• general practice

“Am I pregnant?” she asked nervously. Of course I had no idea but it seemed unlikely from her history. She was determined not to take a test and just wanted me to say “no”. I couldn't. “Well maybe it's just my hormones?” she asked again, hopefully. I could give her no certainty about that either. She is a 32-year-old full-time city worker holding down an intensely demanding job. She looked exhausted and exuded nervous energy. There was plenty of life stuff that might be causing her erratic periods and tiredness, but nothing she wanted to examine, as long as I was sure she couldn't blame her hormones.

Next up was a 23-year-old sedentary secretary with mild facial acne and a degree of obesity. She was sure she had …