Imagination is key in this job

'I've an awful cough and an awful sore throat,' he said, 'and I've been fighting it all week.'

I checked to see if I had a Military Cross handy and if the Queen of England or President of Ireland were available for the presentation ceremony.

'They said I should get some antibiotics.'

Who are 'they', anyway, I thought? Who are these faceless people who apparently are the repository of all the wisdom of the world? What would 'they' know about it? 'They' are amorphous, varying from time to time and person to person; a friend, an in-law, a brief encounter, someone they met on the bus.

Being in the presence of such a hero, and being sometimes a good doctor, I'd thought I'd better have a look.

'Say "Aaah",' I said, professional to the tiny tips of my toes.

Everyone says 'Aaah' in their own way. All we want is something simple, a gentle susurration of the softest breath, barely audible, just enough to lower the posterior tongue and reveal the tonsils, the pharynx and whatever else is in there.

Saying 'Aaah' is part of the ritual of medicine; often it's totally unnecessary, but it makes people feel that we really care.

'AAAAHHH!' it was like a foghorn, a deafening Shakespearean bellow; the blast drove me backwards, the volume counterpointed by a blast of stale air containing CO2 and decaying products of cellular degeneration, probably specific to bacteroides.

'Earth has not anything to show more fair,' said William Wordsworth, 'Than a pair of big swollen pussy tonsils.'

It's always such a relief, a sight which means we can fire ahead and prescribe antibiotics with a clear conscience and avoid another draining fight.

Her throat, predictably, was absolutely completely positively normal; there was not a speck of pus, not a fleck of erythema. Even the combined imaginations of Kurt Vonnegut, Isaac Asimov and Arthur C Clarke would have shrivelled in the face of such unflinching normality.

But GPs can stare such brutal things right in the face and still say, as I did: 'You need antibiotics.'

- Dr Farrell is a GP from County Armagh.

Email him at

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