A Fortunate Woman by Polly Morland

Author:Polly Morland [Morland, Polly]
Language: eng
Format: epub
Published: 2022-05-12T17:00:00+00:00

THE DOCTOR HAS a particular dislike for the epithet ‘the worried well’ to refer to patients whose symptoms or concerns don’t unfold neatly along pathological lines. To her ear, the term has a casually dismissive air that jars with everything she’s learned over the years about the complex layers of relationship that accrete over time. It also carries a nasty tang of ‘them and us’, those deserving of the doctor’s attention and those who, by implication, are wasting her time, as if her time and attention were not the very heart of her obligation to every one of them. In spite of rising use of the phrase by policymakers and some doctors, she’s not alone in this view. A recent article in the British Journal of General Practice did not mince its words in calling for the ‘worried well’ label to be dropped altogether, citing reassurance as one of the vital provisions offered by general practitioners to their patients, well, unwell or somewhere in between. This reassurance is not simply a process of going, ‘there, there, don’t worry, you’re not having a heart attack’. It is also underpinned by an understanding that you will be given time to say your piece and that someone will listen, the doctor bearing witness to whatever it is you’re going through. The point is that this combination of listening and reassurance is not just a nice-to-have. It banks a data point for future encounters, and more importantly functions as one of the core components of doctor–patient trust. It is kindness; it makes people feel better, and that matters.

Last week, a patient came to see her with his wife. He’d had ‘a funny turn’, the wife said, ‘on Saturday night, a sudden sharp chest pain that made him cry out’. The doctor had examined the man, arranged a chest X-ray and an ECG to be sure, but could find nothing to explain the episode. Perhaps just a musculoskeletal spasm, the doctor said, nothing to worry about. But the wife seemed reluctant to leave the consulting room. It had happened, she said, just as her husband was checking their lottery numbers on the TV, and she’d thought for a split second that they’d won. In that moment, the bungalow and the monotony of retirement had fallen away and she had seen it all: the palm trees, the infinity pool, the jacuzzi, the cocktail in a fancy glass and the vast bed with a tropical flower on the pillow. She’d felt the sultry heat and heard the lilt of foreign guitars. ‘We’ve both worked hard all our lives, and we’ve never been on a sun holiday, never been abroad, and I just . . . Well, I could see it all, that’s the thing.’ And back they had walked in silence to the car.

She couldn’t quite put her finger on why, but this was one of the saddest stories that the doctor had heard in a long time. The woman hadn’t intended to make her feel sad.

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