The Jellybean Dilemma

jelly beansAt the age of five I decided that I wanted to be a doctor when I grew up.  Having the ability to heal the sick appealed, but what clinched my decision was the jellybean jar. Our family GP had a huge bottle of brightly coloured jellybeans sitting on his desk, and I remember thinking that a job which allowed unfettered access to such delicious sugary treats was just about the best job one could ever have.  Official taster at a chocolate factory was my fallback career choice.

Fast-forward thirty odd years and I’ve achieved my childhood dream of becoming a doctor, but there is no lolly jar on my desk.  Instead of jellybeans, I offer my young patients stickers as bribes… oops, sorry… treats. For a responsible GP, this makes more sense.  While a single jellybean given at a doctor’s visit is not going to significantly increase not-so-little Johnny’s considerable girth, cause appreciable decay of Dani’s deciduous dentition or cause Tyler to throw yet another tantrum at bedtime, rewarding children with artificially coloured and flavoured confectionery sets a very bad precedent.  We should be teaching by example: promoting good health and positive parenting methods. I know this, and I practise the principle, but a small part of me wants to bring back the jellybean. After all, Mary Poppins was onto something when she sang, “A spoonful of sugar makes the medicine go down.”

Being offered a jellybean at the end of each infrequent visit to the family doctor was a childhood highlight for me.  I actually looked forward to going to the doctor. The poking, prodding and vaccinating were all tolerable, thanks to the sugar fix at the end. I would carefully carry the painstakingly chosen jellybean out to the car in my hand, lick off the coloured coating and then ever-so-slowly suck the gelatinous core, eking out the enjoyment for as long as possible.  If I’d been offered a sticker as a substitute, I would have felt cheated.  Stickers don’t taste as good as jellybeans.

I was reminded of this recently when offered some constructive feedback from a discerning young patron.

“I think you’re a very nice doctor,” she pronounced.

“Why thank you.”

“But…”

But?! I didn’t like where this was heading but I was masochistically curious.

“… I liked my old doctor better.  He had cold hands and he smelt funny and Mummy said he didn’t know what he was talking about…”

OK, now I really didn’t like where this was heading.

“… but he always gave me a frog.”

“A frog! A real frog?”

“No, Silly Billy. A lolly frog. And always a red one. They’re much better than the green ones.”

“Oh. I see. Do you like frogs better than stickers?”

“Der! Stickers are boring. Frogs are yummy.  I reckon that if you gave out frogs you’d be the best doctor ever!”

“Thanks for the feedback. I’ll take it under advisement.”

My inner child can’t help but agree with her.  A lolly-giving doctor would have definitely trumped a sticker-giving one when I was her age. Some kids love stickers and would choose the visual pleasure over the gustatory if given the choice, but many are like I was: orally fixated when it comes to treats.  I’m not about to change my paediatric protocols and I stand by my health promotion convictions, but the idea of using a spoonful of sugar or two to boost my popularity is rather tempting – almost as tempting as was the jar of brightly coloured jellybeans on my childhood GP’s desk.

(Identifying details have been changed to protect patient privacy)

First published in Portraits of General Practice, Good Practice magazine, April 2014, page 15

Mobile Phone Etiquette

mobile phone“So what’s the verdict, Doc?  Give it to me straight.”

“It’s not good news I’m afraid.  The tests revealed…”

A particularly grating ringtone emanating from my patient’s groin cut me off.  Taking the offending phone out of his pocket, he motioned for me to pause while he took the call.

Despite a ‘Please turn off your mobile phone’ sign in reception, I’ve had patients answer phones while undergoing PAP smears, skin excisions (once as I was injecting lignocaine!), ear syringes and ECGs, but this one took the cake.

“Hi mate…  Yeah, now’s fine.  Fire away…  Sorry mate, no can do.  I’m over in Perth at the mo’…  Yeah, for work…”

Five minutes and ten seconds later he hung up and casually said, “Sorry.  Good mate.  So, where were we?”

“Before we discuss your results, I need to ask: Do you know where you are?”

He looked at me as if I’d asked whether or not he believed in Santa Claus.

“ ’Course!”

“When patients show signs of being disorientated, especially when combined with inappropriate  behaviour, I need to rule out serious causes.”

“Huh?”

“You just conducted a five-minute social phone call during a medical consultation…”

“I said I was sorry,” he interjected.

“…just as I was breaking bad news.”

“Are the results, like, really that bad?”  His brow suddenly creased.  “C’mon, you can’t keep me in suspense.”

I did.

“And during this phone call, you indicated that you were in Perth, whereas in fact, you’re on the other side of the country.”

“I was just getting out of helping Johnno move house.  Anyhow you shouldn’t listen in on private phone calls,” he replied indignantly.

“Should I have stepped out of my consulting room to give you privacy?”

“Well no, just not listen.  Look, just cut the bullshit.  I said I’m sorry.  I won’t do it again.  Now can you please tell me my results already?”

I was ready to ask for suggestions as to how I could turn my ears off on demand, but didn’t want to waste any more of my time.

“The tests have revealed that you have two sexually transmitted infections,” I said, matter-of-factly.

“What?!  She said she’d just been tested and given the all-clear.  I can’t believe she lied to me!”

I refrained from mentioning kettles and name-calling pots and proceeded to discuss the specifics.  Afterwards he said, “There is no way I’m going to let the missus find out where I’ve been.”

….

It struck me recently that, as phones become increasingly hi-tech, it’s probably going to become increasingly difficult for this bloke to get away with geographical inconsistencies.  A friend was demonstrating his new latest-and-greatest Smartphone at the time…

“… and it’s got Google Latitude so you can log on and see where I am at any moment.  This phone is absolutely wonderful,” he gushed.  “The only downside is the microphone.  If I hold the phone close to my ear, the other person can’t hear me speak, but if I move it down to my mouth, then I can’t hear.  The speaker-phone function is pretty useless too – muffles the sound terribly and neither of us can hear.  I just love the phone though.  Perfect for my needs.”

“A phone that can do anything except allow you to converse with others, eh?  In other words, it’s a perfect phone for all your non-phone needs.”

“Making calls are not what phones are about anymore,” he bounced back, without even a hint of irony.

I only hope my friend is right, and that one day soon the mobile-phone-induced consultus interruptus is also rendered obsolete.
(Identifying details have been changed to protect patient privacy)

First published in Portraits of General Practice, Good Practice magazine, June 2014, page 15