Patients are just like vultures

When Prometheus scaled Olympus in the dark hours of the night and stole the secret fire (they loved their barbecues, those Greeks), the Gods were not pleased. They punished his transgression by chaining him to a rock at the top of a mountain, and every day a vulture would come and peck out his liver.

This doesn’t sound so bad (I’m nearly finished with mine) but even allowing for my large, much-abused and almost worn-out liver, I do have some empathy with how Prometheus might have been feeling. It was a war of attrition, gradually wearing him down, and over the years some of my patients have become quite experts at these tactics.

‘I’ve an awful pain in my stomach,’ she said. Peck, peck, peck...

‘I see,’ I said, ‘And is this the same awful pain that you had last week, or the one you had the week before?’

‘No,’ she said, ‘It’s a different one. And it’s awful.’ Peck, peck, peck...

‘And when you were with the consultant three days ago at that hastily arranged appointment, did you mention it to him?’

‘No,’ she said. Peck, peck, peck...

‘And why not?’ I asked.

‘What would he know?’ she said dismissively.

‘That,’ I admitted, ‘is a strong argument, but when you were seeing him for last week’s awful pain, it might have been considered reasonable to mention this week’s awful pain as well, what with him being a gastroenterologist and all.’

She shrugged, and then we had a long spell of non-verbal communication.

‘The pain’s awful, I can’t get to sleep with it,’ she said eventually, obviously unhappy at having to state things so baldly and without any of the usual and by now traditional finesse.

‘We have discussed this matter before,’ I said, ‘and we came to the conclusion, did we not, that your inability to sleep might have something to do with the fact that you don’t get up until 1pm, and then you sit on the sofa watching TV all day, your only exercise being the occasional (and begrudged) visit to the microwave or the bathroom. Why don’t we discuss some points of sleep hygiene; I have some very good leaflets.’

But she was too experienced to let me control the agenda; she didn’t even bat an eyelid at the word ‘leaflet’, which all patients despise utterly.

‘I’ve an awful headache as well,’ she said skilfully changing the point of attack. Peck, peck, peck... and my defences crumbled.

‘Why don’t we try some sleeping tablets?’ I suggested.

- Dr Farrell is a GP from County Armagh.
Email him at GPcolumnists@haymarket.com

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