Doctor's Review: Medicine on the Move

April 27, 2017

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Eccentric patients I have known

What doctor hasn’t wanted to write a book about their practice?

Family medicine can be a challenge, no doubt about it. It also has its lighter moments — and some puzzling ones as well. Here are a few such patient encounters taken from the diary of a British physician. He’s collected them in a book length manuscript, Unclaimed Ashes: Reflections on the Art of General Practice, which is currently making the rounds with publishers.

Worms, you say, Mrs. Hodnett?

This morning Nel, one of my receptionists came into my office with an apprehensive smile on her face. She was carrying a large jar filled with water and, swimming around in it languidly, was a worm. Apparently, a Mrs. Hodnett had come in saying she’d found it in the toilet and could she be infected she wondered. Apparently the toilet was only used by her and one other, the gardener. I was pretty convinced that it was an earthworm and told her so, but Nel said that my partner Bob was convinced otherwise and that we should send it to the lab for analysis. Later in the day the lab rang with a confident and slightly amused diagnosis of an earthworm.

A suspected case of exploding foot

Returning to a mountain of paperwork after a short holiday, I came across a letter from Hector Muriel, which asked me if I had heard of exploding foot syndrome. He had attached a cutting from a newspaper in which the comedian Warren Mitchell gave a detailed description of his symptom patterns. Hector was convinced that he, in turn, was suffering from the condition and it took a while to reassure him that it was extremely unlikely.

Multi-coloured stool attack

This evening I had a long a baffling conversation with Billy Herring about the colour of his stools, which had turned green and orange on different days of the week. He also told me that he was now convinced that he was suffering from mercury poisoning from his fillings and was considering having them all replaced. Most baffling of all, was the fact that as he came in to my office, he told me that his father had died last week and yet, Billy seemed curiously detached about it all. I fear for Billy, who at 39, is obsessed with abstruse and strange conditions that may or may not afflict him and, in particular, I believe he spends an inordinate amount of time researching such things on the Internet. Today, he brought me two stool samples, one green, the other orange and wants me to have them tested for mercury.

Kill that chicken

I saw Howard Jenkins again and, as usual, he was accompanied by his wife Winifred.

After I had checked him over again and reviewed his angina, she looked at me conspiratorially and said, “I wouldn't advise you to keep chickens unless you've got a lot of time,” and then added dismissively, “Oh well, we’ve taken up too much of your time already so you mustn't let me ramble on.”

I smiled and asked her to tell me what she meant.

“Well my father was a farmer and we kept chickens and I was in charge of looking after them. One day I had to walk a mile to have one of them killed. On the way, I let it peck around in the grass and I never saw it again. We don't eat meat, do we Howard, what with the way they treat animals these days.”

I listened to her and as usual found myself shaking my head after she’d left at the surreal way in which she engages me in conversations like this.

The Baron’s sensitive stomach

Baron Grunwald was in a somewhat exuberant mood this evening. He told me he had felt so much better last week when I had given him some tablets for his upset tummy that he’d gone out to have a curry. Unfortunately his symptoms flared up the following morning.

“Now Doctor,” he said. “What is to be done? What do I eat?”

I examined his large corporation and found him to be a little distended.

As on our previous meetings, he was wearing a collection of thick gold bangles around his wrist and his neck was festooned with a collection of gold religious symbols. Today, he sported a canary yellow jumper and yellow cord trousers. He had a very loud presence to say the least.

“Now you’ll never guess what I bought from Harrods last week,” he said with a broad smile.

I looked non-plussed.

“A Shar Pei puppy!” he said with a flourish of his wrist.

My jaw dropped.

“And guess how much it cost?”

I suggested £2000, but of course I didn’t have a clue.

“Five thousand pounds,” he proudly declared.

As it turned out, his two Burmese cats were extremely jealous of the seven-week-old pup and had immediately pounced on them intent on tearing it to shreds.

“So I rang the manager in tears,” he said. “You see I practically live in Harrods, they know me so well. The manager said of course you can bring it back.”

He got up to leave. “Thank you so much,” he said, walking briskly out to his bright yellow Ferrari, parked in the practice car park like a gleaming jewel.

A not so serious cough

Some months later the Baron made an appointment because, he said, he was worried about his cough.

“Please don’t let it be pneumonia, I don’t want to die,” he pleaded in a plaintive tone. He had started himself on some Augmentin yesterday that he’d horded some time ago and today, he wanted more.

After I had examined him and reassured him fully that his cough was not pneumonia he turned to the subject that was really bothering him.

“This erection business,” he said. “What are we going to do?”

Earlier I had referred him to a specialist in Harley Street and matters had taken a rather ugly turn when, a week later, the Baron had bumped into his consultant outside Harrods.

“That f***ing man,” he said. “He had the cheek to ask me how my prostate was in the street. How dare he?”

And there was something else. He wanted to show off his new Piaget watch, which he had just bought at Aspreys that week.

“You mustn’t tell my wife,” he said with a conspiratorial wink. “But guess how much it cost.’

I hazarded a figure, which was, of course, ludicrously low.

“Twenty thousand,” he said, flourishing the thing like a matador waving away a bull.

Yes, we have no bananas

Benjamin Brightlington is a large, 1.9-metre-tall asthmatic with an intense distaste for anything to do with Europe. He has told me this on many occasions, believing that the EU is a conspiracy to deflower Great Britain of all its power.

One time he had regaled me with a story about a grocer who had dared sell a pound of bananas and had received a court hearing as a result. Benjamin had contributed some money to a fund that had been set up to help the poor fellow. It was called the Metric Martyr’s Fund50 — a British Advocacy Group that campaigned vigorously on behalf of those who wished to use any unit of measurement they chose.

Today though, I was concerned that he really did need to lose weight and that he might be developing diabetes. I asked him to tell me what sort of food he was used to eating.

“Well I was very good at Christmas really. I had a jam roly-poly and pudding and custard and one of my friends gave me some chocolate fudge. Then we went up to the RAC club where we had spotted dick and custard (a traditional English suet pudding, one portion alone would be about 600 calories), but other than that I've been very good,” he said looking slightly perplexed when he saw the expression on my face.

I introduced the idea of low glycemic foods.

“Does that mean I can’t have tinned ravioli or custard then?” he asked. After I had explained in some detail about the hazards of such foods his attention seemed to wander and so I asked him what had happened to the grocer in court.

“Oh we lost the case,” he said with a shrug. The only people who win these days are the lawyers and what it means is that the laws of this country are completely subordinate to Europe. The chap owes about £200,000 in costs and he’s only a small shopkeeper selling bananas and things like that.”

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