10 November 2021

In the consulting room, the doctor isn’t always the one giving the reassurance

I realised that Cherry, who had recently lost both her husband and her vision, wanted me to know that she was doing OK.

Cherry was on my list for a triage call. She’d seen a colleague a few months before with a harmless skin cyst on her chest wall. Other than that she hadn’t been in contact since June 2020, when I’d referred her urgently because of a dramatic deterioration in her vision.

The phone rang a few times before being answered with a tentative “Hello?”

“Is that Cherry?”

“Oh, hello, doctor! How are you?”

I get this often when ringing patients – enquiries as to my well-being, as though I’m an old friend phoning for a chat. At the age of 80, Cherry is from an unfailingly polite generation. I assured her I was in fine fettle, and asked how I could help. Cherry said she had been experiencing pains in the region of that chest lump for three weeks now. The pattern didn’t suggest anything urgent so we made an appointment a few days hence to give her a chance to book Dial a-Ride.

When arranging face-to-face consultations these days there’s an unmistakable sense of having a Daily Mail columnist perched on my shoulder, scrutinising my working practices with a jaundiced eye. It’s the same when patients attend. The sparsely occupied waiting room no longer signals socially distanced safety; it seems instead like incontrovertible proof of the media canard that GPs aren’t doing very much. For every patient I see in person, I manage another three or four cases on the phone, but there’s nothing to show for all that behind-the-scenes activity – unlike pre-pandemic, when our waiting room used to heave with closely packed patients, many coughing and sneezing their viruses into the under-ventilated air.

Cherry arrived for her appointment. The extendable white stick was not something I’d seen her with before. “The funny thing is,” she told me, once we’d reached my room, “those pains went away straight after you called.” I said I was pleased but that I ought to check the lump in any case. It was indeed only a harmless cyst.

The whole consultation had taken barely two minutes. My immediate thought was that the time saved would really help; I still had a huge amount to get through. But Cherry was in no rush. “They couldn’t save my sight, you know,” she said. I’d read about it in the ophthalmologist’s letters; I asked how she was getting on. She told me about the various hobbies she’d had to give up – reading books and knitting for charity chief among them. “There was a long time of grieving,” she said. And for a few seconds she fell silent.

“But,” she was animated again, “I’ve discovered audiobooks. And I’ve even got an iPad – look! It can read things to me.” She took evident delight in giving me a demonstration of her screen reader, an American female voice declaiming the opening words of an email.

Cherry’s husband, a gentle man called Lars, died three years ago after a distressing decline from Alzheimer’s. They’ve got several granddaughters in their early twenties; I’ve seen two of them through health problems in recent years. And I was the one who referred her between the first and second Covid waves with her sudden loss of sight. We hadn’t spoken since. She tucked her iPad away and got to her feet, ready to leave. Opening the door for her, she found my forearm with her hand and gave it the lightest of squeezes.

I train my registrars to pay attention to how consultations make them feel – it usually tells you how the patient themselves is feeling. Cherry had provoked both sadness and optimism in me, and left behind her a fleeting moment of peace. She would have been grieving Lars when she’d been dealt that other huge blow, the loss of her vision, and all that will have been compounded by fears over her grandchildren’s health. I don’t suppose we’ll ever know the nature of the chest pains. Having got here, though, she had a story to finish, and it dawned on me that she’d been waiting a long time to do so. Perhaps all the media coverage of in-person appointments had nudged her. She’d wanted to tell me that, after all she’d been through, she was finally doing OK, and understood I would have wanted to know.