Bystander

(Cont'd)

On one occasion, after the mother and the son left, an elective student sitting in my room raised his hand, "May I ask why's she attending the specialist clinic? Her problem is rather simple and could be taken care of by her own family doctor."

“Quite right… but our primary care system may not be very satisfactory…” I smiled and tried to be evasive.

“And, even if that’s the case, why is it necessary for you to see her in the clinic?” The student insisted on his question.

I sighed, “My goodness. I have no interest in this woman what-so-ever. All I wish to see regularly is her son – he has all the features of pituitary insufficiency but refuses to see any doctor. His mother is quite aware of the problem but cannot persuade her son either. All I could do is to see him every now and then and make sure he remains in a reasonable shape – otherwise I would have to find some addition excuse to give him treatment!”

PS. The story I outlined is not common. The more frequent happening is we encounter family members who are obviously psychotic or, even worse, having a personality disorder. There used to be a few incidents that I was about to say, “I shall treat the patient, but, may I refer you to the psychiatrist? Or, is it more appropriate for you to see the psychiatric-hospice – if this specialty really exists?”