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Rina’s daughter is with her today and is happy to interpret for me. The problem is that, although very bright and articulate, she is only 11 and I don’t feel it is fair to use her to help translate personal questions about her mother’s mental health. Officially, we should use professional interpreters but it is hard work and time consuming. Even if I can establish that Rina has stress and depression, I probably won’t change the things that are making her depressed and it is so much easier just to give a prescription for another painkiller and wave her on her way.

Doctors do appreciate the importance of treating people holistically and recognising cultural differences but that appreciation doesn’t always help the individual patients in front of me. Sometimes I blame not being holistic on only having ten minutes per consultation, but I could have ten hours with Rina and I’m not sure whether the outcome would be any better. Yet another unsatisfactory consultation and a feeling of short-changing my patient.

<p>Dos and don’ts</p>

Doctors are fairly immune to seeing you naked. Not much will shock or embarrass us, but if we are going to be required to delve into your nether regions, it would be immensely appreciated if you had a bit of a freshen-up first. Men, if you have a problem with your bits, give them a quick wash before coming into my surgery. I personally haven’t had a foreskin for years. I find them an oddity at the best of times. I don’t want to have to peel back yours to discover a crusty layer of knob cheese. You will see me gag. Women tend to be a lot more considerate and, if requiring a vaginal examination, will make sure all is presentable. I did hear about one woman who, while running late for the doctor, gave herself a quick spray of what she thought was a vaginal deodorant. It wasn’t until she saw a puzzled-looking doctor remove a very sparkly-looking speculum from inside her that she realised she had doused herself with glitter spray by mistake

Don’t ask me how I am. That’s my question. We both know that you are here to talk about you. I know you are being polite but one of these days I might just answer the question and spend your precious ten minutes ranting about my cat’s fungal infection and my annoyance at my neighbour’s choice of late-night music.

Don’t ever ever ever say, ‘What’s up, Doc?’ It might seem momentarily amusing but it really isn’t. It is the equivalent of shouting, ‘I don’t belieeeve it’ to the actor from One Foot in the Grave, or shrieking, ‘Riiicky!’ to the corresponding EastEnders actor. We’ve heard it before and it just gets less and less funny. Some doctors hate being called ‘Doc’. I don’t really mind. In my football team there are three Bens but I’m the only doctor so I am affectionately called ‘Doc’. ‘On the ’ead, Doc’ has a certain ring to it. At school I was distinguished from the other Bens by being called ‘Big Nose’, so ‘Doc’ is a significant improvement.

Please don’t ask us medical questions when we’re not at work. I was at the barber’s and he asked me what I did for a living. I foolishly admitted that I was a doctor and he then proceeded to unbutton his shirt and ask me my opinion about a rash on his chest. We don’t want to answer medical questions on our day off and we certainly don’t want to examine you unless you are extremely attractive. I can promise you that this barber wasn’t! The awkward part of being asked medical questions outside of work is that I might need to ask embarrassing questions. For example, one of my wife’s friends asked me why she kept getting urine infections. When I started talking about the possible pH of her vagina and explaining how different sexual positions facilitate the passage of bacteria up the urethra, she looked rather disturbed. She blushed, made her excuses and has barely spoken to me since. My wife accused me of being inappropriate but at least her friend won’t ask me medical questions in the pub again. Some things are just best left for the consulting room.

If you’re a smoker, just be honest about it. So many smokers come in with awful chest infections and, when I ask them if they smoke, they proudly state, ‘No, Doctor.’ When I then ask, ‘Did you used to smoke?’ They say, ‘I haven’t had a cigarette for two days.’ This doesn’t make you a non-smoker and certainly doesn’t merit any congratulations from me. The fact that you have felt so breathless and unwell that you haven’t managed the ten-minute walk to the corner shop to buy your cigs makes you disabled, not an ex-smoker.

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