Our practice has a shop-like roller shutter door. We arrive early each day, to prepare the department, attend our 15-minute bullet meeting and to indulge in a quick coffee, before the rush of the day.

It has become a ritual to watch the door as it rolls up, at opening time, every morning. It marks our first interaction with patients, and is a surprise package. It is also bizarre, because we see people from the shoes first, with a slow reveal up the body until, finally, the face emerges. Definitely a different take on the first impression.

One morning, as the door slowly rattled up, we saw three pairs of feet, close together. When the full picture was revealed, we saw an agitated young woman in a black hijab, accompanied by an anxious young man. It transpired that they were a newly married couple, recently living in South Africa, from Egypt, and accompanied by the groom’s brother, who was translating for them. He was clearly their confidant.

The wife spoke first. She wanted a divorce. Her husband did not love her. Rather puzzling, I thought, after only a few weeks of marriage. What could he have done to illicit such an extreme reaction? So soon? I imagined abuse or infidelity, or perhaps, family meddling in their marriage.

Not so. The brother then painted the picture for me. The couple had approached him for advice, shortly after the wedding night. He explained that the groom could not last more than a few minutes before ejaculating, and his wife was left unsatisfied, angry and confused. She was convinced that this was proof that he did not love her. The brother had all but given up trying to advise the couple. It seemed nothing was helping. The situation was escalating and her fury was undiminished. I was surprised at how much intimate information had been shared, so freely, and so soon, with him. I was also puzzled by the intensity of the anger.

I asked if it was an arranged marriage, and they said not. I asked if they loved each other before they got married, and they replied in the affirmative. I asked if they had any sexual experience before the marriage, and he said not. She was evasive, and I decided not to pursue that any further with her. I asked her if her husband was kind and loving and accepting of her, and she said he was. I looked carefully at her face, as she spoke, and it seemed to me to be an honest answer.

Anger can mask fear, sadness or vulnerability, and I was acutely aware of how sketchy the picture that was presented to me that morning was.  I felt at a loss as to how to proceed in a helpful way. In the end, I did what doctors do. I wrote a script:


  1. Be kind to one another.
  2. Be kind to yourselves.
  3. Believe in each other.
  4. Trust each other.
  5. Be patient. Give it time. Life is a long walk with many challenges along the way. This is just the first of many.
  6. Share and own the problems that come along.
  7. Educate yourselves.  Chances are, others have experienced exactly what you are going through. Use the wealth of literature available to learn from others’ experience.
  8. Never forget to have fun.

We discussed the script at length, giving some concrete examples of how to approach their specific problem, and they left, seemingly more hopeful.

I have not seen them since. I hope that they found a better way to connect and communicate. Perhaps they found my advice trite and unhelpful.

I’ll probably never know.