My first patient was a difficult case of a passport application signing, a solemn duty which demands many years of training and is a symbol of the respect with which we are held in society.
Sounds easy, doesn’t it, but this proved to be an even more complex case than usual, because the back of the photo proved too greasy to be countersigned.
It defied every ink, every ballpoint, leaving me gibbering with frustration until I at last used a cocktail of a battery acid and human sweat. Things got worse from there.
Joe had a moderately raised cholesterol, and I had called him in to discuss his options, because I firmly believe the doctor–patient relationship is an equal partnership and it is our role to enable our patients to make informed decisions; only kidding, it means that when shit happens we can point the finger of blame right back at them, and say, hey, it was your idea, you had to be the smart guy, Mr Know-it-all.
'What we are looking at here,'
I explained to him, 'is a whole new lifestyle approach. High cholesterol is only one risk factor, and we can't view it in isolation, so we have to pay attention to all the other risk factors as well.'
At this stage I went into automatic mode, etc; it's so boring I can't even bear writing the stuff out.
Diet blah blah blah, exercise blah blah blah, don't smoke blah blah blah but somewhere along the line the boredom coalesced and collapsed under its own gravity and I snapped, a bit like Peter Finch, the mad newsreader in Network, ranting: 'I'm mad as hell and I’m not going to take it any more.'
'Listen you fat slob,' I screamed, beginning to rave and drool, 'don’t take this personally; you and your jam doughnuts, having a sweet tooth is one thing, but taking them to bed with you is just sick, here's a bloody diet sheet.'
I flung it at him, making him duck.
'And here's a bloody voucher for an exercise programme at the leisure centre.'
He threw himself behind the desk: 'And here's a bloody scrip for nicotine chewing gum, I hope you gag on it.' I hit him this time, which made me briefly feel better.
He looked rather nonplussed and a bit frightened, but essentially unimpressed.
'Thanks, Doctor,' he said, 'but I'd really just rather take a pill.'
Dr Farrell is a GP from County Armagh. mail him at GPcolumnists@haymarket.com