One of the things that especially appeals to me about general practice is the way that people continue to present me with angles on their problems that I have not met before. Sometimes this causes me to re-evaluate my own assumptions and preconceptions in a way which can be challenging.

Not long ago a young woman came to see me. “I think,” she said, “I could be suffering from premenstrual tension.” I have learnt over the years to be suspicious of the conditional when used in this way. Women seem on the whole to be decided on this issue, only rarely do they want my opinion as to the nature of the diagnosis. So I asked her what made her think so, expecting to receive the usual catalogue of unhappy and uncomfortable symptoms loosely related to the days before her period. But such was not the case. Her boss, she explained, was a …