There's just no getting rid of some patients

'You sent me to see Mr X,' said Joe sullenly, 'he wasn't very nice and was no bloody good anyway.'

Joe is always sullen in the surgery, but every cloud has a silver lining; he always makes me feel good by comparison and for at least one golden moment rays of sunshine sparkle and dance in my usually dark and dank surgery. The darkness and dankness, by the way, is entirely deliberate; when I was young I used to be a Goth (it was a good way to meet chicks and rendered the angst of colour co-ordination obsolete, thus saving time in the mornings), so when I started practice I hired an expensive and rather camp interior designer.

'Give me something,' I told him, 'which will make people uncomfortable and not want to come back,' although, not without some regret, I had to draw the line at thumbscrews, manacles and iron maidens.

I know that Joe is not always so depressed, because I have witnessed him at football matches, cheerfully shouting the traditional invective at his own team with a giant smile on his face. So maybe it's just the combined effects of my sunny disposition and the surgery decor that give him a face like a wet bulldog.

'Why did you send me on a wild-goose chase?' demanded Joe.

I called up the past consultation module on the computer and showed him the incontrovertible evidence of the clinical record: 'Patient requested private appointment with Mr X.'

I wondered if Joe would follow the example of John Maynard Keynes who said: 'When the facts change, I change my opinion. What do you do?' But Joe was made of sterner stuff and was not to be diverted or mollified; the lad was not for turning.

'Two hundred pounds, he charged me, and I'm feeling no better,' Joe continued.

'You asked for it,' I said, turning the screen away from him and idly Googling Britney Spears; I like to keep in touch with what our young people are up to.

'And I suppose you were getting a big cut,' he accused.

Dragging myself away from Britney's complicated career, I thought about the amount of whiskey and beer I could buy with such a windfall.

'I can only dream,' I said sadly.

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