I'm grateful for a little thanks

‘Nothing is more honourable than a grateful heart,' said Seneca, who had quite a way with words when he wasn't too busy corrupting Vestal Virgins or sucking up to Nero or condemning yet another group of Christians to the torment of eating fat and oily food.

I received a ‘thank you’ card last week, something which is nowadays as rare as an urgent referral being seen urgently.
 
On the front the card featured a teddy bear with an aggrieved expression on its face, as if it had recently experienced a series of incomplete and rather disappointing bowel motions.

Inside the card was a rhyme which went along the lines of ‘Thanks for looking after me when I was very ill. I’m feeling much much better now, just wait till I get the bill’.
 
Ah, that zesty greeting card humour, what would we do without it?

Until recently, my usual response would have been to say ‘Hey, that’s nice’, check out the envelope for money, idly wonder if the patient was being manipulative and then bin the card, but the times they are a-changing, and we have to the roll with the punches and play the game, so anything that helps to fatten up and embroider my embarrassingly threadbare appraisal folder represents an opportunity to be exploited to the maximum.

At a start, we discussed the letter formally at a practice meeting, which buffed up the minutes nicely and made a pleasant change from points scoring and slagging each other off. We decided against, sending a ‘thank you for the thank you’ letter.
 
It might, we surmised, prompt the patient to send a ‘thank you for the thank you for the thank you’ letter, to which we would then be obliged to reply with a ‘thank you for the thank you for the thank you for the thank you’ letter and so on.

Before consigning it to the appraisal folder, I also made a few minor editorial adjustments (with the aid of some Tippex and just a little imagination).

These minimal changes did not alter the general tenor of the messages — that I was the best doctor in the world and was so concerned about my patients that pettifogging little trivialities such as attendance at postgraduate education represented only unwelcome distractions from pursuing my lofty ideals.

‘Thanks’ expanded to ‘a million thanks’, and ‘excellent care’ became ‘unprecedented and outstanding care’. ‘Gratitude’ was plausibly extrapolated to ‘Would you like to sleep with my daughter?’ Seneca would have approved.
 
- Dr Farrell is a GP from County Armagh. Email him at GPcolumnists@haymarket.com

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