If symptoms

persist. . .

I ONCE read a book by a philosopher in which it was maintained that there was no drug yet in existence so powerful in its addictive properties that it could be said truly to remove the ability of a man to act in accordance with his own will. Thus, addiction was essentially a moral problem after all, despite the attempts by social workers, psychiatrists and other verminous do-gooders to persuade us otherwise.

There is, however, one thing known to me which is so utterly addictive that it confounds all human attempts to coun- teract its effects. I refer, of course, to the payment of Sickness Benefit, the very life-blood (to change the metaphor slightly) of hypochondriasis. How many invalids has it created, how many new and incurable illnesses has it spawned! The arrival of smallpox in the New World was scarcely more devastating in its effect on the health of the population. The English have as little resistance to the Sickness Benefit sickness as the Indi- ans to smallpox, and the only effective vaccine against it so far discovered is self-employment.

Last week, one of my chronics announced as he came through the door that he was 'covered in arthritis'. That was why he had to spend so much on paramacetamols. It was a scandal that sufferers such as he should have to pay, when he could name 20 scroungers in his road alone who received more benefits than he, and they weren't even ill.

`Do you know S — Street?' he contin- ued rhetorically. 'Well, it's right next to the hospital, and there's no buses what go down there anyhow. But I know a woman what lives down there called Milly what claims bus fare off the Social every time she goes down the hospital.' Ah, what wonderful informers and petty spies for a dictatorship the English would make! They'd deliver up their neighbours to the torture chambers of the secret police just for the pleasure of it, let alone for payment.

One of my patient's symptoms of chronic infirmity was his insatiable need for sex.

'I even have to go down the Golden Eagle and wait for hours till Maggie comes out. She's a bit simple and she'll do it for almost nothing, a couple of fags, like. Mind you, I once nearly got into trouble. There was a notice in the pub which said if you needed sex you could call Gladys, so I did. I was young then and desperate for sex — like I am now. Gladys told me to meet her somewhere and I went, but when I arrived Gladys was working for the CID and they took me down the station. They let me off with a warning, though.'

Suddenly he grew anxious.

`You don't think I'm a finger-ache kind of person, do you, doctor?'

`What's that?'

`Someone who won't work just because he's got an ache in his finger.' `Oh, no,' I said.

`Because I don't consider myself a fraud. I just can't control my nerves, that's all. I wanted to be like my father and go to work every day. I doted myself on him.'

`Yes,' I said. `I'm sure.'

A frown passed over his face like a cloud over the sun.

`But if the Social ask me to have a medical to see if I can work, I'm not hav- ing one. take a hammer and some petrol with me.'

I smiled as I thought of him hammer- ing his petrol alight.

`I'm serious, doctor, I'd really do it.' He got up to leave. 'Can I have a sick note, please?'

`Of course.'

But what to put in the space for Rea- son for absence from work?

Satyriasis?

Theodore Dalrymple