When is it better to be blunt? Imagine a scenario in which an otherwise sensible patient suddenly comes out with something nonsensical: ‘My homeopath said my elbow hurts because I eat too many raspberries’ or whatever.
Now we know this is hogwash, but is it always a good idea to point that out? (‘We’ in this case meaning the blogger and his readership; the patient clearly doesn’t know, otherwise he wouldn’t be visiting a homeopath, and the homeopath doesn’t know, otherwise that would make her some kind of predatory charlatan, and in this hypothetical instance I’ve decided she’s just a wilfully misinformed nincompoop. What can I say? My vignette, my rules. Sandbox your own damn characters.)
Sometimes pragmatism wins the day. Perhaps you don’t want to jeopardise the doctor-patient relationship, or you’re running late, or maybe you don’t have a scooby how to fix his hurty elbow and you’re happy to run with the whole raspberry theory if it means he won’t ask any more questions. So, you just deploy your best De Niro shrug and let it slide.
But what if it’s, ‘my homeopath told me to cancel my curative cancer surgery and start her patented Drupelet-Free Detox Diet instead’? Suddenly the stakes are too high to remain polite. Step aside Bobby, it’s time to go full Dawkins.
Sometimes you have to look at the big picture and tell the truth, no matter how problematic that may be. Which is why I was saddened last week to see Simon Stevens demanding the chancellor honours the £350m-a-week Brexit Bus Bonus promised to the NHS by Vote Leave last year.
Mr Stevens is not an idiot; he knows there won’t actually be any cash for him from Brexit – he might as well pretend he’s gonna secure NHS funding from the helpful Nigerian diplomats living in my spam folder.
And even Jeremy Hunt, on whose idiocy or otherwise I make no comment, knows enough to carefully precondition his response: ‘If there is a Brexit dividend…the NHS should be the first port of call.’
It’s all about politics, of course; Mr Stevens is caught in a desperate race with the government to decide who’ll take the blame for the inevitable winter crisis, and he’s trying to position himself so Mr Hunt ends up eating the biscuit.
But I’d respect him a lot more if he admitted what they’ve both skirted around (and I appreciate this opinion may alienate 52% of my readers, but we’re not talking about elbows here): Brexit is going to stuff the economy and with it the NHS, and by far the most sensible thing to do is to stop the whole sorry process before it’s too late.
Dr Pete Deveson is a GP in Surrey. You can follow him on Twitter @PeteDeveson