Some patients need a little more patience.

There are some patients that require a little more patience. And here's a list that started off as a small paragraph on the internet and has gained some traction.....

Little Miss Its nothing to do with me;  Yes, I’m very overweight. I don’t do any exercise. I don’t take my medication. I won't follow any of your advice. Can you sort me out please?

Little Miss Rude; Those patients that treat the reception staff abominably but are charm personified towards the therapist. Never think that receptionists will go out their way to get them an appointment in a busy clinic. Receptionists are all powerful.

Mr Liar Liar pants on fire; So what’s your alcohol intake for the week? How many cigarettes do you smoke a day? So, you’re following a strict diet and your weight is going up. One lettuce leaf in a burger does not equate to salad. And you reek of tobacco. And you have a half eaten bar of chocolate in your pocket.

Mrs Anne Tibiotic; Can I have an anti biotic. No, you have a viral infection. Yeah but it needs an anti biotic...

The Columbo patient; Appointment is over, notes written up, patient has his hand on the doorhandle to leave the room and turns round and says, "just one more thing". Then announces something really significant like 'Does that explain why my foot has gone black?'

Mr Miracle Seeker; I’ve been in constant agony for 3 months but I’m going on holiday tomorrow.

                                                          

Hello darlin, how you doing sweetheart; To which the answer is 'I’m a healthcare professional and I have a very sharp pointy needle.'

Little Miss Pure Agony; "Can you just see me please, I’m desperate, I’m in pure agony."  "We can give you an emergency appointment at 3.30."   "I can’t make that, I’ve got my pole dancing class."

Mr Secretive;  "Are you sure that’s all the medication you’re on, you seem to be bleeding quite a lot." "Well the anti coagulants are nothing to do with my knee, are they?"

Little Miss Shower Dodger; She'll ask why I’m wearing a mask. Answer is always followed by the line "Your muscles are very tight. Why don’t you have a long hot shower before you come and see me the next time?"

                                             

Little Mr Sociable; "Oh that was great I feel a lot better. I’ve got 500 pictures of my cruise on my phone, do you want to see them."

Mr I Need a Referral patient:  This is every second patient with our NHS. They are closely followed by Miss Can I have a letter.

Mr Spreadsheet: "I’ve made a small spreadsheet of my pain, coloured coded with intensity, distribution, duration going up to 12 different factors."

Miss Phone Syndrome: Those patients who will happily answer the phone in the middle of the consultation just to have a chat with their pals despite visible signage to switch all phones to silent. Patients who say "can I leave my phone on as I’m expecting a call from the hospital/care home/ doctor" are perfectly welcome to do so.

                                                  

Mr I’ve looked it up on google: Congratulations but you still don’t get sciatica in your arm.

Mr Missing in Action; Constant repeat non attendee sometimes accompanied by his friend "too late to be seen". This begs a philosophical question. How can somebody constantly be 13 minutes late?  Surely after the first time being 13 minutes late you leave the house 13 minutes earlier.

Mr Two for the price of one: "Can you just have a look at the wife while I’m here?" Also followed by "Can I bring the whole family?" Using the reception as a creche facility. To be fair most patients phone up and say "I’m really sorry I’m going to have to bring the kids with me."

                                                 

Mr Chronic Complainer; Never ever dare to get these patients better. They really only exist to complain about their pain. However its usually ok to play golf but they are too sore to load the dishwasher.

Little Miss Vague; There’s a long story. It's  not really about anything and that can lead to the conversation. "So where does it hurt exactly?" To which they answer "At the bus stop."  Vagueness of pain can be part of the symptom picture, however there is precisely vague and then vaguely vague.

The Frequent Flyer: What is known in the trade as the Martini patient – anytime, anyplace anywhere.

After reading who has been selected for the position with responsibility for health in the US, I think the issues above are relatively mild. Maybe we’ll see in the upturn in the numbers of Little Miss Conspiracy Theorist attending we all know all doctors are trying to kill off the population or injecting them with brain controlling nanobots. If the patients above had their brain controlled by a nanobot, it might make the job easier. And as I live in close proximity to Glasgow Airport, I could be affected by the mind altering vapour trails from the jets so the madness is not mine.

                                        

Caro






 

THE BRAIN ON CONSPIRACIES

 Kwei--Wednesday

What's the latest conspiracy? (Media Whalestock/Shutterstock)

This is your brain. This is your brain on conspiracies. Any questions?

Merriam-Webster defines a conspiracy theory as a theory that explains an event or set of circumstances as the result of a secret plot by usually powerful conspirators.

Conspiracies 2021

Many have never really gone away and have persisted in the same form for decades. Here are the some of the most current conspiracy theories:

1. Vaccines: (a) they cause disease but governments and big Pharma are covering it all up; (b) the Covid-19 vaccinations are Bill Gates's attempt to microchip us; (c) vaccinations cause autism (yes, that one is still around and will never die); (d) the Covid-19 vaccination alters the recipient's DNA.
2. Covid-19 is not real: (a) the illness is actually caused by radiation from 5G mobile phone towers; (b) it was created in a Chinese laboratory (there's now some serious speculation that this could be true! We'll see.).
3. QAnon-based: high-ranking US politicians and Hollywood celebrities are Satan-worshipping, pedophilic cannibals against the former president, who did not lose the election.
4. Contrails are actually chemtrails, designed to control populations in some way.
5. Joseph Biden and the Democratic Party stole the 2020 presidential election.
6. Anything to do with Anthony Fauci--anything.
7. The FDA refuses to release the cure for cancer.

Why are conspiracy beliefs so hard to dismantle?

Have you ever tried to argue with a conspiracy theorist and gotten absolutely nowhere? That's because you were trying to do it by presenting logic and/or scientific facts. Well, never fence with an amateur, because they'll beat you every time. Conspiracies aren't based on your logic or fact, only on theirs. Often, conspiracists have researched their positions extensively and might have even more knowledge in that field than you do. Trying to debunk their claims is an exercise in refuting a belief in a belief in a belief--and down the rabbit hole you go. You'll never get out.

During an interview, Donie O'Sullivan asked two people about how they were so sure that thousands of votes for ex-president DJT (I'm trying not to utter the name--makes me break out in hives) were sequestered, and one of the responses was, "I watched it on TV." (Take a look at the clip--it's only about 36 seconds long and you just have to hear the punchline.)

This shows the selectiveness of this woman's belief. If anything to the contrary were demonstrated, again on TV, she would have rejected it outright, because conspiracies are self-accepting and other-rejecting. For example, if votes for DJT were dumped or burned (or shredded and eaten by chickens) in the states he lost, how do we know the same thing didn't happen to Biden's ballots in the states DJT won? This question will be met with a blank stare because it makes absolutely no sense to the conspiracy holder.

The brain on conspiracies

Because conspiracies are so immutable, I wondered if there was a physiologic correlate in the brains of conspiracy believers. Apparently, this might indeed be the case.

To start, in a British sample of 990 subjects, results indicated that a stronger belief in conspiracy theories was significantly associated with lower analytic thinking and open-mindedness and greater intuitive thinking. Unlike in a scientific symposium, people who subscribe to conspiracies tend to think along emotional rather than analytic lines. This is why arguments over conspiracies often become so heated.

It is possible that conspiracy theorists use "cognitive tendencies that are neurologically hardwired and probably have deep evolutionary origins." A 2016 study published in Nature found that, in fights, people who were most resistant to changing their beliefs showed "a lot of activation in their amygdala and insular cortex." 

The amygdala (looking at brain from below) [Washington Irving on en.wikipedia ]

The insular cortex (from Johannes Sobotta:Textbook and Atlas of Human Anatomy) 

These areas regulate fear, decision-making, emotional responses and threats, and are very ancient, originating when humans were hunter-gatherers and external forces were genuinely out to attack us.

In other words, belief in something that hadn't actually been proved to exist was a "better safe than sorry" measure.

Why would conspiracy theorists have an active amygdala? My guess is that they were born genetically inclined and that their environment (e.g. parents, peers, culture) further facilitated the development of the amygdala in the direction ("nature + nurture") of conspiracies.

In a very complicated study, the details of which I will spare you, in those subjects who appeared most subject to belief change, activity of the amygdala and insular cortex (as seen in MRI scans) were suppressed below baseline; the opposite was the case for those most resistant to change in beliefs: the amygdala and insular cortex were above baseline.

The bottom line

If you've scanned through this post and your eyes glazed over as soon as you saw diagrams of the brain, here is the takeaway.

The Buddha in meditation with lotus flower (Shutterstock: Andy Lim; fotohunter)

        

So the next time you feel yourself getting twisted emotionally and intellectually like a pretzel over why people believe in crazy conspiracies, just shrug and think, they have overactive amygdalae. Whatcha gonna do? You'll have a much nicer day.