Liam Farrell: Being a fanatic can be detrimental to your health

Nothing annoys a patient more than having nothing wrong with them, and being told that.

When our forebears watched the lightning and listened to the thunder, without a clue what was causing them, they achieved some satisfaction by having a name put to it: Thor, Zeus, whatever, (a big Aryan guy with a white beard is traditional), the label was a big help.

Mrs Magee, for example, loves having her urine tested, and lives for the day that something will show up. I dipstick it, flourish the little plastic strip on high, and then say with all the positivity I can muster: 'Look, it's negative, isn't that fantastic, it means you absolutely definitely don't have a kidney infection.'

But Mrs Magee has been played this game many times before and knows my agenda.

'I suppose you aren't going to give me an antibiotic then, are you?' she says.

Joe has been attending for years with a bewildering variety of non-specific and minor complaints.

Over the years he has undergone every test under the sun, and all of them have been normal, with one notable exception - many years ago his TSH was slightly elevated.

The experienced GP would have kept mum and repeated it in time, but unfortunately we had a young locum on duty, full of new-fangled ideas about telling patients the truth and giving them all the information so that doctor and patient could make a shared decision about their future management blah blah blah blahdey blah. I have paid a heavy price for such reckless honesty.

If the Lord himself (Aryan, beard, usual drill) had appeared and handed Joe a winning lottery ticket, Joe could not have been more overjoyed; at one stroke his years of annoying me supremely validated.

When I returned he gave me a patronising I-told-you-I was-sick look, and over the decades since, despite his TSH being resolutely normal, he still comes in, feeling his neck rather theatrically, and says: 'I'm not feeling too good, must be the ol' thyroid acting up again.' No matter how often I wave the normal results in Joe's face, his belief in his thyroid disease remains as steadfast as any religious fanatic.

As Friedrich Nietzsche said, conviction is a more dangerous enemy of truth than lies.

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