Interesting Questions. Interesting Answers.

Question 1 - What do you do for a living?

Question 2 - For how long do you think you should take these tablets?

I started three very different patients on antidepressants this afternoon. For some reason I asked all three the same question. The three supplied exactly the same answer.

“For as short as time as possible.”

Question 3 - What is the percentage chance that you’ll have a heart attack or stroke in the next ten years?

In Scotland we score cardiovascular risk with a nifty tool called ASSIGN. Smoking and diabetic status, blood pressure, and lipid results are sensed by my computer and an ASSIGN score, my patient’s chance of having an MI or stroke in the next 10 years, appears bottom left corner of my monitor. It’s bold and red and expressed as a simple percentage. Even I can understand that. So can my patients. Ghoulish, like most computery things, but comprehensible.

Twice last week I discussed ASSIGN scores, one face to face, second by telephone. I explained the rules of the game. Didn’t let on that the answer was blinking at me. Then asked the question.

Patient 1 was 60 and a harassed electrician. “50%?” Nope, 15%. Phew!

Patient 2 was same age as me, 50, but a little overweight. Cholesterol 6.2, average in our regional gene pool. MI risk? “60%?” Well, actually, 3%. And of course, to put it another way, that’s 97% chance of not having an MI in the next 10 years. Have a good weekend.” I hear the sound of skipping over the phone. Great start to a Bank Holiday weekend. For both of us.