Thursday, 13 December 2007

Off work, sick

For the first time in my life I've been off-work due to illness for a week.

I thought I'd go see the quack. It's been a long time since I've seen a doctor, so long in fact that the previous doctor has since retired and been replaced. This happened 2 years ago to my dentist - but I used to see him a very 6 months. I'm beginning to suspect a conspiracy.....

But meanwhile, back at the the doctor's surgery - I'm perhaps not fully compus mentus due to the virus and in-approprately large doses of the children's cough medicine (the instructions only went up to age 8 - so I'm about 5 times older than that, and a grown up, and they always leave a bit of safety margin so say 7 times the dosage?) so I'm expecting a bit of banter, maybe a bit patronizing, but we both know its just posturing at this stage to fulfill both our contractual obligations....something like....

dr: What can I for you today Mr M?
me: Why, heal me, physician!

I then proceed to provide a colourful tale of my man-flu. It is of course crystal clear to both parties that this is a virus and therefore medicines are far from appropriate (you do know that there are lots of anti-virals out there, just like antibiotics....but this could turn into a physiology back to the main text) And in addition to demonstrating the value of the states investment in terms of training and salary by verifying my symptoms are in fact due to the virus and not, say, due to being impaled with tyre iron, the good doctor will give me the usual 5 point oil and water change while I'm in there. Checking my blood pressure and such....

dr: well you're not dead yet
me: that's good but I just need a short-range forecast for my sicknote
dr: that is a short-range forecast; you're over-weight, and don't get enough exercise; the fact your blood pressure is so low despite this is indicative of even further health failings.

But how quickly I have forgotten what (most) doctors are like - I say most, because there is a very small number (1, OK, which is, technically, the smallest number) of doctors I have met who actually impressed me as being very clever, imaginitive and being funny. The rest seem to the product of a selection system valuing only the ability to memorize lots of information and look very sincere. The former talent will of course be of some benefit to anybody taking a tertiary course of education but has often been my own downfall. The second skill is altogether more different. A total failure to look for secondary or un-intended meaning in a statement seems to be route by which the candidates acheive their hippocratic serenity. Who knew that this humour bypass, this Asperger's syndrome with eye-contact should be a pre-requisite for entry?

I certainly did not. As a youngster, I considered bearing the staff of Asceplius a noble career, my chance to give something back to the world, not to mention that since my GP drove an E-Type Jag and lived in a big house, a bloody nice salary with a """free health-plan""" .

But for whatever reason, it was not to be. So I found myself on a parallel course of study on the good ship Cell Biology. Somewhat unexpectedly, this led to me actually teaching physiology to medical students! And this provided me a rare opportunity to observe the phenogenesis of the medical mind.

Medicine, and maybe Law, seem to unique in that they allow no dilution by other disciplines. And the way in which they operate (hah!) has not changed for hundreds of years. Oh, change - sure, they moan about it, but at the end of the day, NPFIT, the largest ever overhaul of Patient Records in the NHS boils to changing a green form for a pink one (and of course a £20bn feeding frenzy for an approved list of suppliers). Doctors decide what is wrong with people, nurses ensure doctors instructions are carried out. And with one Health Service, providing centralised super-hospitals for in-patients, call-centers for end-users, locums for out-of-hours work the identity of the doctor becomes irrelevant and thus the ability for the user to discriminate between good and bad is diminished.

Meanwhile, back at the surgery, it actually went more like this:

dr: Hello Mr M, You've not been well.
(this has caught me on the backstep. Not falling into the trap of asking why I was here. But instead opening a conversation with a statement. Was the trap spotted and pre-empted or is the savante merely failing to engage fully in the social interaction).

I pre-emptively scrub "man-flu" from my lexicon for the day.

The diagnosis goes pretty much as I expect. One mistake was saying I worked in IT when she asks what I do far a living. It's true, but this one is still young and keen and now has reason to give me the full, un-abridged, BMA approved story of why I'm not getting a prescription for penicillin in words of less than 3 syllables. Beam me up Scottie,
The reported findings are a bit different from my earlier expectations:

dr (ticks the box marked overweight, but makes no mention): your blood pressure is very good. Do you exercise?
me: no, I know I should, there doesn't seem enough hours in the day.
dr: mhm
dr: OK, thanks for coming in

I like the ancient Chinese system where you pay your doctor to keep you healthy not to treat you when you're ill.

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