Medical Matters:A new report, the Pfizer Health Index, shows that we Irish are "incredibly positive" about our health, and, it would appear, with little reason.
At the same time, a HSE report suggests that the "demand-led" appetite for medicines is insatiable. An image comes to mind of a cheerful crock, breakfast roll in one hand and pint in the other, happily downing pills and keeping a step away from the grave; partying on, as suggested by Charlie McCreevy.
We would appear to be a nation of substance, not style, and most of the substance is around our waists and backsides. Or maybe not. Budgets and forecasts are merely educated guesses.
Maybe as our population swells we need all this stuff. People live longer. Medications change. What was once a fatal illness may now be quite manageable.
Rheumatoid arthritis, for example, is well on the run. Maybe we should revise the budgets upwards, remind the Government and the HSE that it's our money after all, and keep the show on the road. What would Alex Ferguson do - he's used to managing?
On the other hand, it could all be an incredible waste of resources. Maybe if we provided exercise facilities, taught children how to cook and eat healthily and created an outdoor, family-orientated culture, we wouldn't need all these chemicals. Our lipids would be low, our glucose normal, our bones strong and our mood good. The pharmaceutical companies would lose a fortune in statins, diabetic drugs, osteoporosis treatments and anti-depressants, mind you. But what does it matter as long as we're positive?
To be honest, I often find a determinedly positive person hard to manage. Every doctor knows the type. He is in great form. He has already had one heart attack. He has diabetes. He smokes, drinks and agrees with everything you say.
"You should give them up," you say. "I should," he replies beaming at you.
"Your blood tests are all over the place," you say. "I know. I know," he replies.
He looks on you as his best friend and thanks you for everything. Maybe he has a point. At least he'll die happy, or as happy as any of us.
At the other end of the scale are the "worried well". They are blessed with good health, if only they knew it.
Every spot, ache, twinge and sniffle is treated like a huge catastrophe. If a test result is negative, the news is received with profound disappointment.
"You mean you don't know what's wrong with me, doctor?"
If you try to make light of the symptoms you are an unfeeling brute. I used to reassure this type of patient that they were in better shape than I was, but as I become more spectacularly decrepit, this strategy has had to be abandoned.
The "worried well" remind me of the reply the newsreader Ann Doyle gave when asked if she minded turning 50. "Well, when you consider the alternative . . ."
Maybe the odd ache and pain are there to remind you that you're alive so far, and there's worse to come, so enjoy it while you can.
I presume the respondents to the survey told the truth. It is part of our post-colonial heritage to lie to the police, civil servants, tax officials and anyone in a suit.
"So you spend four hours a day in traffic jams, you have a bad back, an ulcer and high blood pressure. You will have to wait years for an outpatient appointment. How are you feeling?
"Incredibly positive!"
Of course you are. Ask the same question in the pub tonight and see if you get the same answer.
Mind you, the non-nationals who responded to the survey felt even more positive than we did, but that is not so surprising. They are young, they are thin, they do the hard manual work that the Irish won't touch and save on the minimum wage.
If they get sick they go home. They are not impressed with our health system either. Hopefully somebody has asked them about that.
I would not care to be sick in Ireland. The arrival of baby Laura to the Harrold family this summer gave me a mere glimpse of a hospital system run by well-intentioned people, but collapsing under the weight of numbers.
When you spend much of your working life on the phone or writing letters, trying to access healthcare for the public, the private, the semi-private and the it-all-depends patients, you realise that things are bad.
When you stroll around the hospital and see the huge crowds in outpatient departments, in casualty, even in the car parks (where the new private hospitals are supposed to go), you realise that we have a crisis.
The Pfizer Index says that 36 per cent of the respondents claimed to have a medical condition. Yet they're happy. And medications are jumping off the shelves. It all reminds me of something a London dole officer told me years ago. He said the nicest, humblest people in the world were the Irish. They were also the least likely to stand up for their rights and to complain. Maybe the Irish have changed, maybe not. Keep taking the tablets.
Dr Pat Harrold is a GP in Co Tipperary.