Greetings to You Lot of Polymalingerers and Partners in Pred - whether New, Old, Ancient, Fossilised, or Cryogenically Frozen in Organic Yoghurt (or whatever your passion) only for Alien Visitors to Planet Earth to discover, and messily thaw-you-out in an attempt to try to make sense of Human Civilisation in a few thousand years’ time.
Ok, it’s THAT time again! No, not to put-the-cat-out (especially if you don’t own one), but to inflict some more Silly Nonsense on those of you who can’t learn and / or have nothing better to do than hang-around with what my old Mum used to call ‘The Wrong Sorts’ all day-long.
“Ok ok ok!”, I hear you shreiking in unison, like Tutti-Frutti fuelled infants in a school playground.
Whether or not you tuned-in to my recent rantings about my experience with my ‘new’ GP is irrelevant. What IS important is that you might want to use the enclosed as a template for your Negotiations with your own GP or their Practice Manager for some of what you need and deserve (i.e, basic Patient Care including Honesty, Empathy, Efficiency and Courtesy).
So, here goes (transcript of my letter):
“Dear Marje, er, GP Practice Manager:
I write to you following my rather scary and confusing appointment with your Surgery’s new, and obviously very capable young lady GP, Doctor Tyson (hereinafter referred to as ‘DT’), to discuss my hacking Cough and Flu symptoms which have persisted for one month, and also to ask for her help and advice in regularly testing and monitoring my Blood Count (Type: ‘Red’) for as long as I continue to chuck little white pills down my throat at 03.00 every morning in often futile attempts to make me feel better whilst enduring the mysterious and unpredictable symptoms of Polymyalgia Rheumatica.
Doctor Tyson, who looks very nice, wears a pretty dress and, unusually for many Young People of either gender nowadays, doesn’t display any decorative Body Tattoos (or at least, not visible ones), at first appeared interested in me as her New Patient. I must confess to having no Tattoos either, so I optimistically thought: ‘Things have got off to a good start between us!'.
In an effort to show DT that I am an equally ‘nice’ and respectable New Patient, I had prepared a list of my symptoms and questions prior to my consultation with her. All of this was carefully written in my best joined-up handwriting, and on a neatly folded sticky note (the type you write shopping lists on) tucked neatly into my best, Nappa Leather Personal Organiser (Vintage Filofax, for those of you who might be Aficionados of these now, largely obsolete artefacts of the pre-digital age).
“So, what’s the problem?” asked DT eagerly.
“Er I have a ‘Shopping List’..” I replied in my usual, humble and oblique fashion.
“Ok, give me the list then!” came back her reply, whilst simultaneously lunging forwards and snatching my precious Organiser from my frail, PMR-afflicted hands with the speed and accuracy of a professional pickpocket ‘working’ innocent victims in a busy shopping mall.
DT (whilst scanning my shopping list like a laser with a barcode, and with increasing urgency in her now, menacing voice): “Ok, so you want regular blood tests AND an ACTH test?! You don’t need them as your ESR is only ‘2’. I’ll re-consider things if you are Symptomatic. Here’s a referral for a Chest X-ray. Take these antibiotics for a possible chest infection in the meantime. When you’ve finished the antibiotics, reduce the Preds immediately to 3 mgpd and then by 1mg every 4 weeks until you’re OFF them. I get ALL of my patients off the steroids within 2 years. Quit smoking and drink less. Any questions..? Take care and Goodbye”.
By now, and although I am normally no ‘shrinking flower’ in Conflict situations, I felt truly ‘KO’d by the deceptively Assertive Dr Tyson, and hanging onto the proverbial (boxing-ring) ropes like a battered and bloodied Loser. I skulked away from the surgery with my head down, and the sickening feeling that DT had, perhaps, intuitively sensed my vulnerabilities like a Cage Fighter using Stealth Tactics with a less ‘Street Wise’ opponent - and she probably had the Match sewn-up from the beginning.
Later, in an effort to make sense of my experience with the clearly formidable DT, this caused me to reflect on my past Life - including a few traumatic childhood experiences like coming Bottom of the Class in A-level Geography (on reflection, I blame the Teacher who was 102 years of age and still believed that the World was 'flat'); my dear, late mother removing the stabilizer wheels from my first bicycle (admittedly, I was aged 32 and a Management Consultant at the time); and, oh yes, that humiliating episode when, er, ohh, sorry, but it’s too distressing to reveal here. All I will say is that the last Trauma involved being ritually stripped-naked in public and beaten-up with a piece of wet lettuce by my supposed Teenage Sweetheart, and with only a copy of The Beano comic to defend myself. You might understand that these emotional scars run deep, very deep.
So, in Conclusion, Mrs Marje, er GP Practice Manager: I can only blame myself for my selfish feelings of resentment and emotional confusion about the ignominious outcome of my consultation with your magnificent and highly accomplished Doctor Tyson. Yes, it was MY fault, not hers.
I accept that DT was only fighting her corner so ferociously and skilfully to protect her modest salary of approximately £100k GBP per year and to avoid any kick-back from an unhappy Patient which might put this at risk, and ;possibly leave her destitute and homeless as a result. I have been shedding tears ever since....
To be honest, yes, I have also been hanging-out with the ‘Wrong’ type of people (i.e. that PMR / GCA ‘Lot’) recently - and so I beg for your Mercy in re-instating my otherwise good name as a Patient of your highly respected surgery, and welcome you advices accordingly. Your, and Doctor Tyson's Forgiveness, if granted, will change my life for the Better, and I promise not to challenge the Medical Orthodoxy ever again.
Yours most humbly and ingratiatingly
Mark Benjamin of WSM
aka ‘Uncle’ MB, ‘Swivel Hips’, ‘Four Eyes’, or whatever alternative term you care to attribute to me"
(end of letter)
What do you think - worth a try?).
Either way, that's it for now. Happy Weekend All. Don’t EVER let things or people (even the Medics!) grind you down or confuse you, and ALWAYS try to keep smiling on the Journey!
MB :-)
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markbenjamin57
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Where do they find these people? And don't they know that "I don't know" is a more useful response than just making stuff up as you go along? My rheumy told me in the span of five minutes at my last visit that if I had PMR pain, I needed to up my Pred dosage, AND, that if I had NO pain, that meant that I no longer had PMR. It's magical thinking. Not confusing, just infuriating. I see him again on Tuesday. We may be wasting each other's time, but I need someone to write the script for Pred. I get my best advice here on this forum. Thanks for the suggestions on a statement of concern.
Ditto, love "polymalingerers" -- I felt like one today, since I had no PMR symptoms, but just felt very out-of-sorts. Working on a slow taper from 7 mg to 6.5, so maybe a little Pred withdrawal. Good day for a nap and a movie (one that doesn't require too much critical thinking).
Markbenjamin57 brilliant letter and I so wish I could send one of this ilk to my doctor. Unfortunately they have us on the ropes as they write our prescriptions and also "generously" allow us to book ourselves a blood test. Hence your realisation that you have to grovel in spite of your real feelings or they could withhold your "treats". We lose the battle but hopefully win the war as we have such a huge advantage with this forum on our side. Hope you are feeling better.
Whenever you go for an appointment, just remember, you are paying there wages........you could remind them of this fact or alternatively, take your money elsewhere, but first ask your friends if they know a good GP.
Yep, I wrote the 'serious' version of the letter to the PM about the GP because on reflection I was sure she'd implied something about taking a view on continuing to prescribe the Preds. Mmmm....
Trouble is, with PMR / Brain Fog / feeling groggy with the Flu etc, in the moment you don't always pick these things up. That's why I put things in writing (i.e. query the GPs refusal of FBC blood tests / ACTH test etc AND her dogmatic, steep tapering advice with the BRS / Dasgupta comments around flexibility / context etc so as to head-off any possible future refusal to write a script for Preds.
Started reading this and thought at first it was serious, a true format of a letter sent to Practice Manager that I know you said you'd sent. Soon realised it was a send up ( why did it take me so long, should have realised from the very beginning!) Thought this was very funny and unfortunately showed that tightrope that we have to traverse in order to get the attention we need. On a serious note - have you had any reply to your real letter? Regards Jackie
Re. the first 'serious' letter, phone message from the PM a week later(!) to say she would ask the local surgery to call me to make a pre-booked appt to see another GP. 5 days later, no call from surgery (!!). I call them to chase things up, no instruction received, and in any case, no appts available before 2 October. And then told I can only 'phone on the day' to get an appt. Typically it takes 11+ attempts to get through, with no guarantees. A total fiasco all round...
So, second letter hand-delivered to PM on Friday asking for satisfactory result on all issues (GP attitude and Appt booking complications & delays etc) within 7 days or I'll lodge a formal complaint with the NHS and / or their regulatory body.
That's why I had to sit down last night and see the funny side / write a parody of this fiasco or I'd have been climbing the walls!
Am on yr wavelength, MB. Your GP Practice sounds much like mine - v similar system. V difficult. Doesn't make one feel cared for or cherished, does it? But what can we do other that soldier on? Keep spirits up.
Mark, if/when you go again to your surgery, DO take someone with you. I'll go, if you like. Maybe they won't be so dismissive when there are two sitting in front of them. Sometime doctors take our breath away and we leave before their words sink in. Too late when you've closed the door.
I would like to hear what practice manager says too.
Well, to be fair, I'm not seriously ill / in danger / incapable etc - just very annoyed about such poor Patient care. The local Practice Group (you might know it - in WSM South Ward, recently changed hands?) now have 7 days to sort things or I'll escalate my issues formally. They won't want that...
Fortunately, I'm quite good at capturing facts and details in writing (The Devils' in the Detail), so I hope this next one to the PM one will wake them up / get a result. But we really shouldn't have to 'do battle' with the medics / their managers like this. Grrr! How would someone who's not good at letter writing and / or confused, depressed / has no-one as an advocate etc get on..? Probably just give-up?
I think of 'those less fortunate' who can't take up their case confidently too. South Ward huh? I don't see my GP's anymore, only to get my meds. Haematology at WGH is my 'go to' these days. It's very sad to see how the NHS in GP practices are so out of the loop with their patients. I'm glad you still have your sense of humour to entertain us. It certainly helped me this morning. Cheers Mark.
I have a friend who takes her phone,slightly ostentatiously sets it to record at the beginning of a consultation and explains she does it so she can check she has understood instructions etc. Never fails...
Yes, and then the incriminating evidence could be shown to all those intimidating rheumies..... who roll their eyes at the very thought of a patient with an opinion....
To be fair to my Rheumy, when he saw my detailed tapering chart / record he was confident that I am an intelligent adult (although some of You Lot here might disagree!), and so can manage my own steroid tapering. My new GP (physician) is a different matter...
Thank you for your communication regarding your appointment with our brand new Guerrilla Paratrooper (GP) Dr Tyson, whom I'm sure you'll agree has fitted right into our Surgery's ethos.
However I think I should point out that really we don't expect comments like yours when we ask for feedback - you obviously didn't follow the correct procedure for ticking all the boxes that gives this practice it's outstanding markings.
For future reference one should always tick the first box - as an aide memoire for our more senior customers (sorry patients) - excellent is usually found in the description.
For your information, to maintain that level of excellence I have come into work this morning -a Saturday- to answer your comments at great expense to myself, well you actually as a tax-payer. Please bear that in mind should you wish to communicate with this surgery again, and consider the day your communication may be received.
Unfortunately you seem to be under the misapprehension what the initials NHS actually stand for - have you not seen our new branding - that nice Jeremy Hunt spent millions on it I believe - it now stands for "No Help Sunshine".
As you are aware all our hard pressed surgery staff are much too busy reading their screens, catching up with friends on Facebook to be bothered with whining pathetic patients. As for requesting blood tests and expecting our GPs to actually answer a question is really beyond our remit.
I don't think you addressing Dr Tyson as "Mike" is appropriate, and querying her prognosis of your polymolywhatsit really was unnecessary. If she tells you to be off steroid within 2 years you will be off steroids in 2 years. No discussion.
On a personal level I should not be referred to as Marje by someone outside my circle of associates. It's really not the done thing as it shows a complete lack of my standing as the Practice Manager, or PM as I like to be known. At all times I should be referred to as that or Ms M Uppet. Just because we refer to you by your first name Matthew doesn't mean the same privilege can be extended to yourself.
Finally can I say how delighted we are to serve you, and thank you profusely for your custom and look forward to greeting you again in the warm and friendly manner which this surgery holds paramount and, as you know, is the cornerstone of a our mission statement.
Dorset lady that is priceless!! My neighbours will think I have lost it as I am roaring with laughter in an otherwise empty house. On a serious note I think it is really worrying that so many doctors and surgeries are simply not giving a service any more. Judging by this forum the problem is really widespread.
Well, more widespread than we would like. Although there are some very good people out there doing a difficult job in very trying circumstances. And I'm always the first to recognise that, they saved my late hubby on many an occasion - he had more lives than next door's cat!
But having spent 40 years working for the public sector I think I have their collective mindset to a Tee, not that I was ever a jobsworth - too bl**dy bolshie for one thing.
Thank you for your lengthly and eloquent reply to my feeble attempt at a complaint about your esteemed Medical Practice. I realise it was futile, and you are a superior being to me in all respects: although I would politely point out the minor punctuation error in para. 2, line 3 (it's).
Notwithstanding, I appreciate that the above is a trivial issue and I bow to your greater intellectual capacity overall - and which is evident in your highly skilful use of long words and sentences.
I regret that I cannot currently reply to you in more detail since I have to meet my daily quota of 2000 'Big Issue' sales by 11.00 this evening, or my boss will confiscate my company-issue dog, 'Brutus' (a nice perk!), - and also the piece of frayed string I recently purloined from the Meat Counter to restrain him from attacking the seagulls here - not to mention passers-by and parking wardens (the latter of which he finds very tasty indeed..).
However, I will respond to you further once things have settled down here, and I can assure you of my continued attention and subservience in the meantime.
As you can see I am now at my Nursing Home, and I mean mine! All mine! And I have to feed the inmates, sorry paying customers, so I really don't have time to bandy words with the likes of you. OBE indeed! Or as we like to say Other Bug**r's Efforts.
You should be advised that I have no wish for you to point out anything - however minor it may be! I have enough problems with Mr Blinkinsop in regard to that!
I also have something in the oven, so I must desist from wasting any more time on such a trivial matter. Stop it Mr Blinkinsop!
Are you sure he's no relation of yours, he keeps muttering something about going to the seaside and seeing his long lost cousin, called Matthew, or Michael or Mary or Matilda........
(...sent from my iphone version 12a - please excuse any unintentional errands in productive sexing...)
Dear Ms Slurpit
Just a quick reply, since I appreciate that you are busy at DHFB dishing-out a Cordon Bleu menu and slap-up dinner to your numerous, posh Customers.
Just to say: any inadvertent reference to your esteemed Dr Tyson as 'Mike' was due to my suffering from a rare variation on Tourette's Syndrome, in which I involuntarily and spontaneously MIKE! link the Christian name of a famous person (in this case, a professional Boxer) with a particular Surname to that of someone who has a similar MIKE! Surname, but a different Christian name (in this case, 'Lucy'). Oh, there I go again... That said, the problem might just have been exacerbated by Dr Tyson's jutting jaw and muscular biceps (the latter of which so deftly extracted my Leather Organiser and shopping list from my feeble grip). Oh MIKE! well...!
I must confess that this highly distressing verbal affliction has caused me problems in the past. I frequently, loudly, and in public, address our friendly local Roofing Contractor, Mr Mike Hollyday, as 'BILLY', much to his consternation: and have recently been subject to an ASBO as a result BILLY. That puts the kybosh on new roof then...
As for the venerable Mr J. Hunt and our treasured NHS: all I can say is that... oh, sorry, my phone credit is running out, so I'll get back to you on that one....
I see you are acting on behalf of a Mario Brockenhurst, a personage of somewhat dubious credentials who has been causing consternation amongst my staff. He has a tendency to come into our surgery shouting about a person called Mike.
I understand he is already the subject of an ASBO, and also seems to have an unhealthy relationship with someone called Teddy and another person who goes by the name of Mr R. Wine. He also has a tendency to throw himself behind a sofa particularly on a Thursday evening. All in all a most disturbed patient.
Perhaps you should suggest he requests a transfer to another surgery. As you are aware ours is a very family friendly, warm and considerate organisation employing the very best of staff, and I don't think Mr Beetlebrook is the kind of patient we aspire to.
I'm sure our staff will do all they can in their powers to assist in his transfer.
Thank you Mrs, er, Marje, To Whom It May Concern, or whatever Salutation is appropriate.
Well, yes. Mr Martin Brokenschmidt does confess to being a 'little' eccentric. But, by 'little', he means 'slightly': and does not admit to being of diminished physical stature other than when soundly kipping after a few glasses of the red stuff - and, inevitably 'horizontally challenged' as a result (who wouldn't be?!).
In his defence, Mr Brokenshirt wishes to state, categorically, that he bears no ill-will to your Practice Staff, despite his occasionally, seemingly odd behaviour in response to Dr MIKE! Tyson's equally rather unconventional style in dealing with her [xxxOpponentsxxx] Patients.
As Mr B's Personal Valet, Bodyguard, Chauffeur and Security Advisor, I can vouch for his Goofy (sorry - I mean 'Good') Character, and will be happy to find an alternative provider of Health Services for him. Thank you for your kind and generous help in these matters.
Further to your correspondence I regret to inform you that our erstwhile Practice Manager, a goodly person by the name of Marjoram Uppet-com-Lately has recently been struck by the vapours - a very debilitating illness I'm sure you and your colleague are aware of, closely liked to polymolywhatsit and generallyconfusionedactivity and has taken a leave of absence.
She was last seen heading for a Yoga and Gin retreat halfway up the Orinoco with a Mr E Presley dressed in matching diamond encrusted white jump suits singing Love Me Tender in a pink Cadillac.
Mr ButI'veonlyhadoneofficer is in luck, we do have a potential vacancy in our surgery in an experimental position, and as he seems to spend an inordinate amount of time lying down waiting for something to happen it might suit him.
I am sorry to hear of the incapacity of your PM with the vapours - these e.cigarettes can be tricky things if loaded with the wrong stuff. No doubt she will be in good hands with Mr Presley, who I believe is also partial to some whacky backy.
I assume you refer to my loyal Master of 2 years, Mr Biteonthebum, aka Old Four Eyes / Swivel Hips. Yes, I will be delighted to dispatch him to your surgery via UPS with the utmost haste.
To assist you in securely accommodating Mr B, I will package him sandwiched between 2 sheets of hardboard bound tightly with gaffer tape and leaving a small aperture for breathing / drinking wine through. I suggest that you store him on a high, narrow shelf, and out of the reach of young children (for Health and Safety purposes) and do not allow him to mix with the general public unless accompanied by an adult.
Please note that Mr B. also occasionally suffers from the delusion that he is the famous Actor, John Wayne, and so please do not be alarmed if he randomly mutters 'Get off Your Horse and Drink Your Milk' with a menacing leer, shoots passers by, and calls everyone in the surgery 'Missie'.
Other than that, I am certain you will find Mr B. to be a harmless, if slightly Bonkers inmate - and / or a very capable Assistant Practice Manager if the occasion arises.
That will make a change from shouting MIKE I suppose!
I will have to consider your very kind offer in the fullness of time, but in the meanwhile I have had an urgent order via some satellitty thingumingig for a ton of deep fried peanut butter and jam sandwiches and a gallon of coca cola (other soft beverages are available, but not quite so deadly) from Ms M Uppity Whatsitnow! and El (or A Big Hunk of Love - as she refers to him).
Do you think I can rely on the Post Office to deliver the aforesaid to Heartbreak Hotel, Suspicious Minds Avenue, In the Ghetto, Memphis. Or perhaps I should give the job to UPS I really don't want to be in a Return to Sender situation - it will leave me All Shook Up.
I really don't understand Ms M Uppity Whoeversaidthat recently, she always seemed such a Hard Headed Woman with a Wooden Heart and almost the Devil in Disguise - such a perfect PM for our practice.
The best read of the night! Thank you for the humor and the laughter .... you are a gifted writer. With this disease .... we all need to maintain a sense of humor. Sleep well fellow polymylongers
Ha ha ha!!!!!! I'll try your approach Mark with my next complaint to Worcestershire Acute NHS Trust. Actually you and other readers might be horified to learn that I was roundly told off by a nurse the other day for quoting a warning in the blurb tucked away in my new prednisolone anti inflammatory eye drops box, about not taking the stuff if you' ve got Glaucoma! A raised and truly animated voice shrilled at me about how dangerous it is to read the manufacturer's warnings as they make us ignorant patients anxious!!! I was roundly told off (politely but firmly) for having the temerity to query the wisdom of the drs decision in prescribing the stuff. Cheers!!!!!😂
Similarly, I was once roundly told-off by a previous GP for putting in-writing my concerns about her advice to 'take Paracetomol' for nasty lung pains - which turned-out to be Bacterial Pneumonia once she pulled her finger out (excuse the expression) and referred me to my local hospital urgently for proper diagnostic tests.
Hi Mark I seriously think you should send it! I would love to see the reply! I once got threatened with an asbo for a gentle letter of compliant about the care of my elderly father! I wish I had written one with the skill you have used to craft yours!!! In fact I plan to base any future letters I may need to write to the NHS on your template
The funny (strange?) thing is: writing the Bonkers stuff here (and your lovely feedback) is actually an antidote to the tortuous process of writing the (2) recent, serious letters to my GP practice where I find myself reviewing and scrutinising every word, phrase and detail with the precision that a Lawyer would be proud of.
But, as I've banged-on here in the past about these things, 'The Devil is in the Detail'
Ha, Pete! ;-/. Don't be fooled, she'll give you the come-on and then run off into the sunset with Elvis Presley in a Cadillac - like she did to me. Neither of us can compete with that (sob, sob etc)
DL's comment about 'tops down' reminds me of when my pretty young next-door neighbour, Samantha, bought a new BMW cabriolet. I asked her, cheerily: "Do you like it with your top down?!" I don't remember much after that - only to say that my black-eye has healed nicely...
Well, tgca, I've noticed that the delightful Samantha does spend a lot of time in front of her laser display board entertaining her gentlemen friends...
Can't wait for the next series (although I fear that our friends outside of the UK won't have a clue what we're on about either!) ...
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That said, the problem might just have been exacerbated by Dr Tyson's jutting jaw and muscular biceps (the latter of which so deftly extracted my Leather Organiser and shopping list from my feeble grip). Oh MIKE! well...! 
