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The patients we can’t say no to

You know who they are. They get angry with you and shout. They tell you with child-like impudence that they’ve come for help to get out and away from their pain. You have to help me, they say, and you have to help me now.

Then they hop from doc to doc, shopping from an abusable list, but they don’t use the respectable names like gabapentin, diazepam and dihydrocodeine. They call them gabas, blueies and diffs.

Eventually, if you’re worn out, broken down and full of doubt, you prescribe them. The gabas are snorted for euphoria, the blueies are necked with vodka and the diffs are taken when they can’t get any gear.

Our patients would never lie to us and we’d never forgive ourselves if we misdiagnosed. So we send them to expensive clinics for expensive scans to get to the bottom of things. And when they return it’s difficult to argue your way out, the hospital flimsy locks you tight into a cast-iron guarantee.

Some of our patients treat us like dealers, to pleasure and to placate, and sometimes it’s difficult to stop, because we have compassion and we’re scared of argument, hate and complaint. 

You know who they are.

We all know who they are. 

Dr Kevin Hinkley is a GP in Aberdeen.