It was half way through the consultation and the only useful piece of information I’d learned about the patient was that she has four children and I only knew this because she had their names tattooed above her breasts.
Asking these patients anything vaguely medical is about as fruitful as asking the Pope’s cat to explain the sacred mystery of the trinity
To be fair, I had also discovered the ages of these offspring as they were inked next to their names in Roman numerals. A curious choice for someone who, it seems unlikely, had ever won her school prize for mathematics.
An appointment with a patient who has registered that same day is always, as the cardigans like to say, ‘challenging’. They are frequently inarticulate, polysymptomatic and demanding. Added to that they usually have a list of chronic conditions which could double up as the index for the Oxford Textbook of Medicine and take more drugs than an un-rehabilitated rock star. But just to add that extra scintilla of edginess to the ten minute consultation, we have to do it all without notes.
The airline industry is often compared to medicine when risk is being discussed. Well this type of patient is the airlines’ equivalent of a blind-folded rookie co-pilot taking over control of the aircraft mid-flight with one engine down and a hurricane ahead. In short it’s a medicolegal nightmare.
In a sensible world one could of course ask the patient what’s wrong with them and what medications they are on, but in my experience asking these patients anything vaguely medical is about as fruitful as asking the Pope’s cat to explain the sacred mystery of the trinity.
‘Are you taking a cholesterol lowering tablet?’
‘Uh?’
‘A tablet for fatty blood’
‘Yeah I think so, is that the one with 40… or it might be 400 on the packet? Begins with t or s or maybe I got that wrong.’
I could go on, but you get the picture.
Extra testing of primary school children has been in the news a lot recently. Not knowing anything about educating primary school children, my knee jerk response is to trust what the teachers say about this, not a Government minister who seems to know even less about primary school education than me.
However, after years of having to deal with the barely literate results of our education system I do think, as they say, something needs to be done.
Dr David Turner is a GP in west London
