A young man saw me today and chewed gum throughout the consultation. He seemed very relaxed and sprawled in his chair. As I turned to do something on the computer he picked up his bottle of water and took a large swig.
This sort of behaviour irritates me. I am not young enough to consider chewing in public socially acceptable. And why do people feel the need to carry water around with them at all times? It is true that I keep a bottle of water in my desk myself, but that is because I frequently consult for hours without a break or a cup of tea (which takes too long to drink). But I don't swig from it during consultations.
The anthropologist in me considers that this behaviour may be a sign of nervousness, or it may be staking a territorial claim on my consulting room. This particular young man is one of many patients I see with chronic complex psychiatric symptoms that appear to arise when a personality damaged by upbringing is stressed by modern urban life. So I adjusted his antidepressant, which seemed a good holistic thing to do (spot the heavy irony here) and will see him again (no doubt).
My “dancing partner” of last week came to see me again today. You may recall that she is a young lady who had been wounded by losing a tube due to an ectopic pregnancy. Today she wore a loose fitting slashed top that did not come together completely at the back, and tight fitting jeans with several slashes. Almost the first thing she said was that her stitches were itching, walked over to where I was sitting, stood in front of me, pulled down the top of her jeans and peeled off the bandage over the scar in her pubic area. Later, when I examined her abdomen formally on the couch she told me that she wanted to get back to the gym to tighten up her thighs. It was clear that she was feeling much better in herself. Near the end of the consultation she asked me when she could resume sex because she was “highly sexually frustrated”, and as she left she said “see you, chuck!”
This was indeed an interesting dance. Despite the way I have described her behaviour, I did not detect any overt flirtation. It could be that she was being provocative for the sake of it, and I will take care in any future consultations with her. However I prefer to think that she was experimenting with expressing these ideas in the presence of a man who she knew would not respond. I have another young female patient who has been severely damaged by sexual abuse and it is clear that she has gained benefit from a series of consultations with a “safe” man. In her first consultations she was “dressed to kill” and I have measured her progress by the gradual toning down (and buttoning up) of her wardrobe.
When I was a young GP I thought that a few of my patients were quite “fit” but nowadays none of them appeal to me (not even the one who is in “mucky films”). Over time I have come to see the skull beneath the skin, and I have learned that even the sexiest dolly-bird has concerns and worries which, Lord help me!, I find more compelling than her flesh.
He knew the anguish of the marrowAt any rate, that's what I shall tell the GMC if I am ever hauled before them for conduct unbecoming. :-)
The ague of the skeleton;
No contact possible to flesh
Allayed the fever of the bone.