Further Confessions of a GP

‘Of course you can, but we’re just going to agree that medical science will never cure you of your symptoms, so instead we’re going to talk about other things that might help.’

‘Er, like what?’ Mrs Patrick asked, looking visibly nervous.

‘Have you ever had a dog?’

‘A dog?’

‘Or joined a choir?’

‘Are you okay, Dr Daniels?’

‘Yes, I really am,’ I said, meaning it.

‘Getting a dog and joining a choir?’

‘Yes, or whatever else inspires you to smile and enjoy yourself ! You can still come and see me and we’ll talk about all the other things you’re going to do in your life rather than take medicines and go to hospital appointments.’

‘But we’re not going to talk about my headaches?’

‘Exactly!’

‘Or my dizzy spells, or sneezing, or nausea, or funny turns?’

‘That’s right.’

‘A dog and a choir?’ Mrs Patrick repeated to herself quietly as she left the room.

This was going to go one of two ways. I was either going to make a massive breakthrough and after 40 years finally free Mrs Patrick and the medical profession from much of her torment. Or I was going to end up being struck off the medical register for suggesting singing and dog walking as a cure for some sort of rare medical syndrome that Mrs Patrick’s next doctor was going to cleverly diagnose.

Danni II

‘You’ve gotta sort this out, Doc. I can’t get no business.’

Danni was pointing to an unpleasant looking cold sore on her upper lip. It had become infected and scabby lesions were spreading up to her nose and cheek.

As a sex worker, the infection on her face meant that she couldn’t get any clients and so couldn’t earn any money. If she had been a teacher with a hoarse voice or a carpet fitter with bad knees I could have given her a sick note so that she could get sick pay, but in her line of work there wasn’t that sort of safety net.

‘I can’t even hide it with make-up.’

Danni had been my patient for some time and I knew her biggest concern about not working would be that she couldn’t afford to buy herself any heroin or crack.

‘How are you buying your gear if you can’t work?’

‘I’ve had to go to the clinic and get some methadone.’

I had once thought that methadone was used to wean people off opiates, but my patients who are drug users mostly just use it to keep them going if they can’t get hold of any heroin. Some of them stay on methadone for years and years, constantly putting off the gradual reduction of the dose that is supposed to wean them off drug dependency for good.

‘Are you on benefits?’ I ask.

‘No, most of the girls are on benefits, but I don’t think it’s right getting money from the government when I’m earning.’

I was surprised by Danni’s moral stance. It seemed odd when someone who was living so far outside of what might be considered ‘morally normal’ was taking a principled stand about claiming benefits. I doubt she ever paid tax on her earnings, but even so her sense of ethical responsibility was admirable.

Danni only ever came in to see me for emergency appointments. I could often help with the superficial problems, such as dealing with an abscess from where she had injected heroin, or treating a sexually transmitted infection, as I had last time she had been in. Frustratingly, I could never get to the real root of her problems, which was depression and addiction.

It didn’t take long to prescribe Danni some antibiotics for the infection on her face, but she didn’t seem to want to leave. ‘While I’m here, Doctor, I wondered if I could just talk to you about something else?’

‘Well, not really, Danni. I fitted you in for an emergency appointment and I’m already running late. The waiting room is heaving.’

‘Oh yeah, of course, Doctor, I’m sorry. I don’t wanna waste your time.’

I felt instantly guilty for cutting Danni short. It was true that I was running late and the waiting room was full, but the other reason I was keen for Danni to leave was that she always made me feel so bloody useless. Her life was so complex and chaotic that I never felt able to even scratch the surface of her problems. I couldn’t cure the general sense of misery that ran at the heart of her day-to-day existence. There was nothing I could do to make her life anything close to resembling happy, so I really just wanted her to leave my room so that someone whom I could actually help might come in.

I once heard someone say that life was like treading water in a swimming pool of raw sewage and that the job of a GP is to direct people to the shallow end. Danni was drowning in the deep end and if I couldn’t dive in and drag her out, the least I could do was offer her a sympathetic ear while she flailed around in the faeces.

‘Sorry, Danni, what were you going to ask me?’

‘Well, it’s just that I’ve got no money, and until my face gets better I can’t earn anything and well… I’m just really hungry.’