A Visit from Our Lord; no miracles in the NHS….


BMJ 12 April 2007

“It’s Our Lord,” said my receptionist, “and before you ask, it’s definitely Him, He has ID.”

“Hang on,” He said as He entered the surgery, “I’d asked for a doctor that believes in Me.”

“Nothing personal, Lord,” I said, “but to rational people you’re slightly less believable than Santa Claus or homoeopathy, all that Samson and Goliath stuff.”

“Hey,” He said, “Samson was a decent hardworking man; runs a barber shop now—or was it then?” He scratched his head: “Omnipresence can be confusing, you know.”

“I’m feeling a bit depressed,” He continued, idly bringing my dead budgie back to life (I’d been meaning to get the cage cleaned out), “Two thousand years, and very little gratitude; when things go well they take it for granted—when they go badly I get the blame.”

“Boy, could I sing a few bars of that,” I said. “The real question is, just how depressed are you?”

“Oh, not too bad, I suppose,” He said gamely. “So I thought . . .you know…. maybe a few tablets . . . ”

“Alas,” I said, “the latest guidelines from the National Institute for Health and Clinical Excellence (NICE) on mild to moderate depression are unequivocal. No medications for you, Lord; instead take plenty of exercise, eat a balanced diet, and try and get out some more.”

“What else do they suggest?” He said, visibly unimpressed by my lifestyle advice, further evidence of His human side.

“There’s counselling,” I said.

“That sounds good,” He said, “I’d like counselling. Where do I go?”

“Hey, we can put the show on right here in the barn,” I said, hoping a Mickey Rooney reference might cheer him up. I patted him on the knee and said, “There, there.”

He seemed to find this unhelpful.

“Anything else?”

“Of course,” I said, “Do you think the fine people at NICE are idiots, that they have no idea what’s really going on out there, on the streets, with the kids? Cognitive therapy is a very effective treatment.”

“Great,” He said, “I’ll have some of that.”

“I have more bad news,” I sympathised. “Because your depression is only mild to moderate, you’re not an urgent case. I can’t refer you directly, you’ll have to see a psychiatrist first, and non-urgent psychiatric cases are usually not seen for about six months, and the waiting list for cognitive therapy is another six months after that.”

“About a year in total,” He calculated, biting his lip. “That’s a long time to be depressed. Any other treatment options?”

“Nada, Zippo, Zilch” I said helpfully. “Nada, Zippo,Zilch,” echoed the revivified budgie.

“So what NICE are saying, in effect,” He reasoned painfully, “is that there are no treatments for mild-to-moderate depression.”

“It is you that say it, Lord, not me. Have a NICE day,” I said, getting up and washing my hands.


Footnote; NICE (the National Institute of Clinical Excellence) might be living on a different planet from the rest of us, but at least they have a sense of humour. Their chairman was most complimentary about this column.



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