The Man with Diogenes Syndrome

This week I won £580,000.00 on the Euromillions Commonwealth Lottery.

The letter looked very official.  The address was a Head Office in Zurich but the letter had been sent from within the UK, franked Royal Mail, second class.  My address within the envelope’s window was accurate.   The letter bore a number of logos in technicolour and was covered in serial numbers and reference numbers of such prolixity that I will not weary you with their detail.  (Incidentally, didn’t the letter to the PM from SPECTRE say precisely that, when the Special Executive stole two atomic bombs and held the world to ransom for £100,000,000?)  Perhaps the PM, and M, and 007, might have reached the conclusion I have reached and decided the whole thing was a scam, and rather an amateurish one at that.

In my case, the following awkwardly constructed sentence seemed a bit of a giveaway:

Please to help us proceed with your claims, this information must be kept away from public to avoid unwarranted abuse of the program or fraudulent acts from criminal minded and unauthorized person(s).

I am invited to make contact to claim my prize.  The contact is an 0161 number.  Where’s that?  Manchester?  It crossed my mind to take the letter to my local police station and ask them if they would be interested in investigating it.  I rather imagine the policeman at the desk would raise his eyes to the ceiling.  Perhaps I’d be done for mischievous misuse of police time.  What’s that expression used to describe people who make nuisances of themselves, for example, with outlandish requests under the Freedom of Information Act?  Vexatious.

I remember one night in Auckland getting home just past midnight to find I’d been burgled.  I called the police.  “We’ll try to get round to you, sir.  But you are the sixth tonight.”  I was being vexatious.  A relative in Glasgow had a similar experience, phoned the police, and said, “I’d like to report a burglary.”

“Not a burglary, sir.  In Scotland, the offence is house-breaking.”

It’s hard to impress the police.  They’ve seen everything.  One evening a few years back I conducted a GP home visit to a remote cottage in a rural location, where lived an eccentric and reclusive gentleman.  I had often visited patients living in conditions of neglect, but I’d never seen squalor quite like this.  I wondered if he was suffering from the hoarder’s obsessional condition, Diogenes Syndrome.  Basically, he was sitting in the middle of a tip.  He was boiling up some water in a billy-can balanced precariously on a gas canister and a naked flame.  He was surrounded by several tons of newspaper.  He also had, within easy reach, a .22 rifle.  I asked him what the rifle was for.  He said it was to protect himself against unwelcome guests.  I offered to arrange hospital admission for him; it seemed an appropriate way to get him out of this dire situation.  He politely declined, pointing out that there was nothing wrong with him.  It crossed my mind to have him sectioned under the Mental Health Act, but the process would take forever and in any case the psychiatrists would probably agree with the patient’s own assessment.  I suppose I might have concluded that the patient was quite entitled to live life as he saw fit, provided he wasn’t harming anybody else.  But sometimes as a doctor I think you have to put your middleclass liberal instincts to one side in favour of common sense.  After all, he was to all intents and purposes sitting in his own funeral pyre.

I decided to call the police.  In medicine, when you want something to happen, you learn to press the right buttons.  If my patient had been willing, I would have known how to persuade the ambulance to pick him up and the hospital to receive him.  But how could I persuade the police to act as an ambulance?  This was where the rifle came in.  They would not be able to ignore the rifle.  I went outside and made the call on my mobile.

There was a protracted silence, followed by a sigh.  I was reminded of the Two Ronnies sketch in which Ronnie Corbett and an attractive young lady are served in a restaurant by Ronnie Barker’s remarkably cheesed-off waiter.  There was nothing on the menu but rook.  My policeman was Ronnie Barker.  I was being vexatious.

“Is the gun loaded?”

“I don’t know.  I didn’t check.”

“Ah.”

But I knew I had him.  The rifle was the clincher.  If he ignored it, and it all went pear-shaped…

Anyone whose profession involves dealing with the public has to be mindful of the potential pitfall of sneering at that which is apparently trivial.  Doctors, particularly primary care doctors, have to be especially on their guard.  First up, we should never call a complaint “trivial”.  It begs the question, trivial to whom?  It can’t be trivial to the patient otherwise he wouldn’t bring it along.  Of course, many medical conditions are self-limiting and for those, the best possible treatment is reassurance.  A doctor who is overwhelmed by a plethora of self-limiting conditions can actually stop believing in the existence of serious pathology, and start believing it’s all in the patient’s mind.  I can well imagine a policeman could develop a similar lack of respect for the endless complaints of the public.  When a policeman, or a doctor, starts to think that everybody is just bonkers, it’s time to take a sabbatical.

So I’ve decided not to burden the harassed police force with my Euromillions.  I imagine the paperwork involved would be enough to furnish the slum of the man with Diogenes Syndrome.  And yet, I’m leaving a tiny gap in the crime statistics.  And I suspect that the millions of unreported scams that occur every day, millions of tiny gaps, must add up to a giant lacuna in our understanding of the world of lies and deceit we have somehow unwittingly created.  Sometimes I’m tempted to think the whole of human interaction is nothing but One Great Scam.  Maybe governments are the biggest scammers of all.  Aaron Copland has a song – Everyone’s a Dodger.  Even the parson’s a dodger.  What a thought.

Such accidie.  I am become the cynical doctor and/or policeman who stops believing anybody.  I’d better take a sabbatical.

 

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