you are called to review a 26 year old doctor in London. he is currently at a career crossroads of sorts partly due to the fact that the profession he is working in is dying a slow painful death under the weight of beaureaucracy, and, that life satisfaction is at an all time low because of the vast amount of time invested without reward in said profession. tonight he is attempting to review a series of topics for his postgraduate examination tomorrow. however fatigue is clearly setting in and you note his heavy eyelids of exhaustion as he thumbs through yet another book of practice questions. you note no rashes and he has no pets but has travelled to western canada earlier this year.
what will be the MOST appropriate way to manage this patient? (select best response from five)
A. sit down with the patient and explain to him that everyone has doubts about their direction in life at some point. this is most likely a transitory period and if in a few months he still feels this way then perhaps some time out to rejuvenate and reflect may be very beneficial. as for the exam, it is not the be all and end all and also can be sat again if necessary.
B. slap him about and kick him in the nads because he's an annoying fuck and deserves a good kicking.
C. nod sagely while he drones on with his "nah nah nah but what is the point if medical training is being sacrificed for meeting government targets nah nah nah" and see if there's anything worth nicking from his flat. hmm... 20 GB 4th gen ipod in corner... doesn't appear to work though...
D. pick up his immaculately compiled revision notes, rip them up then taking a dump on the shreds whilst saying "how do you like that bitch? how do you like that?"
E. intravenous antibiotics and urgent per rectum examination
5 minutes allocated. answers tomorrow.
[I am listening to Hope by R.E.M - formerly Leonard Cohen]