Friday, 28 January 2011

Own goal!

In a previous life, before deciding to become a GP, I decided that to make people better you had to talk with them for hours on end about their childhood whilst they reclined on a leather couch. Thus I started my medical career as a trainee psychiatrist. It didn't take long to realise the hell of psychiatry, dealing with the mad (whom I felt sorry for) the sad (who made me depressed) and the bad - the latter alas did my head in so much I realised it wasn't for me, though I did persist through to sitting the MRCPsych Part1. I took 6 months out to do a job as a GP registrar and realised this was my true calling so never returned to psychiatry.
Because of this I am now registered under Section 12(2) of the mental health act to be a specialist GP who can make an assessment independent of the local mental health team, as to whether someone suffering with  a mental ailment can be detained against their will. (It's a lot more complicated but I'll keep it simple!)

So I was called out last night at the end of surgery to see a chap by the local emergency social worker. Theoretically  this work covers the whole of North Wales but was surprised to hear this chap was just on the edge of my GP patch.
We traipsed out to the middle of the Welsh countryside. I joined another GP from the next county and 2 social workers.

He was a chap in his early 30s who was a heavy cannabis user and had not left the house for months. He had been released from prison prior to that for attacking a policeman.
Basically the was not "sectionable" in that he had a mild personality disorder (because he told us!) and blamed all of his behaviour on this fact. He seemed reluctant to accept responsibility for his own behaviour. Basically a bit of a twat.

He didn't like going to his doctors as they were on the other side of the county and he "always got aggressive with doctors". Great. An aggressive twat.

I suggested he saw one of my local colleagues whose surgery was within a mile or so of this chap's house so he could more easily access local services.

"I don't like coloured doctors. I'm not racist but my mum was once attacked by a black and white minstrel" (or some such story). An aggressive racist twat, and one who was not willing to leave the house and would be bound to want regular home visits.

I couldn't believe what I said next...
"So the next nearest practice would be.... ummm.... me! (DOH!)"
His eyes lit up "Really? Aghhhh cool! You're that doctor that rides bikes and everything aren't you? Can I have Sativex (cannabis spray) to help me chill out?"

The other GP just gave me one of those looks as if to say "Ha ha! You stupid bitch!"

I immediately felt my heart dipping in and out of my left shoe as if to get some practice in.

Own goal I think.


  1. Ah, but before long you'll have him 'cured' and a pillar of the local community, no doubt... :) Good luck - sounds like you're going to need it.

  2. "to help me chill out?" said the patient.
    I see this problem with anger in many pot/cannabis users.
    "He seemed reluctant to accept responsibility for his own behaviour."
    Is he "mentally ill"?

    Tell me who gave him the excuse for his behaviour?
    If you have an excuse, why take responsibility?

  3. He is not "mentally ill" though he does have a "mental disorder" ie a personailty disorder. The latter is still sectioanble under the latest version of the Mental Health Act if there is risk to life and limb od self or others. There wasn't.
    I am bound by "professionalism" and was surrounded by colleagues as I was put on the spot. I also secretly love a good challenge!!