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At the heart of general practice since 1960

Just a perfect day

Real general practice is alive and well, and Dr Tony Copperfield is right in the middle of it.

Real general practice is alive and well, and Dr Tony Copperfield is right in the middle of it.



I've just had a perfect day. I didn't drink sangria in the park, admittedly (this is Basildon, remember, and cider doesn't scan so well) But, otherwise, it's been spot on.

Yes, I was at work. No, I haven't had a lobotomy. Yes, I was seeing patients. No, I'm not setting you up for a cheap joke.

All it took was three patients. And two of them were visits. Look, I know this is weird and that you may be worried for my mental health. But I'm fine, really. Just bear with me.

Patient number 1. A 72 year old man who never ever comes to the doctor, so my serious diseases sensors are already flashing. His opening gambit? ‘I've got a growth in my bottom and I'm worried it's cancer.' OK, that's clear. As is the diagnosis, after I've popped him on the couch and taken a look: a perianal haematoma. He's as happy as anyone would be who thinks the cancerous bottom has fallen out of his world, only to be given a reprieve. The two minute grateful handshake takes longer than the actual consultation. No ‘While I'm here's', ‘Can I have my repeat prescription?' or ‘But that's not really why I came…' . Wow. A lucid story, a definite diagnosis, a gratefully accepted dose of reassurance and see you in another ten years. It doesn't get much better than that. Except it did.

Patient number 2. An 80 year old man living on a farm (yes, we have one or two of those in Essex, they're the green bits that help distinguish one bit of concrete sprawl from the next). Not much to say here except I had to fight off a combination of dogs, turkeys and a pig to get to him. He had gravitational oedema because he's been wheelchair bound since a stroke, and amused me by being ‘delighted to see you again, Dr C,' particularly as he's blind. More satisfying reassurance, but mainly it was a nice drive through fields.

Patient number 3. A bit of background here. She's a lady with COPD who's had recurring chest infections over the last few months, never quite resolving with the usual antibiotic/steroid combo. But a normal chest X ray. A low-grade puzzle, in other words. Suddenly, she's asking for a home visit, for the same problem. She's never done this before, so I've already decided to admit her. As expected, she's not good. I go downstairs to call the medics, anticipating the usual tedious ‘Why don't you just arrange some IV antibiotics and home oxygen/ why don't just boil your stupid FY2 head, you tosser? ' conversation. And as I walk into the lounge I'm confronted by…what? An anxious family? Father Christmas? Monica Belluci doing a pole dance? No. It was more surprising than any of those. It was a roomful of parrots. An unfeasible number of parrots, in fact. More parrots than I've ever seen in one place, and bear in mind that I've been to Parrot Land, Leicestershire.

This prompted two noises. One, the squawking of, you guessed it, parrots. And, two, the sound of a penny dropping. It's been a long time since I've seen a case of bird-induced alveolitis, as I explained to the FY2 in a conversation that turned out to be rather less painful than I'd originally expected.

And that was my perfect day. It was like an episode of All Creatures Great and Small, except I was a GP rather than a vet and the animals only had a bit part. It gave me a warm glow, not least because it had absolutely nothing to do with commissioning, revalidation, primary cardiovascular prevention or anything else which would not fit into a James Herriot plotline. What it means, my friends, is that general practice is still out there. Hurry, though, it may not last long.

Anyway, at the end of my perfect day, I fed the animals in the zoo, watched a movie and then later, when it got dark, I went home.

'Sick Notes' by Dr Tony Copperfield is out now, available from Monday Books.

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