‘I want a health check,’ she commanded, forceful and unsmiling. Doctors and nurses are not used to being ordered about in this way; it is easy for hackles to rise and defences to spring up. The doctor felt attacked and was tempted to retaliate, to point out that this was family planning, not a well woman clinic, for example. Instead, she inwardly observed this difficult atmosphere, and wondered what was behind it. ‘We haven’t seen you for some time,’ she commented. Mrs A. shrugged, but remained silent. ‘Are you still on the Pill?’ ‘No,’ another shrug, then defiantly, ‘We use a sheath.’ The tension level in the room rose. ‘Look, I’ve come for a health check – that’s all!’ The doctor thought to herself, ‘Contraception produces tension, but is not to be discussed.’ She changed tack. ‘Of course we will examine you. Have you been having any problems?’ Immediately, the reply shot back, ‘No.’ Another glare at the watch. The doctor sat back and waited, refusing to be bounced into this checkup, realizing that, so far, she had been doing the work here. Now she let the patient decide how to continue.

*39/197/1*

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