Drugs: who cares?
On an ordinary Monday morning, 11 year old James and his mother visited the surgery. James's medical record contained a referral letter with a reply, about some behavioural problems he was having a year ago, from a community paediatrician. The surgery is located in a poor neighbourhood in Nottingham, and these kind of referral letters are familiar to me, even though I have been working as a junior doctor here for only two months.
Before I can even introduce myself, the mother starts talking about the hopeless situation with James and the way it affects her own depression. After listening for 15 minutes, I know that James has been suspended from school several times because of fighting and bullying, that he has no playmates, that he steals from his mother, and that there is absolutely no corrective measure that affects this behaviour. James looks uninterested and laughs about these stories.