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There are five categories of heartsinkers, each with their own delightful idiosyncrasies. Which one are you?

Phil Hammond Md
Monday 21 October 1996 23:02 BST
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Are you a hateful patient? Of course not. In 1951, a psychiatrist called Groves coined the phrase to describe patients who really piss doctors off. Since then, we've become a tad more empathic and hateful patients have been replaced by heartsinks, to signal the direction our hearts move when one enters the room.

Heartsinks come from a variety of backgrounds but share the ability to exasperate, defeat and overwhelm. Many have had their symptoms for eons and should have long since been pushing up the daisies. There are five behavioural categories of sinkers, each with their own delightful idiosyncrasies which make the job of a GP so stimulating and rewarding. Which one are you?

Manipulative help rejectors not only possess an endless stream of symptoms that the doctor is powerless to improve, but also delight in reminding him of his impotence.

MHP: (slamming bottle on the desk) Well, there's your pills back doctor! Didn't help me in the least. Surprise, surprise! I've had all the treatments, I really have. And do you know why? Coz I'm a medical mystery, I really am. My consultant ...

Dr: Professor Cranley?

MHP: I call him Roger. I'm his favourite patient. Last time he opened me up, he said it was like a bloody battlefield in there. Very, very rare, what I've got. I suppose it was stupid of me to expect an ordinary doctor like yourself to understand my rather difficult and complicated problems. Still, thanks anyway!

Entitled demanders are also incurable, but don't enjoy it. They constantly whinge to the doctor about their symptoms and perceived shortcomings in the service.

ED: Nothing wrong? Nothing wrong? Whadya mean? I'm a bloody cripple, I'm in bloody agony. I've never known pain like it.

Dr: (Hopefully) Wish you were dead?

ED: I do. Take my shoulders, they've completely seized up. I can't even move my arms (moves arms in wide arcs). And what are you going to do about these shakes? You keep ignoring them just like you keep ignoring this twitch in the corner of my eye. That's how multiple cirrhosis starts. I'll report you to the General Medical Council, I know my rights (repeat and fade).

Self-destructive deniers refuse to take any responsibility for their state of health but still insist on parading themselves in front of the doctor at regular intervals just to rub it in.

SDD: I know what you're going to tell me doctor. You're going to tell me to stop the whisky. But it's the only pleasure I've got in life. And besides, it gives me something to do while I'm smoking. And you can't tell me smoking's bad for me because my father ...

DR: God rest his soul.

SDD: He smoked 175 Woodbines a day and lived until he was 417. And I know my diabetes is all over the place and me bloody blood sugar's bloody high ... but it's only a doughnut.

Dependent clingers trick the doctor by offering excessive flattery and gratitude for his actions, and then consult him for absolutely everything that goes awry in their lives.

DC: (Thirty minutes late and slowly manoeuvring double pram full of children and shopping through the door, ripping the skirting board off on the way). Hello Doctor.

Dr: Oh God.

(Children dismantle surgery)

DC: Thank you for seeing me again at such short notice. You really are the only one who understands me. You're not like all the other doctors, they don't seem to listen like you.

Dr: Get on with it.

DC: Doctor, I know I only saw you yesterday but I've got so many problems I just don't know where to start, so I've made a list. Scottie's been pulling at his ears, and baby Kylie's nose stud's infected again ...

Dr: Lovely.

DC: I've developed a hard bit of skin on my heel from where my shoe keeps rubbing, Bill's back's never been the same since the dog knocked him against the refrigerator, and that red wine stain never did come off the carpet with the salt like you said it would.

Professional consumers are entitled demanders with breeding. They assiduously ascribe to every new media health fad and treat their doctors as employees.

PC: Doctor, I'm sorry to call you out again but it's the baby.

Dr: Jacasta?

PC: No, Tabatha.

Dr: Yes, of course.

PC: This allergy business has got completely out of hand. She's totally hyperactive, running up and down the stairs. She won't sleep. Do you know, sometimes she comes into mine and Tilly's room at three o'clock in the morning and asks for a cuddle?

Dr: Well, we can't have that, can we?

PC: No we can't. It's all quite tragic really because she simply adores pistachio nuts, she really, really does. I don't know how we're coping. Tilly's missed bridge twice.

Dr: No?

PC: Yes! And I'm further down the squash ladder than I have been for several months. Now, I've read an article in the Sunday Times colour supplement ...

Dr: (instinctively) Oh shit.

PC: ... about this marvellous new clinic in Hungary which specialises in small British children with nut allergies. We'd a referral today to the top professor there this afternoon. And, of course, (puffing torso out for dramatic effect) we're in Bupa!

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