Two contrasting patients in this morning's surgery. First a charming elderly teacher, to whom I expressed regret that his symptoms hadn't improved. "Never mind Doc" he said, "you can't cure everything". Then he thought for a moment and, with a twinkle in his eye, added "I bet you thought you could cure everything when you were young!" He was of course alluding to Oscar Wilde's remark that "I am not young enough to know everything". I really like and admire this chap, not least because he is still working enthusiastically as a supply teacher as he enters his eighth decade - and all without the benefit of Prozac.
Less admired was a woman about half his age, who brought a number of requests to her emergency appointment. She told me blithely that she never wanted to see my partner Elizabeth again as she is patronising and incompetent. One of her requests was for more nicotine replacement patches, initially prescribed by the incompetent Elizabeth a few weeks ago. I asked how she was getting on at the smoking advisory clinic, which we ask our patients to attend as a quid pro quo for being prescribed patches, and learned that she was not attending. I suggested gently that perhaps she had thought it beneath her dignity. She stared at me sharply before the conversation moved on.
Usually I spend most of my time trying to look friendly, helpful and approachable, especially with children and patients that have a history of violence. But I am beginning to see that there could be benefits in studied neutrality or even a stiff formality at times.