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speaking of headaches

Our diarist, now working as a locum, discovers he is happy to sacrifice patient continuity

Our diarist, now working as a locum, discovers he is happy to sacrifice patient continuity

Fortunately the dried blood washed out of my hair quite easily this morning. I was in the park yesterday with the son and heir. My somewhat haphazard schedule as a locum has allowed me to spend more time with him and properly shape his development: you know, hunting, gathering, that kind of thing. So when he put a tentative little hand onto the monkey bars I thought I'd lead the way and I vigourously jumped towards the first steel loop. There was unfortunately a fiendishly hidden second loop (i.e. I didn't look). The sharp contact between my head and this loop shook pretty much the entire frame, slides and all. It also caused the son and heir to clap a hand to his own head and look surprisingly worried. Moments later he toppled off a ladder to the slide, so both of us had now incurred moderate head injuries in the brightly coloured and softly padded play area. My main hope is that in future years his memory won't stretch back to this sterling example of fatherhood.


Speaking of headaches, I met a highly agitated female last week. She was the kind of patient that you call from the waiting room and immediately sense the rolling cloud of misery that precedes them. It's so hard to prevent an almost pavlovian sag in your own spirits. So she sat down and launched without preamble into her litany. The sun rapidly retreated behind a cloud and the music faded from the room. I began to think that within five minutes one of us was going to have to leave, and I didn't mind if it was me. Central to her upset was that, according to her, if she didn't eat the moment she became hungry then she developed a terrible headache. This had rather predictable consequences on her waistline.

Food cycle

She then began a detailed account of what she had eaten. I initially thought this might be the week's menu, but I rapidly realised it was only that day. And this was a morning surgery. The list went on and on. I came close to saying ‘You seem to have over-estimated my interest in your diet'. Instead, I suggested that she try to distract herself from her hunger pangs by some light exercise. I explained to her that if the blood flow could be re-routed from her bowels to her muscles this might break the cycle. Now, this made a kind of desperate sense to me at the time. Judging from her reaction she would have been happier if I had recommended eating live ants.

Double-edged sword

Her tear-stained eyes slid slowly off me to focus dimly on the window beyond. ‘Oh well' she sighed and intoned the magic words which instantly made us both feel better, ‘I'm seeing Dr. R in two weeks. I'll discuss it with her.' And there it was, the perfect example of the double-edged sword of being a locum. I no longer have ‘regulars' who break up the treadmill of seeing patients; each and every consultation involves meeting someone for the very first time. Yet I will never, save through some catastrophic misfortune, ever have to see that woman again.

Dr Geoff Tipper is a newly qualified GP in Maidenhead, Berkshire

Dr Geoff Tipper Dr Geoff Tipper

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