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Mrs Enid Perkins was one of those patients a sensible GP tried to avoid. If discovered away from the protective walls of the surgery, her strident voice could be heard by all complaining about the appalling state of the health system, or worse still, how poor Percy’s prostate woes were no better and, ‘Exactly what are you going to do about it, Doctor?’

The woman controlled the lives of her husband and children with reins of steel, allowing no diagnosis to go unquestioned and no treatment unchallenged. But still she returned, week after week, leaving quailing receptionists and frustrated nurses in her wake.

One day, Mrs Perkins sat in the waiting room quietly. She did not arrive ten minutes early, demanding to be seen immediately. Neither did she harass young mothers, whose children were usually in her opinion quite out of control. No harrumphs of disgust were heard as she flicked through the pages of the latest women’s magazines.

In my office, she failed to berate me for my lack of a tie and sat without ceremony.

The breast lump she allowed me to examine, after declining a useless chit of a girl as a chaperone, was hard and craggy and accompanied by an obvious lymph node.

The indomitable old lady offered no argument to the likely diagnosis of breast cancer. She had no comment to make regarding my plan to refer her urgently to the dreadful local hospital. Sitting quiet and still, she stared at the wall opposite as tears rolled down her wrinkled cheeks.

“Whatever will Percy do without me?” she asked.

An awkward pat of her arm was my only reply as Enid Perkins crumpled before my eyes. Some time later, dry-eyed and stiff-backed, she settled her account and left the surgery.

I did not see her again. Swallowed whole by the bureaucratic machine that was the Public Hospital and Palliative Care Service, prescriptions alone were my only contribution to her care as she rapidly faded. And died. My failure to know just what to say prevented any positive action on my part.

Three months after she died, Percy Perkins spoke for the first time of her during a routine visit. “You know, doc, it was odd. My Enid never once cried, not even at the end.”

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A/N: Both Enid and the doctor are figments of my imagination. However, they are moulded by twenty-five years experience practising medicine and the personalities and situations that I have encountered over those years. So often, I become aware the face presented to me in the consulting room is a careful construct, and the real person behind the patient remains a mystery.