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Well into her late 40s, every other part of Julie’s body was moving in a southerly direction, but somehow her breasts were defying Newton’s laws and appeared perfectly suspended by an invisible force that was maintaining them at an exact right angle to her body. I was rather hoping that Julie was completely unaware of the tricky battle going on in my head, but I suspect not. She was wearing a particularly skimpy top given the cold spell of weather we’d been having and just when I seemed to be successfully maintaining uninterrupted eye contact, she would push her chest out and wriggle in her seat, throwing me completely off my game.

I had met Julie once or twice before, but had no previous recollection of her breasts. I would like to point out that I don’t generally remember my patients on the basis of their bra size, but such was the oddity of the bosoms that I was trying desperately to ignore that I couldn’t believe they would have previously passed me by unnoticed. I had watched enough episodes of Celebrity Big Brother to be able to at least hazard a guess that they were fake, but such was my desperation not to be caught staring that I couldn’t be 100 per cent sure that they were in fact due to prosthetics rather than genetics.

After the normal small talk about the weather, Julie told me why she was there.

‘I just need another sick note, Doctor.’

Scanning through her medical notes, I could see that Julie only ever really attended the surgery for sick notes. Every six months or so she would see a doctor and be signed off work for depression. She had always declined counselling or antidepressants, but when on her last visit I’d asked her to fill in a depression questionnaire, she scored maximum points and so the sick note was extended. Surely this time I couldn’t sign her off work quite so readily. She had almost certainly had a boob job since her last visit and this was throwing me into an ethics minefield. Can you really be too depressed to work yet voluntarily endure the pain and stress of major cosmetic surgery? What about the money? Are you allowed to claim benefits if you have a spare £6,000 for a new set of breasts? Most importantly for me, how was I going to broach this sensitive subject? Such was my inert sense of awkwardness, I could barely bring myself to even glance at Julie’s breasts, let alone declare them as a topic of conversation. Imagine the embarrassment I would face if I cited her false breasts as evidence that she couldn’t be depressed and they turned out to be real! I decided I would have to approach the subject from a different angle.

‘So, how is your depression at the moment, Julie?’

‘Actually, not that bad, Doctor. I’m feeling happier than I have done for a long time.’

Great, I thought to myself. No sick note for you, and I wouldn’t have to mention the two white elephants in the room. This was turning out to be considerably less stressful than I had feared.

‘I was depressed before, so my Gary bought me these new boobs for my birthday and it’s worked a treat. My Gary always knows how to cheer me up and they’ve put a big smile on his face too! What do you reckon of them?’ Julie asked, proudly pushing her chest in my direction.

‘Well, erm… I hadn’t really erm… noticed…’

‘Oh get away, Dr Daniels, you’ve barely taken your eyes off them since I walked through the door,’ she said, smiling broadly.

I was now staring at my computer screen intently pretending to be checking something important, while secretly wishing the ground would swallow me whole.

‘Well… erm Julie, so… erm… getting back to the reason for your visit here today. Surely you don’t really need a sick note any more now that you’re no longer depressed?’

‘Thing is, Doctor, I am much happier now, but my Gary’s a cheeky little rascal and he ordered a cup size or two too big. Let me tell you these things weigh an absolute ton and my back is bloody killing me. So if you could just cross out depression on the sick note and replace it with back pain that would be grand.’

<p>Mrs Patrick</p>

Mrs Patrick was my nemesis. As already mentioned, she was the very first patient I had seen at this surgery and I can still remember her venomous distrust in me the first time we met. Her misgivings about me had not diminished, but nor had they prevented her from visiting me at least once per week for the past nine months. Such was the frequency of her visits that some days I spent considerably more time with her than I did my own wife.

‘Just a few problems today, Doctor,’ she uttered as she pulled out a lengthy list of her ailments neatly jotted in blue biro on a scrap of paper.

The production of a ‘list’ always causes my heart to sink a little, but when the list belonged to Mrs Patrick, I usually completely lost the will to live. It was a Thursday morning and I had last seen Mrs Patrick on the preceding Monday afternoon. How could she have developed a brand new list of medical ailments in less than 72 hours?

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