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A plague of opinion

Saul Miller is a GP in Northumberland.

The door is barely opened. ‘I’ve a bone to pick with you’, wheezes Mick through the widening gap.

As opening gambits go, at least it’s clear there is more to come.

He takes his time lumbering across to the chair. It shudders as he releases himself back into it. I am forced to wait expectantly: he commands the silence.

‘I’ve had my annual check’, he finally announces.

‘Yes, Mick’, I respond, unclear where this will be headed. ‘It does not paint a pretty picture.’

He pulls a face. ‘A plague of opinion! A man may wear it both sides’, he quotes irascibly.

‘Shakespeare!’ I note, adjusting my comb-over.

‘Besides,’ he adds, watching me do this, perhaps pointedly, ‘whoever told you painting pretty pictures is the goal?’

I look up, acknowledging the challenge. ‘So, what is the goal?’ I ask.

‘Exactly!’ He exclaims. ‘I’ve had someone ringing me up about my cholesterol, another on about my blood pressure, someone else messaging me about my risk of diabetes, and then yesterday someone else again sending texts about fatty liver.’

I sigh. ‘It’s all true though?’

‘Yes, but none of them seem to know or care about what the others are up to.’ His long bushy eyebrows are raised high. ‘It’s as if they’re all in parallel universes.’

‘They’re all doing good work, Mick.’ I protest gently. ‘You know that, don’t you?’

This exasperates him further though. ‘You’re still missing the point!’ He splutters, spittle landing in neat small globules on the corner of my polished mahogany desk. We both try to pretend we didn’t notice as he tries again.

‘Let’s go on a different tack’, he suggests. ‘How about your messaging systems?’

My head goes back in surprise. ‘How about them?’ I ask.

‘Well, once upon a time if I needed you, I walked into reception and asked for an appointment. And if you needed me, you’d write. But you rarely ever needed me.’ He paused, reflecting, then added, ‘And you always begrudged the price of the stamp.’

I nodded, accepting all this.

He continued. ‘But now, it’s like the reins are off and the messaging is galloping away!’ Is his hand on my desk for emphasis or to wipe that spittle, I wonder? He carries on, ‘You phone my mobile, you email, you text, you send alerts to my apps. You even texted me a happy birthday for God’s sake!’

‘We’re just trying to be friendly and helpful’, I say, wrinkling my face defensively.

‘Yes, but it’s all so quickfire and transactional now’, he complains. ‘Whatever happened to letting time pass? To saving things up? To knowing me from Adam? Some of us really appreciated all that!’

Mick calms down for a moment. His hand comes off my desk, leaving a faint smear behind.

‘We mind that your desk came from pristine rainforest felled by slaves,’ he says sadly, wiping ineffectually at that smear, ‘but we’d forgive you that.’

Surprised and suddenly embarrassed, I feel heat in my cheeks. ‘I hoped people would think at least something positive had come out of that human and ecological tragedy,’ I fluster, ‘but I still don’t know what you want!’

He sighs this time. He lumbers to his feet. ‘No one now pulls it all together. Once a year at least. There’s a hole in holism!’

He’s wheezing again as he gets to the door, I notice, limping from his bad hip.

‘You’re too fat!’ I tell him.

His head turns back sharply, but finally he’s smiling. ‘That’s what’s been missing’, he says gladly.

‘You’ll still not lose any’, I protest.

He’s heading out again. ‘You know I’ve never even tried! Forgive me that though and we’re even!’

Deputy Editor’s note: This is a fictional encounter.

Featured painting: Angelica Kauffmann, Diomed and Cressida (from William Shakespeare’s ‘Troilus and Cressida’, Act V, scene ii), 1789. Public domain.

The British Journal of General Practice and BJGP Open are bringing research to clinical practice. BJGP Life is where we add the debate and opinion to help ensure everyone benefits from that research.

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