Liam Farrell: Keeping things confidential

'Three men may keep a secret,' said Benjamin Franklin (while turning over in his grave at the election of Donald Trump), 'if two of them are dead.' Discretion can be tough, but patient confidentiality has always been a cornerstone of medical practice, and like every other family doctor, I hold many secrets which I will carry to my grave.

But, as in so many things, perfect is the enemy of good, and when confidentiality is carried to extremes it becomes a paralysing force, making normal communication impossible. If the right hand doesn’t know what the left hand is doing, how can they clap? There has to be a crack in everything, that’s how the light gets in.

Joe was complaining of Symptom No 23, an ‘awful’ cough, a complaint which was as, usual, contradicted by his animal vigour and vitality, what the Trump administration would have called ‘alternative facts’, i.e lies.

‘I’m worried about my confidentiality,’ said Joe. ‘When I’m in the waiting room, everyone else in the room knows I’m there as well. Not very confidential, is it? They’re probably all talking about it.’

‘Joe,’ I said. ‘Your arrival in the waiting room is like the sun coming up every morning, we have learned to rely upon it. In a time of chaos, fear and anti-intellectualism, in the era of Boris, Trump and Le Pen, it is comforting that some things never change.

‘Indeed, your absence from the waiting room would be more likely to cause speculation around the village, in the bars, the coffee-shops and massage parlours, and among the peasants in the mountains; they’d probably think you weren’t well.’

But Joe, in his self-centred narcissistic way, which might in the future qualify him for high political office, did have a point.

‘How about this for a plan?’ I said. ‘Phone me just before your daily visit, I’ll leave the rear door unlocked, you can slip in that way and through the back office without anyone noticing, that way only you and I will ever know you’ve been here, and I shall clasp your secrets to my bosom, even your most sordid little peccadilloes.’

‘You and I are of like mind,’ said Joe.

‘Except,’ I said. ‘One of us is joking.’

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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