The first half of my morning surgery was stressy. I was feeling unloved and put-upon by our dear Government and the computer system was running extraordinarily slowly, sometimes taking more than five seconds to respond to a key-press. This made it even more difficult to review patients with complex problems, and once again I began to run late. Then I used a four letter word in the presence of a patient, for the first time in my career. I wasn't swearing at him, but he mischievously asked me what I though of the Secretary of State for Health. Normally I am circumspect in my comments, but this particular patient is the brother of a local GP and we get on very well. He was amused rather than shocked, and at the end of the consultation he put his hand on my shoulder in good-natured complicity. A little later I needed to carry out an intimate examination on a female patient but all the nurses were busy and there was a long wait before one was free to chaperone me. My patient made it clear that she sympathised with my problem and appreciated the care I was taking in looking after her. I was touched by the kindness shown by these two patients. Things improved rapidly thereafter and I regained my usual friendly matter-of-fact manner. A quick calculation at the end of surgery showed that I had averaged just over 14 minutes per patient, which is not much slower than my usual rate.
I like listening to patients, and in particular their accents. I find it remarkable that voices can be so distinctive. We are fortunate in having patients from all over the world visiting us in Urbs Beata. This evening I saw and heard a rather pretty young lady from Norway and two charming American gentlemen, coincidentally from the same city. This gave me the opportunity to compare their accents and identify what they had in common. As we walked down the corridor to my room the second American asked “am I your last appointment of the day?” This rang a bell. In an earlier post I described the shock of finding myself in a poem written by a patient's daughter. That daughter has lived in the States for many years, and one of the lines of the poem (describing her father's visit to me) was “he was his last appointment of the day”. So I told the story to my patient, and he asked if it was not a British thing to say. There is absolutely nothing wrong with the grammar or vocabulary to a British ear, but we just wouldn't say it! I suppose the British equivalent would be “am I your last patient?” which sounds a bit more personal. We had an interesting chat about health systems, and guess what? He finds the system in the UK superior to both the USA and France where he has also lived. We may be doing something right, but our politicians have evidently not heard this good news.