'It's a bum rap being a patient'

By BBC Doctor Colin Thomas

The transition between the roles of doctor and patient is not an easy one to make.

It's rather like a mechanic taking his or her car in to be fixed - they probably have a fair idea what might be wrong, but because they are the owner their judgement is not quite so impartial.

I, for one, can never really tell if I'm totally overreacting to a problem, or leaving it far too late because I feel that my doctor will think I'm totally overreacting to the problem!

When I was a medical student I had a rather embarrassing problem 'down below' and, like all good patients, I had put off the inevitable trip to the doctor's as long as possible.

In the end though I could delay no longer.

I was referred to the hospital where I was training as a student, which is always disconcerting.

For example, do I turn up in my white coat as Medical Student Thomas or do I turn up in mufti as Mr Thomas, a local resident with an embarrassing bottom problem?

I chose the latter, but when you're known in the hospital it doesn't really make any difference.

I knew everyone

Of course it's inevitable as soon as you walk into the hospital that you meet every single person you've ever known.

"Oh hi Colin what are you doing here?"

I was tempted to say in a very loud voice: "I've got an arse problem and I'm going to see the specialist".

I didn't, of course, although inside I felt like everyone looking at me would see a neon sign flashing above me saying "embarrassing problem below".

Even the student nurse on the clinic was one who I knew quite well, and I did at that point wish that the ground would swallow me up.

I should have taken a leaf out of a colleague of mine's book who had a much more embarrassing and - how can I put it? - special problem.

In those type of clinics everything is secret, but he conspired with the specialist to pretend that he was coming down to the clinic to discuss a patient on the ward with a particularly difficult problem.

He arrived with the 'fake' patients notes, and when the clinic door was locked the pretence was dropped and he became the patient.

My consultation was with one of the specialists who taught me during my clinical training.

In fact it felt like I was taking part in my surgical finals examination rather than having a medical consultation.

He took the opportunity not only of getting out of me what my symptoms were, but extracting my own self diagnosis into the bargain.

Then came the physical examination.

"What sort of piles did you say you had Thomas?"

"Er, 3rd degree sir?"

"Rubbish." he said. "They're only second degree".

With a proctoscope up my bottom I wasn't going to argue.