In this consultation, a new patient with a letter from his previous doctor, whom he saw privately, outlined the last treatment, which had minimal therapeutic basis. The patient is anxious to continue with this bogus treatment. The new doctor’s problem is maintaining the patient’s confidence and gaining respect without denigrating his previous doctor’s treatment.

The story unfolds that the patient, whilst at Cambridge, had difficulty finding a doctor with whom he had a sympathetic understanding. However, he eventually alighted upon his private doctor, who had a tremendous reputation. The doctor didn’t believe in tests but was “very Positive”, obviously excluding confidence, and gave the patient Vitamin B12, Valium and Thyroid extract.

The new doctor is reluctant to carry on this rather dangerous mixture, and the interaction centres around whether he will or will not prescribe. He eventually reached a compromise that he would name some drugs on a reduced dosage, instigate some tests, and review the patient again shortly. This stratagem appears to meet with the patient’s approval.