Today’s GP is a kind I don’t see often. He’s enthusiastic, spells things out; it feels like it’s part consultation, part seminar. I leave with a prescription and an intricate drawing of the outer ear, middle ear, inner ear and nose, a spidery doodle of tubes and lines which makes perfect sense to me. The plug of wax I need to get rid of is a neat blob of biro ink. On the reverse is a little plan of action, all in block capitals – determined to challenge cliché to the very last, the handwriting is perfectly legible. I sit there and watch him type out his notes on the screen (“We have a new system, this is our second day” he tells me at the start. I like it; it makes it harder to see at first glance just how often I go to the doctor.) He reads out the notes as he taps away at his keyboard.
I feel like I’ve seen a lot of doctors over the past year and a half. I’ve sat on the standard issue Robin Day school assembly chair outside the consulting room many, many times, smiling awkwardly at my fellow patients, waiting for the door to open and to be invited inside. I always feel stupid, at that point: on the walk over to the surgery, I know what to say. When I get there, I can still remember how to phrase it. But somewhere in that interminable wait between getting there and being seen, the words evaporate, and often the symptoms do too. I look at the other people there: old ladies; exhausted parents with squawking children; dour convalescents; and I wonder whether I’m a fraud being there at all.
My appointments always take about ten minutes and start with me apologising for coming in. “It’s just a little thing,” I’ll say, “but it’s been worrying me.” Of course, I never tell the doctor how much: that inner voice is only shared with the unlucky ones, like my wife or certain selected friends. I always leave saying “Thank you for clearing that up”, I tell the doctor to have a good day and I walk home through the sidestreets, past the Polish church, and the inner voice tells me all the things I should have said. The doctor is wrong: it’s serious really, and the reason the doctor couldn’t tell me that is because of everything I didn’t mention.
Every doctor I’ve ever seen has been wrong, but I’m not dead yet.
There are lots of different kinds of GPs, in my experience. Many are the most common type – anything you go and see them about, you’ve seen them about too soon. They tell you to come back in a couple of weeks, and in the meantime there’s always paracetamol, aspirin, or their favourite, “plenty of rest”. They think that’s the cheapest and most readily available medicine of all, but in my experience it’s the most difficult to come by. I used to see a mad Greek doctor who was the opposite – he would refer you to the hospital for anything, or tell you to hightail it to Accident & Emergency. I had to stop seeing him; he was the only person I’ve ever met more worried about my health than I am.
The others actually do things, but it’s mechanical. Open your mouth, stick your tongue out, lie on the couch, touch your nose, keep looking at my finger while it moves, let me shine this in your ear, cough, I’m going to feel your stomach, go and wee in this cup, walk in a straight line. Has it been happening long. Is it worse at night. Have you been under a lot of stress. The worst ones are a call centre in human form, a bunch of tests and tables you are walked through. All the time I'm jumping through those hoops and answering those questions I have that friction, because I’m thinking: I’m not really ill but I think I am. You claim to know I’m not, but you won’t convince me.
My attempts to train myself to trust doctors, to be comforted by them and to believe that they know best have not been a success. Despite that, I still quite like them. You get the locums, young, eager, showing concern. A recent one, an upbeat, rosy-cheeked Geordie lady, listened with patience and tried to help and I made a mental note not to ruin a good thing by going in and seeing her again. I was rewarding her, I suppose. A few weeks later I saw her, on a Saturday, walking past Fat Face and I thought that you should never spot doctors off duty. Their role is to be there behind a desk dispensing wisdom, not to be slouching round town in a fleece being human and badly dressed. Why I expect doctors to dress well I have no idea, but for some strange reason I do. I prefer woman doctors, given the choice. My whole life seems to have been spent asking women if there is something wrong with me; the doctors always say no, the others always say yes.
Every now and again, there’s a referral. The specialists are very nice, and friendly, and helpful. They either explain that there’s nothing wrong, or tell me that it’s a grey area where nobody really knows very much. Sometimes things clear up, sometimes they don’t. They can be managed: acupuncture for the RSI, pills for the acid, nasal sprays, bits and pieces. “There’s a lot we don’t understand”, the specialists always say. But you’re the specialists, I never say in response, but I think it as I smile back and thank them for their expensive time. We drive away in the car, my wife looks at me and says “Are you happy now?” and for a few weeks I am, until the voice starts telling me again that the specialist has got it wrong. I have nobody to blame but myself: if I’d explained it perfectly, they would know that I’m dying.
I can’t tell you how little fun it is, being like this. Walking through life with my psychological brittle bones, every headache, every twinge, every minor change the harbinger of something fatal. When I was young I was terrified of that fable, “The Ant And The Grasshopper”, because I hated hard work. I identified with the grasshopper – leaving things until the last minute, never doing enough homework, not getting off my arse – and I knew that one day the winter would come and I would not be prepared. I’d fail exams, not get a job, lose my job, having nothing in reserve to get me through. But now I come to the end of my thirties it’s “The Boy Who Cried Wolf” who haunts me. I think that one day I’ll be really ill and it will be my wife and my friends who have nothing in reserve, because I’ve burned all their care and concern on things that never happened.
My regular doctor, when I can see him, is a smiling, bespectacled, eternally patient man. I’ve seen him about so many things that I’m beginning to wonder what’s left to surprise him with. I stopped seeing him because I got so embarrassed and ashamed, because I knew I was asking about the same things again and again. He has a little twinkle in his eye, as if I’m an entertaining diversion, but I can’t see how he can enjoy this, not really. He’s a neat, precise little man and he delights in telling me there’s nothing wrong with me (“You’re not going to get a cancer referral out of me today” he told me once – he could probably save a lot of time by just saying that at the start of every appointment). At the end of our appointments, he types “PLAN” on the screen and then taps out a list of things we’ll do. I appreciate him doing it while I’m there in the room – but I do wonder if there’s a second screen, a screen I can’t see where he types what he really thinks.
I don’t know much about him. He ran the marathon last year. He doesn’t drink or smoke. His first name is Lionel. And yet I’ve probably seen more of him in the last eighteen months than I have many of my friends.
The last time I saw him was the most difficult of all. I went with a list, and I ran through it in my head all the way to the surgery. I said it to myself again and again as I sat on the school assembly chair, like it was a dream I desperately didn’t want to forget. I saved the hardest bit until the very last, when we’d established that everything else on my list wasn’t serious.
“So what’s the third thing?” he said.
“I think I might, well, I think I might suffer from health anxiety.”
Health anxiety, the acceptable term for it. It used to be called hypochondria, and probably still is by many people. I used to think that a hypochondriac was just someone unlucky enough to get ill more often than most people; it’s only the past few years that has convinced me that that isn’t the case. I know that it’s called health anxiety, because I Googled it. I also know that, because I think I have it, I’m not allowed to Google other symptoms. In my head I’ve caught at least half of the diseases out there, thanks to a combination of internet search engines and an imagination that has never done me any good – meningitis, Meniere’s disease, ulcers and heart attacks and every kind of tumour known to man.
“What makes you say that?”
The hard bit: the speech I’d rehearsed that sounded stupid in my mind and was going to sound even stupider out loud.
“I think – no, I know – that I come here a lot. I worry a lot about my health. Whenever I do, I always feel like it’s going to be something serious, even though I know rationally that it can’t be. And even when I’m told that it isn’t I don’t feel reassured. I get incredibly anxious that I’m going to die.”
If anything, it sounded even stupider out loud, but I knew – however much I wanted to – that I couldn’t pluck all those words out of the air and cram them back in my mouth. I knew, too, that if I hadn’t said them I would have had an angry and disappointed wife to report back to, something infinitely worse than a lot of illnesses. But there, it was out: the reason I’d gone to the doctor so many times, the riddle it had taken me so long to unravel. Had he known that all along?
My doctor paused for a second, and then brought up that screen again. He scrolled back over about the last dozen appointments I’d made and my whole medical history flashed before my eyes. Looking at the text, I relived all the agony, all the shame, all the embarrassment and all the all clears that I never quite believed. Many of the appointments had that word in the note, PLAN; so many plans, going back for years. All that time wasted making those plans, when I could have been making other plans. When I should have been. All that energy that could have been spent on housework, or cooking, or watching movies or reading books, on being a better husband or a better friend.
My doctor looked over his glasses at me and I saw kindness I hadn’t expected. And there it was, that twinkle again.
“I think we have enough here to make a diagnosis of health anxiety, don’t you?”
As he typed the word PLAN onto the screen, I thought about how curious life can be. I’d worried for so long, about so much, for so little in return, and having gone through all that, it turns out there is something wrong with me after all. I thought so, my wife thought so, lots of my friends thought so and the doctor thought so too. Now I just need to find out how to fix it. For the first time in a long time, I think that maybe I will.