Last but not least: the ethics of the ordinary

‘Just a quick one doctor,’ The last patient on Friday afternoon gave Mike a big smile as he beckoned her into his room. He gave a sigh of relief and returned the smile as she sat down. It was 20 past 5, and catching the train to London to meet an old friend seemed a realistic prospect. The afternoon had run to time: one person with complex emotional needs had thankfully been followed by three non-attenders. ‘It’s simple really,’ Mrs Barnard explained, ‘I need to know which surgeon to go to for gastric banding.’ Mikes had a sinking feeling. This sounded far from a quick one. He suppressed his resentment, and tried to feel (or at least to look as if he were feeling), that the care of his patient was his first concern. As he checked her records, he reflected on previous patients he had referred to NHS weight reduction programmes. Weight loss drugs were only for those who were receiving counselling and had already lost some weight: was it 3 kilograms in 6 months? To be considered for bariatric surgery might take a year after the drugs had given her orange diarrhoea. And did she …