Prove Yourself

Apologies in advance if this comes across as whinging, but I must shed light on one particularly nasty habit that I am regularly confronted with. It is exhibited by the patient who feels that words alone are not enough to convey their plight, but that hard evidence must also be given in support.

On Tuesday this was Mrs D, who had a terrible, and almost certainly life threatening... cold. On describing her symptoms, each was presented with one of a selection of unpleasant, virus spreading displays - a chesty cough, a snotty sniff, a sorrowful swallow - I refrained from asking her about her bowels...

It's an odd performance, and one which I presume is given in a drive to increase credibility or gain sympathy (unfortunately it has rather the opposite effect!). It has crossed my mind however that it is potentially my own fault - have I somehow presented myself as a tyrant? A menacing keeper of medication to whom a patient must prove themselves in order to be helped?

I hope not, and in fairness, I suspect that it's actually done subconsciously. However, if this is ringing any bells with you my advice is this; your doctor is on your side and will believe what you say even if it is not accompanied by sound effects. In omitting them, there is the added advantage that you may spare him from catching whatever it is that you have, and you're certainly more likely to remain friends.

The Fear

It's been a cancer week this week. Not people who have it, but people who are terrified that they might. Three patients on three consecutive days, each agonizing that their headache might mean a brain tumour, their indigestion could be stomach cancer or their mole, a skin cancer. And then it was my turn. For half an hour on Sunday I had cancer, or at least I thought I might.

So I've been wondering, what is it that makes this particular disease so utterly terrifying?

It can't simply be the fear of dying, as there are plenty of illnesses with the potential to end this way that don't give us the shivers quite like cancer does. The knowledge that the illness process is sometimes painful and debilitating perhaps explains it partly, but then what about a stroke? For me, it's the few tragic stories of healthy people being told they have 8 weeks to live - that sense that it could happen to anyone at any time and that you might not know about it until it was too late.

One thing I strongly believe though, is that the horror with which we regard this disease is unhelpful. I'd never want to underestimate the suffering that cancer can cause, but the stigma that we've attached to it only adds to this. What a difference it would make if we could remove the cloud of dread that envelops it and learn to accept it for what it is.

First Question

One of the best perks of being a GP is having the opportunity to meet a huge assortment of different people. It's not so much the variety in race, religion and culture that I find interesting, but the contrasts that you encounter in the way in which we all think, behave and express ourselves.

So this is 'amateur anthropology with a medical slant' part one, and the question that I have been mulling over this week is this; why do we lie to doctors?

There's a particular incident on my mind. I met Jim (a fictional name of course) for the first time on Monday. We were talking about his newly diagnosed Diabetes when the question of smoking came up. Happily, Jim doesn't smoke, and we both cheerfully agreed that this was great news. He did however look slightly awkward when I met him outside a cafe later that morning, drawing deeply on a cigarette! I don't suppose it was his first.

I wonder if there is anyone who hasn't done this? Who hasn't used the words 'occasional alcohol' and 'social smoker' to explain away a 20-a-day habit washed down with a couple of bottles of wine and a packet of pork scratchings?

Is it through shame of a bad habit or a desire to make a good impression? Perhaps there are some who just don't want the information recorded and others who are simply trying to avoid the lecture (I'll admit my 'smoking is bad for you' lecture is particularly unexciting). Maybe it's based on an element of denial and invincibility; 'I'll give up that morning bottle of Vodka soon, so the doctor doesn't really need to know about that'.

I wonder....