Opening my BMJ a few years ago I was delighted to read that a disability which had caused me considerable distress all my life was a recognised condition with an imposing title called ‘PROSOPAGNOSIA’. This word is derived from the Greek prosopon — face and agnosia — not knowing. (The internet uses a name that is easier to spell viz. ‘Face Blindness’.) This difficulty in recognising patients and colleagues has caused me endless problems as a family doctor.
When I started general practice in the 1950s there were no receptionists or secretaries (or computers). The custom was to open the waiting room door and say, ‘Next patient please.’ A woman would enter the surgery and my nightmare would begin. Not knowing who she was I would say politely, ‘What can I do for you today?’ But the crunch came when I had to write a prescription for her. ‘What is your first name?’, I would ask, desperately hoping she would say Jane Brown. If she replied ‘Jane’ I was sunk and had to admit defeat. ‘I am afraid I have forgotten your name’, I had to confess. ‘But you saw me at home last week when I was confined to bed’, she replied. ‘Ah!, but you look different with your clothes on’, I would say triumphantly. But this was an excuse that wore thin and could not be repeated on future occasions.
Colleagues too were a problem. I met one in the car park one morning and after holding a rather confusing conversation for a few minutes had to admit that I had mixed her up with another female doctor. That very afternoon I accosted the same woman and said to her, ‘I confused you with another doctor this morning!’ ‘You’ve done it again’, she retorted rather coldly, leaving me shamefaced once more.
Prosopagnosia can result from brain injury and is then designated as acquired. But the commonest cause is probably genetic, and parents and siblings may have the same condition. In my case my mother shared my own difficulties with facial recognition. She had married a clergyman and one Sunday after church service she asked a young female member of the congregation how her new baby was progressing. ‘I am Miss Smith’ came the steely reply. (In these days unmarried mothers were not commonly present in the average congregation.)
Eventually I tried to spread the word among my patients that my ability to recognise people was severely restricted. If I failed to smile at them in the local supermarket, chemist, or even in my surgery they must not assume I was rude, uninterested, or snooty. Their GP was simply a confused, distressed, but genuine prosopagnostic.
- © British Journal of General Practice 2018
