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At the heart of general practice since 1960

Defeated by a puddle of piss

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It was late afternoon on the Tuesday after the Easter Bank Holiday weekend. Not only that but I had been off on holiday for the week before. I was not, frankly, having a good day. I can suggest with good evidence that none of us in the practice was. I was running an hour late.

My final patient, a golden-haired, long-legged professional young lady, huffed and puffed her way in. She had presumably noticed the coughing, breathless old guy with the two walking sticks being shoved in before her. But her irritation was still apparent.

‘What I want to know doctor,’ she asked somewhat impatiently, ‘is why my urine smells of beefy crisps.’

Occasionally I am accused of fabricating material in order to make this magazine column more interesting. But you know what? I don’t make it up. Someone actually went to the effort of making an appointment on the busiest afternoon of the year to ask me this question.

The five years at medical school are arguably not enough. There are maybe 10,000 diseases that can affect the human frame and understandably, due to limited time, the colleges tend to stick to teaching us about the ones that make a blind bit of difference to anything.

The beefy crisps thing is probably not on any syllabus at all. Other common presentations not covered include ‘Why have I got this small lump on my scrotum?’ (because it’s a scrotum) and ‘I’ve got cancer in the middle of my chest’ (no you haven’t, you’ll find that’s your xiphisternum).

We have to work these ones out for ourselves once we’re in the postgraduate environment. They are not in the textbooks.

‘Er, how long, does it hurt, do you eat a lot of beefy crisps, and why do you care, Ms Markham?’ I asked, extraordinarily politely (as it generally pays to do when you are talking to someone who happens to be a solicitor).

‘Always, no, only cheese and onion generally, and it’s always been at the back of my mind,’ she replied.

I owned up. ‘I missed the beefy crisps piss lecture. I apologise. I am remiss. I have failed you as your personal physician. Can I go home now please?’

She conceded that looking it up on the internet might be a better bet, and we parted as friends.

Driving out of the practice, I saw my second-to-last patient, the breathless old guy with the walking sticks, struggling up the road. He had made about 200 yards in 20 minutes, so I stopped and offered him a lift home. It was gratefully accepted. It was only after he had got out of the car and I was driving off that I noticed a big wet patch on the passenger seat.

The moral of that particular episode? No act of kindness ever goes unpunished. On the positive side (if you can imagine one), it did not smell like beefy crisps.

‘How was your day dear?’ asked Mrs Pev once I had got home and finished in the car with the wet-wipes.

I considered for a moment. ‘On balance, it was a total pisser.’

Dr Phil Peverley is a GP in Sunderland.

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