She thought her request was reasonable.

She needs more. She implores me to send off a sample to determine paternity.

Alas, I must share the disappointing news that a pregnancy test

with that specificity has yet to be

developed.

Another patient informs me:“ I

think I might be pregnant.”

“ Is your period late?” I ask.

No reply

“ Are your breasts tender?”

Silence.

“ Morning sickness?”

Dr Pam Rachootin GP in Adelaide, SA.

No response.“ Tiredness, weight gain, fre-

PICTURE CREDIT

quency of urination … fetal movements?” I ask in exasperation.

“ I think I’ m pregnant because we are planning to buy a new car.”

My eyes involuntarily move

they themselves are.

upward.

For example, a mother with a

“ Whenever we plan to upgrade

febrile child has just got him to sleep.

the family car, something cataclys-

She rings you on a Sunday night

mic happens,” she says, pointing to

at 8pm to book a telehealth appoint-

her five-year-old playing quietly on

ment for when he wakes up.

the floor.

She estimates he will wake

“ The second time we planned to

between 2am and 4am; she needs

purchase a new vehicle, my job was

the appointment then because she

threatened, so we deferred again.

won’ t know what to do at that point.

“ I’ ve just made arrangements to

And you are meant to remain

test-drive a station wagon. That’ s

calm, pleasant, helpful, reassuring

why I’ m here.”

and totally professional— even as

uncertainty; she needs the security

naturopaths after consulting a

case, why should I go through all that

On another occasion, I found

you reel from her audacity.

of knowing that the alternative prac-

doctor.

bother, pain and expense needlessly

myself baffled by irrationality while

You politely decline the request

titioner has trained as a specialist.

One patient informed me that,

when I can just take my chances?”

trying to obtain a patient’ s family

for a telehealth appointment

But even that won’ t completely

although the naturopath had agreed

Fortunately, I was able to talk her

medical history.

at that time, smothering your

reassure her because“ we all know

with my diagnosis of a plantar wart,

around.

The fellow assured me there were

less-than-charitable feelings( dan-

that two specialists may disagree”.

he had also enlightened her as to

She phoned to give an update,

no diseases of consequence in his

gerously near eruption level) as you

“ This is so distressing— my

why.

after visiting the plastic surgeon.

relatives.

suggest she call Healthdirect instead.

inner peace is being destroyed,” she

I reminded her I had explained

“ I am so glad that you sent me to

As he was not young, I couldn’ t

These are the scenarios we were

admits.

that warts were caused by a skin

see him,” she said.“ It turned out it

believe they had escaped all the com-

never trained for in medical school.

I suggest she see her GP to discuss

virus.

was a Casanova!”

mon medical conditions.

Dermatology presentations

her predicament.

She countered:“ The naturopath

I’ ve also observed how pregnancy

“ Are you sure your parents don’ t

appear particularly problematic.

She rejects my suggestion, saying

said I had it on my foot because I

in patients may be another trigger for

have any illnesses, such as high

You are accosted on the street by

bringing out irrationality.

blood pressure, diabetes, heart dis-

a woman in the neighbourhood who knows you are a doctor.

She asks if you happen to know of an“ alternative skin specialist”.

‘ What did your father die of?’ I ask.‘ Oh, nothing serious.’

There was the patient who came in and wanted three referrals simultaneously so she could choose which obstetrician best suited her and her

ease, cancer, depression?”“ No.”“ So, they’ re both alive and well then,” I asked, totally unconvinced.

What is she on about?

embryo.

“ No,” he said.“ My father is dead.”

“ Do you mean a doctor who did

she doesn’ t want to rush into any-

didn’ t want to move forward in life.”

I declined.

Hallelujah, I thought.

an extra six years of specialist train-

thing because, deep down, pointing

Another patient had a suspi-

Then there is the patient dis-

“ And what did he die of?” I asked

ing to become a dermatologist and

to her solar plexus, she really does

cious-looking skin lesion on her

tressed by the possibility she is

eagerly.

then renounced it all in favour of

know that everything is okay.

nose.

pregnant.

“ Oh, nothing serious.”

alternative medicine?”

In my mind, I imagine pointing

The dermatologist thought there

The urine test is positive, but she

I refrained from further ques-

“ Yes.”

to her brain and silently paraphras-

was a 50 % chance it was a melanoma.

is not satisfied. She wants to know

tioning, took a deep breath and

“ No, I’ m afraid I can’ t help you. I

ing her last comment to myself:

The patient declined treatment. I

whose it is.

moved on.

don’ t think there is such a species.”

“ Deep down, I really do know that

called her in to hear her reasoning.

I tell her that, if the urine she

She tells you she believes in alternative medicine but can’ t stand

everything is not okay.” Some patients self-refer to

“ Well, that means there is a 50 % chance it’ s nothing, and if that’ s the

brought in is hers, then the pregnancy is as well.

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