Many years ago, in the days before I learned to fear Heaven, a patient once brought her sister along for company during a testing session. This sister was (to put it kindly) plain of face, and her conversation was limited and trite. And yet she also had a certain indefinable subtle charm, and I found that I was paying her the sort of exaggerated attention that men pay to attractive women. I couldn't put my finger on quite what made her attractive, but undoubtedly she was.
After observing a couple of testing sessions this woman mentioned to me that she had done quite well out of her recent divorce settlement. She didn't need to work, she said, but could she come voluntarily and work part-time for me, as unpaid secretary?
I was excited by this proposal and enthusiastically agreed. I was a married man, so it would have been an exquisite relationship, forever hovering deliciously at the edge of forbidden carnality. For some incidental reason the plan was then dropped, but over the next couple of years she rang me from time to time, and each time I felt the excitement again. Eventually she came to me as a patient. She had developed a rheumatic complaint, and wondered whether her mammary implants were responsible. What I did I don’t remember, but I do remember the sudden flash of revelation. Now at last I realised what her subtle attractiveness was! I had been on the brink of a deep meaningful relationship with two inches of silicone.
Doctor, beware: - allergists of our persuasion, if male, face unique temptations. If you've been in the business for more than a year or two, you've seen her. The lady, perhaps in her 40’s, with PIMS (or as I prefer, PRIMS - Psychological symptoms, Rheumatics, Irritable-bowel, Migraine Syndrome). The first time you see her she looks like somebody's granny, bloated, bent, beaten. Then after 3 months of diet and desensitisation she comes swanning back in looking like somebody's mistress. She's feeling better than she can ever remember, the old symptoms have gone together with a few stones of excess weight, she's bought a whole new wardrobe to suit her new svelte figure, she looks stunning. And she knows it because for the first time in 20 years she's turning heads, and getting the kind of exaggerated attention that men reserve for attractive women (whatever kind of rubbish she may be talking). She looks at her faithful old husband, who stuck loyally at her side throughout all the years when she was feeling so rotten, and she suddenly realises - hey, I don't need him any more! All those years when she needed him every day, to do all the jobs that she felt too ill to cope with, to believe in her and give her love and support - she doesn't need any of that now. She suddenly realises that she can afford to trade him in, and if in any way he's been lacking over those years, less than satisfactory in the loving support department, he's had it.
Allergist beware! You are likely to be her next target! Why? Because you were the first doctor to take her seriously (instead of throwing her out with a prescription for tranx). You were the first man to pay her the special kind of attention normally re-served for attractive women (she didn't realise that you were just doing your job, taking a careful history, being willing to take bizarre complaints seriously - she felt both flattered and legitimised). Unlike most men, you know in intimate detail how her body works. And most of all, you presided over her miraculous cure, her metamorphosis from ugly duckling into graceful swan. You yourself have seen her blossom into this stunning princess with the model-girl figure. (Note, many of these patients are also chronic hyperventilators due to the tissue acidosis that accompanies allergic reactions. Hyperventilation, apart from enhancing the bosom and causing it to rise and fall interestingly, is also a normal physiological concomitant of sexual arousal, so don’t mistake its aetiology in this case!)
She starts dropping hints, none too subtle, about how she's fed up with her marriage. The usual phrase is "I need to be true to myself", or some such claptrap from the feminist literature. (For myself, I find I have been less often targeted in recent years since I adopted the garb of an orthodox Jew, but even so, surprisingly, there have been a couple of ladies who started expressing a hitherto-unsuspected fascination with Judaism and a desire to learn Hebrew.)
Some of these ladies do actually leave their husbands. Of the dozen or so I have seen over the last couple of decades, I can think of only one who finally found happiness (allegedly) with a new man. The others all found that the poverty, nastiness and loneliness of divorce overwhelmed any satisfaction they got from their "freedom", indeed most lapsed back into comfort eating and lost all the health and beauty they had sacrificed so much for.
Should you succumb to temptation with a patient (I managed to avoid that, thank Heaven, though there were plenty of other temptations in those days that I did not), you are liable to find that the relationship you thought had reached its culmination with this union was in her eyes only just starting, that at the peak of the first climax you suddenly lose interest in her, that Hell hath no fury, and that the GMC, for all its recent benign facade, still takes a very dim view of what you have done.
Truth is, we clinical ecologists have been granted a unique power in recent decades, to restore health to the sick and the scorned, and bring joy back to the lives of those who had despaired, and we need to use that power responsibly. Try to be strong. Good luck.
