Introducing the queen of drug reactions

She was a new patient, which is in itself usually reason to be suspicious.

The kind of patient I like is one who never comes, who doesn't know who their doctor is or even where the health centre is: these patients are low maintenance. In contrast, a patient who goes to the trouble of actually changing GPs by definition already knows all these things and is already active.

However, I had a bit of time on my hands (I'd just struck off one hundred patients because I didn't like them), so I leafed through her chart, and a long-dormant clinical interest began to stir.

'I see you have quite a lot of allergies,' I said.

'Hundreds of them,' she replied proudly.

'Penicillin,' I said.

'Ah yes,' she said fondly, 'that was my very first time, gosh, it seems so long ago now, I was just a slip of a girl, I used to be quite the dancer, you know.'

An air of nostalgia filled the room and if James Herriot had been there he'd have made another series out of it, him and Siegfried trundling up and down the Dales chasing after bucolic cows.

I had a different vision; some long-departed GP, whey-faced with frustration and fatigue, trying to pin a diagnosis on a rash and seizing on a recent prescription of penicillin to make a definitive diagnosis. One of the unwritten rules of medicine had been observed; the more uncertainty there is about a diagnosis, the more certainty with which it needs to be delivered.

I thought briefly about looking for funding for a research project on how many recorded penicillin allergies are spurious and presenting the revolutionary findings to a packed auditorium of distinguished professors and academics, receiving awards from all over the world; then I realised that I didn't really give a shit.

'Erythromycin,' I continued.

'Made me fat.'

'Indeed,' I said, observing that her dancing days were long past. 'And HRT?'

'Made me depressed,' she said happily.

The consultation continued in this vein, every drug having it's matching revolting side-effect.

'So you're just about allergic to everything,' I concluded.

'Except diazepam and sleeping tablets,' she said. 'Can I have a prescription?'

Dr Farrell is a GP from County Armagh. Email him at .

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