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Dispatches from the front line

Home visits are not normally Phil’s cup of tea – but this one brought a smile to his face

Home visits are not normally Phil's cup of tea – but this one brought a smile to his face

I have railed against home visiting in the past. It's not a good thing generally. Homes (patients' homes, not yours or mine obviously) are dusty, unsanitary, malodorous, badly lit, occasionally mired in dog shit and invariably too far away from the surgery.

If God had meant us to do home visits, He would not have created dogs, cats, or soft furnishings that absorb unlimited amounts of urine like huge six-foot long sponges (as I can confirm from one memorable, but never to be repeated, episode when I actually sat down in a patient's house).

So I'm slightly embarrassed to disclose that this week I have visited the same old bloke four days in a row. He's 89 and acutely confused, but not so confused that he or his family will countenance admission to hospital. ‘He'd rather die,' said his wife, and I have been concerned that he might actually get his wish.

On Monday I thought he might have a UTI. He was widdling every five minutes, had lost the plot mentally, and had been saying ‘Oh dear, oh dear, oh dear' every few seconds for three days.

On Tuesday he was no better despite the antibiotics, and his wife was asking whether I could shut him up with some sort of tablet so she could get some sleep. After 10 minutes in his company I could sort of see where she was coming from, but I explained I was treating him, not her. She conceded my point.

On Wednesday his chest sounded like a box of frogs and I wanted to get him into hospital, but the wife and daughter weren't having any of it. ‘People die in there!' exclaimed the daughter, and she had a point. It's been true of hospitals for as long as they've existed – you can't deny it. The corollary of this appeared to be, to their mind, that if he didn't go into hospital he wouldn't die. I had my doubts about this and told them so.

Today, Thursday, I went to see him again. ‘Oh dear, oh dear, oh dear,' he said as I went into his bedroom. He was thrashing his head around and seemed to be as confused as Pete Doherty on a stag weekend. He hadn't been passing much urine so I examined his abdomen for a bladder. I noticed a star-shaped scar over his pubic region (typical useless GP – I hadn't noticed it on Monday) and I asked: ‘What's this from?'

My patient suddenly stopped thrashing his head around.

‘Bloody Germans!' he said. ‘Come again?' I asked. ‘Sodding Germans!' he repeated. ‘Normandy, 16th of June 1944; bloody square-heads shot me in the privates! I wouldn't care but I'd only been married for a month!'

His wife and daughter were overjoyed. ‘He hasn't said anything sensible for a week, doctor! This is wonderful!'

He sat up and pointed a quavering finger at his daughter.

‘That one. She even married a bloody German. I'm lucky my grandson isn't called Adolph!'

He sank back on his pillows. ‘Gimme that bloody cup of tea, I'm parched,' he said, as his family swarmed happily round him. And quietly, grinning to myself, I let myself out.

Dr Phil Peverley is a GP in Sunderland

Phil Peverley

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