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The patient most feared
IN his 1969 film, Take the Money and Run, Woody Allen has his antihero, Virgil Starkwell – a petty crim – captured, convicted and locked away. When caught breaking prison rules, he is subjected to a particularly horrific punishment – he is locked in solitary confinement for three days and three nights with an insurance salesman.
As the Armani-suited, briefcase-toting salesman follows the hapless Starkwell into the tiny underground cell and the door slams shut over their heads, one experiences the sense of dread conjured up by a level of hell not imagined even by Dante himself.
It is the same dread that chills one’s marrow as the surgery door closes behind the most feared of all patients: the Loquat.
Though still unrecognised by Medicare Australia, loquaciousness is a disorder every bit as rampant as obesity and even harder to treat. Quite apart from its oppressive toll on the community at large, it is estimated that the eradication of this odious affliction would eliminate overnight the workforce shortage.
Just recently, the Department of Conversational Studies at Yale has released a diagnostic tool to aid in the detection and treatment of this appalling malady.
Class I Loquaciousness: Like nature, the patient abhors a void, and will fill any silence with a steady stream of conversation. Such conversation is often, though not always, relevant, and can be successfully interrupted by the clinician.
Treatment consists of elimination of conversational voids by the clinician, who thus (ironically) becomes the source of what has been termed ‘prophylactic clinical verbosity’ (or PCV).
Class II: The patient does not wait for a void in order to initiate conversation, the latter being largely irrelevant, rampantly digressive and often resistant to PCV.
Treatment consists of prearranged interruption of the consultation with a mock emergency.
Class III: The patient has mastered circular breathing (often self-taught), thus rendering all attempts at interruption ineffectual. The conversation itself is meaningless, irrelevant and exhaustingly inexhaustible.
The treatment consists of laryngectomy, most often obtained through a community treatment order, as the patient is manifestly a danger to all those within earshot.
The study of verbal diarrhoea has yielded some interesting results. Recent genetic testing carried out on 156 Class III patients recruited from Federal Parliament has revealed the existence of an Interlocutory Inhibitory Gene (IIG) which allows for the ordered cut and thrust of normal conversation.
It would appear that when this gene is switched off, afflicted individuals are no longer aware of the fact that those around them are capable of speech.
The search for triggers that might switch off the IIG would seem to indicate that such ill-fated individuals, in early life, are led to believe that they have something of interest to say, even when it is abundantly apparent that they do not.
Eradication of this blight, therefore, would favour a return to the precept that young children should be seen and not heard.
Until then, we as clinicians can only continue to lobby Canberra for a loquacity loading on all consultations.