What's his is mine.

One common sign of drama is tears.

She had not been seated 2 seconds before they started to flow. Heavily, between sobs.

Depression excluded.

Experience has taught me that patients who are depressed rarely burst out crying in that manner before speaking. Especially when they had been happily chatting with a member of reception staff one minute before. (Yes, we notice these things).

I was in an unfamiliar room and looked round for tissues. There was none to be found. Good.

"I'm sorry, I haven't got any tissues. What's the matter?"

The tears stop quickly. She had made her point that this was very serious....and I had no tissues.

"I am not sure how you can help me" sob, sob. "My husband is hiding money from me!"

I am listening now, my mind is sympathetic. I am trying to recall all the local Domestic Violence and Women support group contact details. I am thinking Financial abuse here, planning my assessment questions.

"I mean, don't get me wrong, he is a nice husband and dad, he gives me all the money I need and I have access to our joint account. He does not monitor my spending or anything like that."

Okay..... Scratch the financial abuse line of thought.

It turns out her husband is spending some of his own money on things he likes, without telling her. She stopped working to have children, had two children, the younger was nine years old. Her husband had encouraged her to return to work a couple of years ago but she is not prepared to do so.

She is not suspicious that he is having an affair or accumulating debt. She just wants him to tell her how he spends his extra money.

My time is ticking away so I am trying to medicalise this whole doctors appointment business.
I start asking questions to explore depression, anxiety, delusions....all negative.

"I know you are not a marriage counsellor" she says

You do?!!, I do not say.

"But I asked him to go to marriage counselling with me but he won't because he does not see any problem with our marriage. I mean, there isn't any problem in our marriage really. It's just this issue bothering me"

She goes on to give more background to the marriage, children, etc. I look at my watch. Time's up. Now I am running late.

"Is there anything I can do to help, medically?"

"I am not sure really, can you suggest a marriage counsellor. I have found some but they are a bit too far for me."(20 minute drive)

"Might be a good idea to try and convince your husband to go with you first." I suggest. "I'm afraid I haven't got much more time left, you can arrange a review appointment if it becomes a problem for you as we discussed"

"Ok, thank you doctor. Please can you just look in my ears, I think I have wax...."