(2013) Looks Could Kill by David Ellis Read Free Book Online Page A

an agreement that she would talk to Emma for a bit, but that she would have to leave soon to top up the parking meter.
    “So, Mrs Thompson, can you tell me what brings you here today?” asked Emma, using the open-ended introductory question suggested in her psychiatry hand-out.
    “Well, it’s like, it’s this thing that, I don’t know how to put it, but it’s like I don’t, you know what I mean, don’t you?”
    Emma was going to ask her to repeat what she’d just said, but she decided on a different tack in the hope that it would resolve her patient’s expressive dysphasia.
    “I’ve got a letter from your GP here, and it mentions you being depressed. Can you tell me about that?”
    “Well, it’s like, it’s this thing that, I don’t know how to put it, but it’s like I don’t, you know what I mean, don’t you?”
    Now someone once told Emma that when people are as tongue-tied as this poor woman clearly was, it’s usually because they’re embarrassed about something. And reading between the lines, Emma got the impression that the embarrassment was related to something ‘down there’. Emma caught her eye and the wave of embarrassment she experienced immediately confirmed her feminine intuition.
    “Now, Mrs Thompson, I’m going to make a stab in the dark, but I think you’re embarrassed about something and that you haven’t been able to talk to anyone about it, and it’s that what’s made your GP think you’re depressed. Am I right?”
    And that unleashed the floodgates. It turned out that her husband was a “philanderer” and he accused her for being a “frigid cow”, which is why he had to “get it” elsewhere.
    As far as Emma was concerned, there wasn’t actually the slightest hint of clinical depression, just utter frustration with an appalling husband who seemed to enjoy mistreating her in any way he could. Emma couldn’t see much point in doing a full history and mental state examination, but she did it anyway to keep the senior registrar happy.
    So Emma presented her case to the senior registrar and then he invited the patient into his consulting room so that he could confirm her findings.
    “So, Mrs Thompson, I gather from your GP that you’ve been feeling depressed.”
    “Yes, terribly depressed, doctor. I can’t sleep, I can’t eat, I can’t concentrate, I’m crying all the time and I’ve got no interest in anything. To be honest, I’ve even thought of, you know, doing something.”
    “Do you mean like harming yourself or even taking your own life?”
    “To be truthful, doctor, I have.”
    So the senior registrar concluded that the GP had been right all along and started her on an antidepressant.
    The senior registrar told Emma that the key learning point from that case was to accurately diagnose depression. The learning point that Emma took home that afternoon is that sometimes patients will say anything in order to get a prescription.
    And Emma decided that the parking meter ploy was an excellent way for a patient to do a bit of boundary setting.
     

October 1984
     
     
    It’s generally assumed that female medical students will take to obstetrics like ducks to water. The reality for Emma was far different. Distant memories of a bustling woman in brown uniform and sensible shoes at her own birth loomed large for her. And as she entered the antenatal clinic, who should loom large but a bustling woman in brown uniform and sensible shoes. 
    “You!” she said.
    “Hello, I’m Emma Jones, a 4year medical student. Where should I go?”
    “Well, not here for a start; we’re far too busy.” And the bustling woman in brown uniform and sensible shoes bustled off.
    Emma eventually negotiated her way out of the overcrowded antenatal clinic, only just avoiding being squashed between a Scylla and Charybdis of two very pregnant abdomens.
    The students’ introduction to obstetrics took place in a seminar room that doubled up as the ‘birth training centre’ and seemed to