Liam Farrell - The glass will always be half empty for some

Joe is always pessimistic; asked if his glass was half-full or half-empty, he'd say, 'Don't care, it probably tastes like shite anyway.'

Joe's pessimism is such that he has become a skilled exponent of the nocebo reaction, which refers to harmful, unpleasant or undesirable effects a subject manifests after receiving an inert dummy drug.

Nocebo responses are due only to the subject's pessimistic belief and expectation that the inert drug will produce negative consequences. The term nocebo (Latin for 'I will harm') was chosen by Walter Kennedy in 1961, to denote the counterpart of the term placebo (Latin for 'I will please'). He was on his way home from Woodstock at the time, I think, my memory of those years is rather hazy, just that it was a great time to be young, I lost my kaftan (that's a metaphor, you understand) and the music was unforgettable.

If I prescribed Joe even a packet of Smarties (more inert and inoffensive you cannot get) he would immediately come down with nausea, abdominal pain and vertigo, all deeply unpleasant yet, and this is important, objectively unverifiable.

'They're tearing my guts out,' he would declaim, slamming the packet down on the desk, 'And the green ones are the worst.'

But I came to regard him as a challenge; bringing a ray of sunshine into a dark and dreary life is just another small strand in the great tapestry of general practice. That we don't get any points for it shows how little the bureaucrats understand our ancient profession.

So I'd been doing some serious research, watching a lot of stand-up comedy, old Benny Hill episodes and so on, looking out for a telling new joke, and I reckoned I'd come up with a killer.

'A polar bear goes into a bar,' I said, 'and says to the barman, "Can I have a ... beer please?" And the barman says: "Why the big pause?"'

I thought there was a flicker of reaction. 'Do I see the beginning of a smile?' I said hopefully.

'Naw,' said Joe, implacable as ever. 'I was just working up a spit.'

'Exhaustia est patientia mea (my patience is exhausted),' I said. 'Nunc tincidunt ante faciem meam outta laedere (now get outta my face before I hurt you).'

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