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Eight legs good

So she’s going on and on and on and on and on and on and on and on and on and on and on and on, way beyond her allotted ten minutes.

Nonetheless, I’m fascinated. Because there is something in the air between her right shoulder and her right ear, in suspended animation, and what I initially thought was a bit of fluff can’t be, because it’s moving – no, crawling – towards her.

So it’s a spider. And the fact that it appears to be on a web that it has spun is a testament to how long she’s been sitting there. But it also makes the consultation much more interesting, not least because it reminds me of a tiny Boris Johnson suspended on that zip wire. Maybe it’s waving a teensy flag.

I feel I should tell her, but it would be rude to interrupt her symptom litany. Besides, I’m intrigued as to how this might pan out.

I’ve dealt with infestations before, of course. I’ve picked maggots from a leg ulcer. I’ve seen hair so colonised by head lice that it seemed alive. And I’ve treated the Holy Grail of parasitophiles, cutaneous larva migrans. Yes, in Essex.

If my mental trajectory arithmetic is correct, it’s on course for her right external auditory meatus

But this is different. It’s dynamic and entertaining. My eye is literally a webcam, focused on the spider’s progress. Which at this point seems to have gone out of sight somewhere on the patient’s neck/back. I reckon that, if only could examine her lung fields, I could do the honourable thing and swipe it off. But the respiratory system appears to be the only bodily area she hasn’t yet complained about.

‘Any cough?’ I ask, suddenly.

‘No,’ she replies, startled.

No matter. It has reappeared. And my spider senses are tingling. Because, if my mental trajectory arithmetic is correct, then it is on course for her right external auditory meatus. Oh. My. God. If I don’t intervene, something awful will happen. Boris will enter her ear.

‘…and I sometimes get these crawling feelings,’ she says, which is when I interrupt, intervene and, like a magician, reveal a tiny arachnid in my hand.

‘Oh,’ she says. Then she leaves. I’m not sure if it’s simply hard for her to continue or she’s satisfied that this must explain all her symptoms. Whatever. Boris is now living happily in my draw in his matchbox No. 10. And he’ll be unleashed whenever I need to negotiate an exit.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield