Liam Farrell: That's as may be, but I still want an antibiotic

Overzealous? Not me. So I knew just what to do when Mrs X told me: 'I've an awful sore throat and I need an antibiotic.'

I'd actually rather cut off my own hand than refuse Mrs X her weekly prescription for antibiotics - it'd save trouble in the long run and probably be less painful. But this time, maybe it'll be different, I thought, maybe we'll work everything out by reason, diplomacy, dialogue and mutual co-operation.

According to the Academy of Medical Royal Colleges (AoMRC), there is growing evidence that pressure for doctors to do something at each consultation has led to patients sometimes receiving treatments that are of little or no value.

Which is hardly news; in ancient Mesopotamia, when he wasn't massacring the neighbours, King Hammurabi was establishing the Code of Hammurabi, one of the earliest surviving codes of law.

Included in this was a law threatening overzealous surgeons with the loss of a hand or an eye. Nowadays, we could just take away their big shiny cars.

'Before I prescribe antibiotics, which of course I shall do with a heart and a half,' I said to Mrs X, 'the good people at AoMRC have advised that you ask me three questions.'

I handed her the list, which she squinted at suspiciously.

'Do I really need this test, procedure, or treatment?' she read.

'No,' I said, 'any more antibiotics and one day a big green monster will jump out of your chest and run screaming down the road.'

Her glare was in the terawatt range, just for me. It made me feel special. 'Are there simpler options?' she continued.

'There certainly are,' I said. 'Heretical though it sounds, medical science would advise rest and plenty of fluids.' This was followed by a long silence, a threatening kind of silence, with shades of a mob, a rope and a hanging.

Finally, she asked: 'What happens if I do nothing?'

'You'll get better on your own,' I said. 'Your immune system, which has evolved over millions of years, will respond to this undoubtedly crippling viral infection with gusto and enthusiasm.'

'That's as may be. I still want an antibiotic,' she said, implacably.

And as the ghost of Hammurabi came whispering to my mind, I thought, well, I don't really need my left hand.

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

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