It’s good not to talk

“Mr X doesn’t talk to patients,” she said.

Joe had been having some problems, but was unable to contact his consultant. So I’d rung Mr X’s secretary.

“Pardon?” I said, wondering if I had heard properly. Or was this the ultimate expression of keyhole surgery; doctor and patient shouting through the keyhole at each other?

“Mr X doesn’t talk to patients,” she repeated, like Browning’s wise thrush, which “sings each song twice over, / Lest you think he never could recapture / The first fine careless rapture!”

“Really?” I said, increasingly fascinated by the concept; it seemed a quantum leap in the field of doctor-patient communication. Or maybe it was an alternative universe, caused by that Hadron Collider and those Higgs boson thingies, where in Casablanca Victor Laszlo comes back out of the mist and says to Bogie, “Sod your letters of transit, I’m not flying Ryanair.”

And then, logically, there must be a reciprocal anti-universe, where not only do consultants talk to their patients, but neurologists luxuriate in an earthly paradise of headache referrals, orthopods dream of golden fields of patients with low back pain, gastroenterologists would dance till dawn with irritable bowel syndrome, the heart of a rheumatologist goes all a-flutter at the very thought of fibromyalgia, and gynaecologists shudder with a visceral delight at the prospect of yet another prolapsed vaginal wall.

“Mr X doesn’t talk to patients.”

That closed the deal; as the Bellman said, “What I tell you three times is true.”

I like to keep an open mind, so I could see Mr X’s point. When you don’t talk, you can’t say the wrong thing. And patients are selfish; all they want to do is talk about themselves. Hey buddy, you feel like saying, it’s a big world out there, it doesn’t all have to revolve around you. The history is over-rated; context is just as important. Called to the ’hood, with pimps and crack hoes jumping on the bonnet, the experienced clinician will have a fair idea that it’s not going to be a croquet injury. And at the end of the day, they need a scan anyway.

I admit I was being mischievous. I could have asked for more details; the sanction is probably limited to phone calls, and I’m sure Mr X does sometimes talk to patients, under controlled conditions.

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