Second opinion

I SEEM to have an adverse effect on my patients. Far from making them feel bet- ter, I make them feel worse. For exam- ple, only the other morning I saw one of my patients walking down the street arm- in-arm with a friend, enjoying a jolly good joke.

Alas, this happy situation was not brought about by any treatment of mine, quite the reverse. She has only to appear in my consulting room to be at once crip- pled by pain and crushed by depression so deep that she is almost speechless with misery.

It is true that my view of our earthly existence is not altogether a sunny one, but surely I do not communicate my darker thoughts so unequivocally by my very manner of being that people who encounter me are at once thrust into the abyss of despair, not to mention neural- gia and a host of other symptoms?

Could there be, perhaps, another explanation of the contrast between my patient's happiness on the street and her misery in my consulting room? Reader, there could. My patient used to be a nurse who worked on a geriatric ward, but one day slipped on the hospital corri- dor which was being mopped by a clean- er without any notice to the effect that wet stone floors are slippery.

One man's negligence is another man's opportunity, of course. The prospect of early retirement on full pay with a nice lump sum into the bargain danced before my patient's eye even before she hit the ground. No more medicine time, no more tea for fractious geriatrics to drink up for their own good; henceforth her time would be her own.

Only one problem remained: to con- vince enough doctors that her injury was severe and permanent. In this context, permanent means when doctors have grown sick of trying to cure their patient. They'll say and sign anything then, just to get rid of him or her.

On the day on which I saw my patient tripping merrily down the street, my first in-patient was a young man who had taken a few too many aspirins. He was chatting happily to another patient, but as soon as he saw me his face clouded over: the mere sight of me had pitched him into the Slough of Despond. His mood became ever blacker as he approached my room.

He was wearing a T-shirt with the fol- lowing legend:

No scares No worries No regrets No fear NO SHIT!

A cannabis leaf was tattooed on the back of one hand, a swastika on the other. On one forearm was tattooed the letters ACAB, on the other NWA: All Coppers Are Bastards and Niggers With Attitude. On his neck the word 'Jade' was tattooed.

`Why Jade?' I asked.

`She's one of my daughters.'

`How many do you have?'

`Three.'

`One mother?'

`Three. I don't get on with none of them.'

He was now 22.

`Why did you take too many pills?' I asked.

`I ain't got nowhere to live.'

`We could find you a hostel.'

`I don't want to go to no hostel.'

`We won't be able to find you any- where else.'

`Well, I'll have to go on taking over- doses then, won't I?'

He left my room with a face of thun- der. A few minutes later I saw him laugh- ing and joking with another patient.

Theodore Dalrymple