One feature of general practice is how forgettable most of it is.
‘What can I do for you today?’ I ask my patient. He looks baffled.
‘Er, I was here six hours ago. You thought I might have appendicitis and asked me to come back this afternoon.’ I look at him. I don’t remember ever having seen him before in my life. And yet the notes bear out his story.
They are not all like this. There are some patients who leave an indelible impression on our memories, and there are a few that I will probably recall when I am too senile to remember the names of my own sons.
One such patient was Bob, whom I met when I was an SHO in New Zealand. The matron was showing me around the geriatrics ward on my first day, when a stentorian voice bellowed: ‘Why, bugger me! Ah kna thy accent bonny lad! A Geordie like me! Howay over and tell us how Newcastle United are getting on!’
I’m not a Geordie by the way. You have to be from Newcastle to be a Geordie and, like 90% of people from the North-East, I’m not. However, the rest of the world thinks we all are, and after a while you can’t be bothered to argue.
Bob was an evil-looking, skinny octogenarian, rendered paraplegic and almost blind by a dozen or so strokes. Dishevelled and perpetually unshaven, he was a foul-mouthed chainsmoker who couldn’t use his arms to reach his cigarettes.
The nurses had reasoned, with admirable humanity, that there was now no reason on earth why he should try to give up smoking, and so had rigged up an ingenious cigarette holder out of an old wire coat-hanger so Bob could have his regular fix. Every eight minutes, he would shout, ‘Norse! A new tab please!’ and someone would slip another Woodbine into the wire cage.
The contraption wasn’t perfect, and about twice a week he would set fire to his own bed. But he had his own personal fire-extinguisher on his bedside cabinet, and I think he regarded the regular dousing with foam as a type of bed bath.
Bob had three hobbies – smoking, swearing and breaking wind. He only needed assistance with the smoking; the others he could do remarkably well unaided. His swearing was surprisingly fresh and original, and I picked up a few choice phrases from him that I still use to this day.
But his true gift was flatulence. The nurses couldn’t understand it. He ate the same diet as the other patients, but was unique in his ability to produce the dreadful, pervasive effusions that made the ward so unpopular with visitors.
On my first ward round, the consultant and his team collected round the foot of his bed. I was giving my report, when Bob, grinning wickedly, lifted a shrivelled buttock and ripped off a sustained basso profundo effort that cleared the beds on both sides. As the ward round dissolved in disarray and I frantically waved his notes around in a vain attempt to clear the air, he cried plaintively: ‘Divvent criticise us, doctah! It’s the only pleasure Ah’ve got left!’
Dr Phil Peverley is a GP in Sunderland.