Thursday, June 4, 2020

The dead fairy sign

Does your doctor have a protocol for fairy touch prevention for stroke prevention? It has only been hundreds of years for your doctor to come up with a prevention solution for fairies.  Is hundreds of years enough time for your doctor to do something?

The dead fairy sign

. 1998 Aug 8; 317(7155): 396.
PMCID: PMC1113672
PMID: 9694758

Graham Lewis, general practitioner, Hampton, Middlesex
Insight is reflecting on the words of others. In medicine this means listening to your patients. My memorable patient was a little old lady, who remarked towards the end of a long Monday morning surgery, “Oh, doctor, you have just killed a fairy.” Wondering if my ears needed syringing, I was creating a list of possible psychiatric diagnoses as the patient continued, “Didn’t your mother ever tell you, every time you sigh you kill a fairy?” I was forced to admit that she had not.
This was surprising because a childhood spent in Cornwall had given me a healthy respect for, and knowledge of, the unworldy. I had recently bought my wife, whose family was full of such odd sayings, a copy of A Dictionary of Omens and Superstitions. This book provided no reference to sighs, fairies, and death.
From then on each time I started to sigh mental images of fairies falling from the skies, dying in mid-flight, began to haunt me. These were not the fay, gossamer winged creatures pictured by Arthur Rackham that are again in fashion. My fairies were the original Celtic fairy or piskie. These are amoral creatures, childlike in nature, and capable of great malevolence. In folklore they were held responsible for those otherwise inexplicable episodes of misfortune that afflict us all. Indeed, until recently, being touched by such a fairy was commonly recognised as the cause of a stroke. These were not creatures willfully to destroy, for—like bees—would not the death of one cause the rest of the swarm to fall on you? My sighing days were over and I began to observe others.
Within the practice it struck me that certain patients singlehandedly slay fairies at an almost genocidal rate. On entering the consulting room they have slaughtered several before seating. More lie mortally wounded as the first sentences are uttered. These patients usually present with a list of multiple symptoms or complaints. These patients are difficult to manage, frequently returning with yet more worries or symptoms. My newly discovered mental imagery now revealed a trail of fairies, dying fairies, spiralling down like sycamore seeds in the autumn winds, as these patients left the room.
I now understood why, whatever the advice I proffered, they would soon return with yet more woes. For dogging their steps, growing ever more malicious, were the surviving fairy brethren. Angered by the untimely demise of their kinsmen, they would now ensure misfortune to guarantee the patients’ return. It dawned on me that a chance remark by a little old lady had revealed a new category of patient. These were not just depressed, stressed, or heartsink. They were fairy killers.
Some patients, caught early enough may, like me, benefit from this novel insight. The more Rambo-inspired all seem to have been blinded (by the fairies?) to any possibility of insight. An attempt at explanation only lead to the sort of puzzled look I originally gave the little old lady. Any effort to push the concept is unnecessarily dangerous. The patient could leave the list or, worse still, the local community mental health team might begin to pay me undue attention.
However, now as they leave the room from a supposedly final consultation I can unfailingly spot the patient who will shortly return with yet another tale of woe. For as the surgery door closes, there lying on the floor (visible only to those with eyes to see) and gasping its last breath is a small dying fairy.
And the little old lady? I never saw her again.

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