There’s a program on British TV called Britain on Benefits, or Benefit Street or Sneer at the Impoverished or something. A colleague recently mentioned a particular episode to me. Apparently the woman featured is unable to work because she suffered from anxiety attacks. The show recounted how she didn’t have any money because all her benefits went on the thing she used to help her cope with her attacks – getting a tattoo. That’s just ridiculous isn’t it? Actually, based on my experience, not necessarily.

This week is National Carers Week. A lot of people will rightly be helping you to learn about caring. Instead, I would like to tell you what caring has helped me to learn. We’ll come back to the tattoos in a minute, but I want to start at the beginning.

There’s a disabled space in the car park where I work, and it infuriates me when it gets used by people who don’t have a disability. One customer explained to me that he’d used the space because he was tired. As a consequence I had developed the habit of looking to see if any of the people who got out of the car in that bay have some sort of disability. The trouble is that disability is not that easy to see. You can’t see blindness, or detect chronic pain. There are plenty of conditions most non-medical professions would never have heard of. My wife carries around a little card explaining her illness. Where appropriate she hands the card to medical personnel who know less about her illness than she does. There’s a lot to know, and even the experts can’t know it all.

Even if you know what’s wrong, understanding what it means is a different thing. After ten years or so I am still learning how my wife’s partial sight impacts her, and what I need to do to best support her. Being aware someone suffers constant pain is not the same as understanding how demanding and exhausting walking 50 paces can be. Only this week I discovered that her partial sight means that she finds it difficult to negotiate situations when we are both going through the same doorway from different directions. Until then I had simply assumed she was being obtuse. And we've been married for 13 years.

Given all this, how dare you imagine you can judge how able bodied someone is by seeing them get out of a car? Doctors tend to take patient histories (and also degrees) before arriving at diagnoses. Are you a doctor with a patient history to work with? No? Then sit down Commander Judgey, you don't know what you're talking about. Why are you even asking? Because we've all been made little policemen, haven't we? All constantly being told that everyone else is on the fiddle, faking injury, scrounging money they're not entitled to, and snaffling other people's parking places. Rather than acceptance, tolerance and desire to understand, this fosters a climate of suspicion and mistrust in which people are self appointed experts on the basis of nothing more than an artificial necessity. Which brings me back to tattoo lady.

Mental health is more complex, to me at least, than any other aspect of medicine. It's easy enough, relatively, to tell if someone has a broken leg. You can scan it with an x-ray machine, which (usually- I've seen House MD) finds the problem. But finding mental health problems is way harder, and you can't usually do it with blood tests or a CAT scan. I don't know why this woman copes with her anxiety disorder with tattoos. But I am willing to offer a suggestion based on human beings I know. I've met a few abuse survivors who have anxiety problems. I've also met quite a lot who feel they have lost control of their body, and want to reclaim it as their property. Several I know have done this with tattoos. Most of the survivors I know have tattoos. I'm not saying this lady was a survivor, I have no idea. All I'm saying is that it is explicable. It's probably explicable in ways I'm not aware of. If we stopped wandering how we're being tricked and started asking how we could help, we might find that the whole world gets a tiny bit better.

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