Yesterday, Mrs Unhappy wanted a visit because her husband had gone out, and there’s no way she can come to the surgery alone because her legs won’t work. Knowing her well, I realised that there is no arguing with this and set off to hear the latest instalment of the soap opera of her life.
It takes a while to reach her house and when I get there I almost die of passive smoking.
Nevertheless, risk is a part of the job, so I fight my way through the Woodbine smog to find her smoking at the table complaining that her quarter of a citalopram hasn’t solved the multitudinous problems of her life, her husband, the other woman and the spiralling cost of tobacco.
Mrs Unhappy, like many patients, wants to be happy. She isn’t prepared to take anything or do anything to achieve that, and would like me to sort it out for her by non-pharmaceutical means. She’d also like a sick note, since I’m here, because she obviously can’t be expected to leave the house, and a letter for housing because this place is filthy and he won’t hoover.
It’s very difficult to turn the expectations of the Mrs Unhappys of this world around. Her view is that life has dealt her a raw deal, and that others should be expected to change this. She does not see where her contribution lies in all this, because she is a victim and victims cannot be accountable.
I leave after a difficult half hour, made more difficult by my attempts to draw breath no more than once a minute, and try to find a read code for ‘endless cycle of misery and fag ash’, which would sum things up, but there isn’t one, and I settle instead for ‘had a chat to patient’. No quality points there — but one for the global sum?
Dr Selby is a GP in Suffolk. You can write to her at GPcolumnists@haymarket.com