NHS consultant colleagues usually treat us with some respect – and so do most of our patients.
Plus, I can console myself with the fact that the dinosaurs eventually died out.
We don’t know what did for them, exactly, but I favour the meteorite theory. In this consultant’s case, I hope it’s a direct hit.