Often when my patients ask me for my advice it is with the expectation that I will be able to give them a quick Yes or No answer. I frequently disappoint them; the great majority of decisions made in general practice are a shade of grey as opposed to black and white.
For example, one patient might ask me if she should take a cholesterol-lowering drug, or another might ask me whether he should have an operation on his knee. The patient hopes I’ll simply say yay or nay, but in both cases I’ll actually drone on endlessly about the pros and cons. I’ll recite boring facts, such as risk statistics, drug side effects and surgical complications. Eventually, after imparting my wisdom, I’ll turn the question back to the patient and explain that it is their body and their decision.
However, just occasionally, I do have the very satisfying opportunity to respond to an enquiry with a definitive answer.
One such question is: ‘Am I going to die, Doctor?’ This is one of the rare questions to which I can be 100 per cent sure of giving the correct answer: ‘Yes, you are definitely going to die. We are all going to die.’ I appreciate that the patient is usually asking whether they are going to die in the immediate future, but the reality is that as soon as we try adding that sort of clarity to the answer, we start moving back into that very unsatisfactory grey area again.
‘Is there a bug going around, Doctor?’ is perhaps the only other question I am commonly asked that I can always answer yes to. Unfortunately there is always a bug going around. It’s how bugs roll. If they stopped going around they’d die out, which sounds appealing, but according to microbiologists would result in disaster. I’ll take their word on that.
A less common question asked by a patient recently was whether it was okay for him to have sex with his partner via her colostomy. Now, I really don’t consider myself to be particularly prudish – patients tell me about all sorts of slightly alternative sexual behaviours and I rarely raise an eyebrow. Even if I wouldn’t necessarily choose to partake in all of the said activities, anything that takes place between two consenting adults in the privacy of their own home is okay with me. Not colostomy sex, though. That’s a straightforward no.