HOW TO EMBRACE POOR HEALTH

Robert Simpson gives medical

advice to those who no longer wish to work, but need a regular income

I PROPOSE to set myself up as a consul- tant to advise patients who want to embrace poor health instead of work.

You have been subscribing to an insur- ance policy to cover you against loss of earnings from prolonged illness or acci- dent. You have been particular to find employment with a company that guaran- tees a substantial part of your salary in protracted illness. And there is the Wel- fare State.

I am assuming that you didn't marry into money. If you were smart enough to do that, you don't need my help.

Tell no one of your plans, least of all your woman. Much better that she should love you and your ailment for your own dear sake. In any case, she might spill the beans.

The big problem is to find an appropri- ate illness.

Your whole splendid future depends completely on obtaining from the doctor medical certificates for your employer and the insurance company verifying that you are quite unfit to work.

Ideally, you should select an illness inca- pable of precise diagnosis by any known scientific test. Avoid any site of the body that can be inspected or approached through one of the orifices. Most certainly don't mention your bladder or they will ram a periscope into your tully-wagger. Surgeons enjoy doing that. Equally humiliating is what is called sigmoidoscopy — direct inspection of the bowel.

A bank manager may bully a client, a professor may ridicule a student, a general may terrify his troops, but none of them has the power to whip down a man's trousers, bend him up, knees to chin, and push up him what feels like the muzzle of a trench mortar with a light on the end of it.

So don't claim that you are crippled by your bowels. Utter not a whisper that your orifices are in disarray. Avoid any com- plaint which might call for a surgeon. They are such meddlesome fellows that no part of the body is sacrosanct. They go pushing catheters into arteries and veins. Even one's heart is no longer a private place. Angina used to provide a marvellous retreat into invalidism because quite often its presence was diagnosed purely by the patient's description and history of the pain, and not on physical findings. You could have angina in spite of a normal elec- tro-cardiogram.

Years ago I knew a man who was accepted for a substantial life assurance after he had been admitted to a private hospital and tested and probed by doctors for two days. They did every test, he said, including looking up his nose to make sure his ears were on straight. He dropped dead of a heart attack three days after paying his first premium. The company had to pay up. Wasn't that a wonderful coup? It's pos- sible to beat the doctors sometimes.

Adopt a disease with symptoms that don't obstruct your physical activities. Angina, therefore, is a symptom to be avoided; your doctor would hesitate to approve a trip to the top of the Andes and he would be surprised to learn that you had climbed the Pyramids. You have always wanted to travel.

What we doctors call positional vertigo Is capable of some exploitation. It's dizzi- ness, associated with particular move- ments, and frequently we cannot find the cause of it, but it has this drawback: your GP may say it's unwise to fly when you have positional vertigo. Avoid any complaint remotely associat- ed with the brain, because you might find yourself subjected to some very unpleasant tests. A patient of mine had an angiogram performed two years ago. A dye gets injected into the arterial system in the brain. My man hasn't been right ever since. He has consulted his lawyers. On the other hand, slight deviations from the mental straight line are a fertile field for the man who feels he could go for long spells without working. Adopt mental peculiarities which are just a little off-beat: eccentricities and idiosyncrasies which endear you to your community. At all costs avoid anything that might get you labelled as manic, violent, psychopathic or schizophrenic.

Be careful not to get locked up as a lunatic. Avoid actions which could label you as perverted. Foster the impression that you are entertaining, amusing, with a good line in patter, benevolent, avuncular, gentle, and totally harmless to children and small animals.

Your new self cannot be grossly differ- ent from the old 'you' because this 'illness' isn't going to kill you and you have to live with yourself for perhaps another 40 years at least. Your new mask has to be some- thing that you can wear lightly and painlessly. Think of the benign version of the absent-minded professor. Wear differ- ent-coloured socks on each foot, don a pink velvet bow-tie for serious occasions and cause consternation among your

'I see you've had your mid-life crisis.' friends more by what you do than by what you say.

You mustn't do anything that would bring the law down on you. Don't put rat poison in your neighbour's port wine. Walk the tightrope between the socially acceptable and the slightly outrageous that causes a titter, but don't be too much of an embarrassment to your dear wife because you are depending on her going with you on your travels, to deserts, moun- tains and mirages. Getting away from home appears to improve your health miraculously.

Because of your poor health you won't be allowed to drive your car, but then who wants to, if his wife is prepared to do it for him? She will make hotel bookings, check arrival and departure times, rid you of boring nonentities, be a very thorough but- ler, aide, valet and driver.

At no time must you indicate that you are unfit to administer the family financial affairs. Never indicate that such affairs are not your concern; just quietly take charge of the moneybags.

You may be extremely forgetful flushing other people's spectacles down the loo and going to the vet to get your yellow-fever injection — but you must never forget your good manners. At all times, be understanding, courteous and charming to your betters, meaning those on whom you are completely dependent to carry off your charade. There are so many ignorant and rude people about that your impeccable good manners will mark you out as someone very special. However, you don't have to prostrate yourself before bishops or kiss the mayor's ring.

Be particularly polite to your distraught wife and family. By opting out of the main- stream, you may be condemning the chil- dren to a second-class education. Young Orson may feel that your fecklessness has deprived him of a Harvard doctorate.

At times you may be driven to distraction by your family's inability to understand the new you. But don't throw a tantrum. Avoid hysterics, otherwise you will be taken to the doctor to have your face slapped. If you are completely nonplussed or even insulted by an unsympathetic remark, adopt the hurt, confused look of a duck in thunder and, as quickly as possible, let your good nature shine through again.

You will quickly learn to perform mental and emotional cartwheels that will amuse you, remembering that you are doing the whole thing not only for a livelihood, but also for your own entertainment.

Think of the millions who struggled out to work this morning hating every minute of it. Don't laugh out loud.

The author is a practising doctor and was Minister for Community Relations in North- ern Ireland 1969-71.