in sickness and in health

In general I'm a peace-loving sort of woman. Except when sparring at karate. Or when arguing with my husband. Except for those situations, I do try to be accommodating and understanding; I'm happy to 'go with the flow', as they say.

At work I am certainly no tough nut. If a patient tells me they've been sick, even if they appear to be thriving with good health, I tend to give them the benefit of the doubt. After all, some symptoms aren't readily apparent to the observer. A person may have pain, or nausea, and I have no way of assessing this definitively. Similarly, I try to be generous when a patient has emotional distress and doesn't feel able to attend work. I wouldn't say I'm a pushover, but I'm certainly not hard-line. If a patient is just feeling overwhelmed by life and is completely stressed-out, a day or two off work may prevent them spiralling downwards, and needing several weeks off work. I'm happy to supply a medical cerificate.

I can only recall a few instances in my working career in which I have refused to give a medical certificate. One I clearly recall was when a cheery young man told me he was going fishing the next day, and requested a medical certificate to cover him for the day. I had to try hard not to laugh as I refused this request. (I mean, couldn't he have at least tried to invent a sore throat, a stomach pain, something?!)

Then last week, there was Unhappy Chappie*. Mr UC came to see me with a long list of requests - scripts, referrals, results and the like. I scurried to try to fulfil Mr UC's wishes. After twenty minutes, I had whizzed through it all, and was wrapping up the consultation. He then piped up with one more query:

"Could I have a medical certificate for the next couple of days please?"

"Why? " I queried, concerned (and also imagining further lengthy discussions about this new problem!). "Are you ill?"

"No", Mr UC replied blithely. "It's just that I've taken today off to trim all my hedges right back, and I always get a sore back the next day, so ... I take another day off afterwards."

I blinked. For a minute I was speechless. Then I ventured tentatively, "So, is your back any worse than usual at the moment?"

"No. No, it's fine right now. It's just that I like to get the hedges done in one fell swoop, and the weekends can be busy, so..... you know..... I take the full day, no kids around, get it done." I sat, stunned. "And then I pay for it the next day", he finished.

"Well," I began gently, "I can give you a certificate saying you attended for a doctor's appointment today. But I can't give you a certificate saying you're sick. Because you're not sick in any way."

Mr UC's eyebrows shot up. He glared at me. "But Dr Doodlehead* always used to give me a certificate for this. Every spring!".

I smiled wanly. "Um, well ...... I can't speak for Dr Doodlehead, but ...... it's not legal for me to give you a certificate to trim your hedge. And if your back gets so sore from doing all the hedges in a one day, then .... as harsh as it sounds .... perhaps you shouldn't be doing it all in one go."

Mr UC's eyeballs bulged. He muttered to himself something about 'Dr Doodlehead never had a problem with this'. He seemed to simmer down though, and took his prescriptions, and thanked me as he left. But later that day, the practice manager e-mailed me, saying 'I just had a complaint from a most unreasonable man. See me about this sometime."

Anyone who knows me would know that I am not a person brimming with self-confidence. I have an average amount of confidence, I suppose, but with my work is probably an area where I have the least confidence. I have had patients complain about me a few times in the past, and it has always upset me quite a lot, and made me question myself. But this day last week, when I got the e-mail, I just laughed. I laughed out loud in my room, and I decided not to spend a moment worrying about displeasing this gentleman. Because you can't please everyone, and you can't trim their hedges either.



*Patient and minor incidental details have been changed to protect the guilty!