British patients are all perfect – and very well-behaved. This is because they are terrified of British doctors. Model patients who wish to further improve performance will be careful:
1. never to get sick at weekends, or after office-hours. Not only is the doctor annoyed, but your neighbourhood chemist has shut in sympathy;
2. not to live alone. When you’re ill, there’ll be no one to take you to the doctor’s. He hates making house-calls, and reasons that if you’re really sick, you’ll make an effort to come to him. If confined to bed, you’ll need a friend to collect prescriptions from the chemist, who will not deliver;
3. to ask no questions. About anything. Display no familiarity with medical terms or generic drugs. Do not inquire about side-effects (in the case of medications) or risks (in the case of surgery) ... much less the percentage chances of success;
4. never to need something major, like a heart-transplant. His heart isn’t in it. This counts as ‘crisis’ medicine, and many Brit-docs consider that scarce NHS resources can be better deployed in improving general standards of care than in keeping just one person (you) alive. It will be hard for you to share this view;
5. never to bother the hospital nurses, or ring the bedside bell. It may distract them from something really urgent, like a NUPE/COSHE meeting;
6. if having a baby, never to praise midwives to doctors, or vice versa. They loathe each other, and have long-standing rivalries about who should do episiotomies, and who gets to suture. Just keep your head down, and make sure the new-born does likewise;
7. not to look closely at hospital decor (which causes clinical depression). Try not to think about Legionnaires’ disease;
8. to ignore the tatty squalor of your GP’s office. Cast from your mind rules of basic hygiene. Try not to shiver in the draughts. On no account think about AIDS, and pretend not to notice that he used the same thermometer on the last patient, and you didn’t see him clean it;
9. never to ask for a check-up. Preventative medicine is an ‘American’ idea (Brit-docs are Yanko-phobes) and is associated in his mind with hypochondria. He much prefers to see you when it’s far too late. At least that way, he knows it’s real;
10. not to mention American medicine at all, unless you wish to trigger a violent episode. Brit-doc cannot decide which to disparage first: (a) the huge incomes of his Ameri-colleagues, or (b) the huge malpractice suits awarded against them.
His professional nightmare is that one day, model Brit-patients will turn nasty, and wake up to the possibilities of (b) when he hasn’t enough of (a) to support it.