Liam Farrell: GPs have turned breaking bad news into an art

Breaking bad news and then getting the blame for it is all part of the tapestry of general practice, though over the years I've become quite good at it; as Francois de La Rochefoucauld said: 'We all have strength enough to bear the troubles of others.'

But I'm not without a sense of compassion. I often try to soften the blow with the gift of music: Your auntie Rose is dead sung to the tune of Happy Birthday, or the gift of humour: 'You have two months to live, gosh, but that was from last month, and this is February'. Or the gift of charades, which is tricky, as medical terms don't lend themselves to mime - once I had to abandon a consultation prematurely, as the patient was in pain and was nowhere near getting: 'Your pilonidal sinus is as big as a horse'.

But Joe was a tough call; in his hands a guitar was an instrument of torture. We'd tried many schemes. We'd file his strings so that they'd snap. We'd employ women to chat him up, but Joe was no beauty, Ireland is a small country, and we soon ran out of women.

We tried fake phone messages that his granny was dead, which strangely worked the first three times. We suggested he try another instrument, which only led to the Great Accordion Disaster of 1998.

The band was being compromised, music and beauty were the real losers, and because of my medical training I was selected to break the bad news. Sticking my finger down my throat in the graceful Irish gesture of farewell, I left to do the terrible deed.

'Me and the boys were thinking,' I started, 'that maybe you should ...' I could see the mute appeal in Joe's eyes. Had his senses, so musically useless, subliminally warned him that the knives were out?

It felt like kicking a spaniel, of which I have had some experience. His dog-like face, the hairs growing out of his ears, the greying of his stubble; perhaps it was fear that made him play so loudly, just as primitive tribes bang drums to frighten away the demons of the night: deep down Joe was afraid that he was no good.

'Joe,' I tried again, 'maybe you should ...' and then I heard myself damn us all to a dread musical Gotterdammerung, 'bring in the accordion next week.'

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