the doctor's shame

I behaved badly this morning. A young man comes in to discuss his antidepressant treatment. I know him well. He has been tried on a variety of therapies; drugs, counselling, assessment from the local psychiatric team: none has been of any real benefit to him. The psychs wonder if he has a "depressive personality disorder" which is another way of saying they can't do anything for him, and don't really want to try any more. He saw one of my partners a couple of weeks ago, when a range of options was put to him, without any firm conclusions being drawn. I read out the notes made by my colleague on that occasion, and invite comment. He just seems to stare out past my right shoulder and says nothing.
"Excuse me, are you even listening to me?", I ask, a little brutally.
His eyes fill with tears and he stands up.
"I just can't talk to you" he states, and makes to leave. I attempt to stop him, saying we must talk, but it makes no difference.
"Please!" I shout, but he is gone. There is a moment's anger. What the hell am I supposed to do? I ask myself. But then I realize I have stamped on his fragile ego in a quite unacceptable way. Without waiting for him to issue a complaint about my behaviour (I doubt if he would anyway, such is his apathy and lack of drive), I write a letter of apology for my unprofessional conduct and arrange for my staff to deliver it to his flat by hand. This is something I very rarely do, but it seems the right thing to do in the circumstances. For the rest of the day I am in the shadow of my appallingly insensitive behaviour.

This afternoon I begin the arduous task of shelling the 2000-odd hazel nuts harvested from the tree in our garden. It takes me back vividly to the autumn of 2006, just after my son died, when there was a similarly bumper crop, and it seemed God was compensating us for our loss by granting us this small bounty. In truth it requires a fine, warm summer for our hazel tree to perform. The summers of 2007, 8 and 9 were all miserable, damp and cool, and we didn't find a single nut in any of those years. But now I have this wonderful (if time consuming) gift once again. When I have finished, and I calculate the whole project may take anything up to 10 hours, we will have enough for 3 or 4 nut roasts to share with carefully selected friends and neighbours. And it gives me something to do while the girl is away. I have yet to hear whether she has arrived safely in the Holy Land, but there have been no reports of plane crashes either, so I assume she is OK...