Baby makes paper aeroplanes out of leaflets (he is not partisan, any political party pamphlet will do). But I have always wondered what happens to the letters that I write. I am told that these make a difference, and so the requests keep on coming. But any other kind of letter of support – particularly for housing and benefit departments – seems to make little impact these days.
Take my patient Jake. I have not seen him for some time, which for him is usually a sign that he is well. I have recently written letters to various agencies about his disability. Today he is pacing up and down the room.
I inherited the largest consulting room in the surgery from our senior partner when he retired - but today it feels cramped with a large desk, old fashioned couch, a shelf overflowing with books and a six foot three inch Jake who is sweating profusely as he walks right up to the wall, stares at the thermostat, turns and walks back again.
I know Jake is ill when he comes wearing earphones - he once told me that music protects him from the sounds of the outside world. Earphones dangle from his ears today and I can hear piercing music penetrate the air as it mingles with the sound of traffic from the window.
There are the only two significant medical problems listed on Jake’s medical record. But the words leap out from the screen. ‘Schizophrenia’ and ‘pulmonary embolisim’. Jake has pleuritic chest pain and shortness of breath. But he gives an incoherent history and will only allow a limited physical examination.
It becomes difficult to ascertain whether he is having a panic attack or if there is a respiratory or cardiac cause for his symptoms. I ring his carer who earlier made the appointment but then could not attend as they were short staffed. He seems to think that Jake has become agitated because his PIP allowance was recently stopped.
This may well be true. But Jake does not look well. He is pale and clammy and I dial for the ambulance. Some 10 minutes later I am escorting him off the premises when he suddenly lurches towards me. As he grabs hold of my hand, my heart jumps into my throat.
‘You’re a doctor. You tell them not to stop my money. They’ll listen to you!’
I nod my head. ‘OK!’
He smiles widely then, as he is helped into the ambulance.
I will try, I add to myself. Although I doubt that anyone will listen.
- Dr Aziz is a GP in Bristol