Out of jealousy for his professional position, so I believe, he was described to me as an amateur. I don’t see him that way. He is kind. He is not confrontitive in a harsh way – and that helps people to examine their own behaviour just as well as, if not better than, being forceful.

Three people say that they have heard me say something, I must have said it – all be it as a slip of the tongue – and I have to apologise without any explanation.

No, I can’t to that. I have to run PROMIS (with Robin and Meg) according to what is best for PROMIS. I can hear the concerns and hopes of individual members of staff but I cannot afford to take them into account primarily.

We found his wrist splint on top of the wardrobe in his bedroom. For some reason he had poked out all the cotton wool lining and then slipped his hand out of it. Then he said that he had fallen over and hurt it and needed to go to hospital again. Earlier, on my mobile phone in the presence of the entire group (because I would rather keep him in the room so that he had a chance of being helped by the other patients) he had telephoned his mother to say that he was currently in Ealing (he was in Kent) and that he would be home by 2 o’clock this afternoon (he won’t). He had no recollection whatever that his family had brought him to the Recovery Centre yesterday.

After two weeks in Kent she wants to move to secondary care in London. As I have said before, I don’t treat appendicitis with Penicillin and Aspirin and I don’t give secondary treatment to people who need primary. If she leaves Kent she leaves altogether.

As Dr Theodore Dalrymple pointed out in an article in The Times, “In many NHS Trusts, bullying is defined as behaviour that causes a person to feel bullied”. There is no defence against that.

When counsellors become healers, they get in the way of the therapeutic process of the Anonymous Fellowships. We are guides, not gurus. The last thing I want for myself is a reputation as a wonderful counsellor. I am a catalyst: the real work has to be done by the patients themselves.

Robin is paid well, not because he is our son but because Meg and I value him for the work that he does. PROMIS would be a very different place without him.

I do basic check-ups all the time, when patients ask for one when and I think they are sensibly clinically. Today I received a report on a check up a patient of mine had gone through elsewhere. In addition to the routine history taking, physical examination, blood tests, chest x-ray and ECG, he had had an ultrasound examination of the abdomen (to exclude an aortic aneurysm) and pelvis (to exclude prostatic abnormalities), an echocardiogram (to exclude structure and functional abnormalities of his heart) an MRI virtual colonoscopy (to exclude polyps and cancers), MRI Tomography scan of the head (to look at the brain and the arterial system and the sinuses) and MRI Tomography scan of the heart (to look at the heard and the major arterial branches).

A comprehensive check-up of this nature will have cost a fortune but he obviously considered that it was worth it. Like it or not, there are some clinical conditions that can be picked up only on specific tests and they can be devastating if they are missed. On the other hand, one has to bear in mind the possible risks of each test and also the fact that the only test that is absolutely accurate is post-mortem examination. Also we should beware of creating neuroses in people who are perfectly healthy.

Clearly, doctors have to make judgements, within financial constraints and in considering the availability of diagnostic facilities and also through using clinical common sense. But this patient made the judgement for himself. This is his privilege because of his financial status. In time, the cost of the tests will come down, the procedures will become more accurate and the risks less significant. The concept of a check-up is sensible. The extent and the timing and frequency are debatable but even they can be judged more or less appropriately. Anyway, it’s the way things are going.

He has talent but no judgement.