Fun with the family album

Phil is reeling after visiting an elderly patient and being treated to some family photos

I was asked to visit an old woman today, and it has left me in a state of shock.

The request was fair enough. The lady had just been discharged after four months in hospital following pneumonia; two months in intensive care and another eight weeks on the medical ward. She is obese, diabetic, hypertensive, and has suffered left ventricular failure and congestive heart failure, currently in fragile remission. She had home oxygen and her lower legs were weeping enough serum to cause a circular stain around the armchair that she never leaves, apart from assisted trips to the toilet. In one sense, she is very old indeed, in the sense that she is never going to get much older than she is now. In another sense, she's not that old, because she's 58.

The household is a classic underclass set-up. Grandmother, mother and daughter live together in a council house. There's no sign of a man, although at least one must have been involved at some point. However, they're not there now.

They like their photographs in this house. I inspected the inflamed swollen wrecks that constituted this old lady's lower limbs, and made some sad crack about how she wouldn't win any Lovely Legs competitions. The daughter butted in. ‘Oh but she did in the old days! Look!'

There is a computer in the corner of the room, and with a few clicks the daughter showed me pictures from Butlins in the 1970s when her mother actually DID win a lovely legs competition. There she was, already thick around the middle, but in a white flowery swimming costume and with a sash and a glass of champagne. I made the appropriate appreciative noises.

I was getting ready to leave and, like a fool, I made another comment. ‘That's a lovely photo,' I said, referring to a classy shot on the wall of the granddaughter reclining on a couch.

‘That's nothing,' said the mother, swelling with pride. ‘Shonelle's a professional. She got a job modelling wedding dresses. Look at these!' A few more clicks of the mouse and I saw Shonelle modestly but impressively wearing a number of gowns in Durham Cathedral.

‘Very nice,' I said, and meant it.

‘She's gone into glamour modelling now,' said her mother. ‘It was her own choice to take the next step. She's done Page Three and everything.' Another click, which I was not quick or savvy enough to stop, and there was Shonelle in her nuddy with her legs round her neck, in a pose more appropriate for a gynaecology tutorial than for a family album. Both grandmother and daughter beamed. Inside, I curled up and died.

I made my excuses and left, as the tabloids say. I didn't ask, as I might have done, why there was only one step in their minds between modelling wedding dresses and posing entirely naked, when I might have imagined there were about 15 steps.

Neither did I mention (because I can't) that Shonelle, who I first met 15 years ago when she was two years old, had recently consulted me with symptoms suggestive of genital herpes. I suppose, in a household like this, they'll find out soon enough.

Dr Phil Peverley is a GP in Sunderland