Backache leads to earache

It is true that I have the patience of a saint.

‘I have a letter here from a specialist about your lower back pain,’ I said. I emphasised the words ‘from the specialist’ to underline that this treatment was his idea and not mine, partly to augment any placebo affect, but mainly to absolve myself of any blame in the future, because I knew it wasn’t going to do one damn bit of good.

‘He describes you,’ I continued, ‘as a very pleasant lady, so obviously he doesn’t know you as well as I do?’

She laughed heartily at what she thought was an amusing piece of droll spoofery, but my comment was a valid comment.

Because I am sometimes a good doctor, I am aware of the problems patients have with compliance. Even the simplest regimen requires a thorough explanation; it is best to imagine that you are talking to the village idiot.

‘He wants you,’ I continued, ‘to take one tablet in the morning and two at night; is that clear?’

‘Absolutely clear, doctor,’ she agreed, anxious to please, ‘that’s two in the morning and one at night.’

‘At the risk of seeming pedantic,’ I said, very slowly this time, ‘that is almost but not quite precisely correct.

So let me repeat myself; he advises that you are to take one tablet,’ (I held up one finger) ‘in the morning and two,’ (two fingers) ‘at night’.

‘No problem,’ she reassured me, ‘that’s one tablet in the morning.’ There followed a long and tortured silence as I waited in vain for the other shoe to drop. Eventually I could stand it no longer. ‘And two at night,’ I snarled.

‘And two at night, of course,’ her tone suggested that this was implied.

‘Of course,’ I agreed, ‘but please just humour an old man, whose enjoyment of life has been overwhelmed by the unbearable ennui and the tedium of the family practice, by telling me exactly how you are going to take these tablets.’

There was a long silence, and I could see her eyes narrowing and brow furrowing,

evidence of the internal struggle as the mental arithmetic went on. ‘One in the…’ she started, concentrating hard.

‘Morning,’ I hinted.

‘One in the… morning,’ she continued hesitantly, ‘and… something about the evening.’

‘Nearly there,’ I encouraged her, ‘you are getting warm.’

‘And… and… two at night!’ she finished exultantly, jumping up and down with delight.

‘Your back pain seems much improved,’ I observed.

- Dr Farrell is a GP from County Armagh.

Email him at GPcolumnists@haymarket.com

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