Sometimes I despair. Where are we going with this reductionist, target driven medical care?
Mary was referred to my morning surgery by the nurse. She was 83 years old. Her blood pressure was 160/90. For goodness sake she is 83!
Protocol guidelines say that her blood pressure should be 140/90. Mary had been taking tablets for her blood pressure for 15 years and her blood pressure had not altered over the last 4 years. But guidelines are guidelines.
She asked me if it was her nerves that maybe had put her blood pressure up. I asked what she meant and of course what she really wanted to do was tell her story. She had been a widow for 20 years and she was finding it increasingly difficult to look after her elder brother that lived nearby. She was getting more and more tired having to cope with him as well as her own house. She did all the shopping and looking after the bills. A cleaner came in once a week. Her family lived by and helped out when they could but she did not want to bother them too much with her troubles.
We as doctors want to check her blood pressure presumably to lower her risk of a stroke. Or is to reach our targets and get paid? She wants someone to listen to her story and offer a bit of support and advise. I hope she left feeling she had shared her troubles. After she left I contacted social services to see if they could offer some help for her brother.
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