Well, it’s the start of another year and time to look back on events of the past year or more, so I have decided to cast my mind back on some of the more bizarre GP moments of my medical past.
Some of the juicier moments will have to be excluded for fear of patients recognizing themselves, but that still leaves some tales worth recalling. Such as the incident of the big-toe. It was late evening and the last case of the day involved the rather painful business of removing the nail of my patient’s big-toe. The most painful part of the procedure is the injection of local anaesthetic around the edges of the nail – something that the brave man stoically endured. While we were waiting for the anaesthetic to take effect I got an emergency call – an elderly lady had collapsed in a nearby block of flats. I explained the nature of the emergency and, grabbing my old black bag, rushed to the address given. Unfortunately, once I’d pushed through family and neighbours I could see that the poor woman was beyond my help, but manfully tried to resuscitate her all the same. After admitting defeat, I busied myself with consoling the family and friends and calling the undertakers. In such circumstances there is nothing better than suggesting a cup of coffee or tea; it keeps everyone busy fussing in the kitchen and helps to defuse the situation for a while.
As usual I waited for the undertakers and helped phoning ministers and distant family members. Eventually the suitably mournful looking, dark-suited undertakers arrived and I could take my leave. No matter how experienced you are, this sort of scenario takes its toll and as I lifted my bag into the car, all I could think of was a glass of red wine, my long due supper and bed. The route home took me past the surgery where, I noted with alarm, the lights were still blazing! And then I remembered the poor guy with the toe whom I’d hurriedly left some 2 or 3 hours before! Surely he had left in disgust? But, no, there he was, still expectantly sitting, his toe sticking out from the sterile drapes like some beacon of patience.
Needless to say the anaesthetic had long since worn off and he had to suffer the agonies of a repeat set of injections. Thirty-five years later he walked into my surgery (no, not limping) here in the Karoo and I had to endure a lengthy retelling of the tale to my laughing receptionist. It was the least I could do. I can’t recall if I sent him a bill for that night’s work – hopefully not. Mind you, in 1976 a consultation put you back all of R4.00. Fortunately, in my second year of practice, this was raised to R4.40.
I have never been a cigarette smoker, but loved to puff on my pipe and I remember many a session in my consulting room, puffing away companionably with a fellow pipe smoker – almost blasphemous by today’s standards. Which brings to mind another tragic.funny story: it was late one night and I was suturing some poor woman who, in desperation, had slashed both her wrists. Understandably she was emotional and stressed and kept begging for a cigarette, which I did not have. Then I remembered a box of cigars I’d received as a gift and half jokingly suggested she might try a panatela. To my surprise she gratefully accepted the offer. I fired up the cigar, placed it in her mouth, and donned a new set of gloves to continue my repairs. Everyone was happy. Except that I’d forgotten the little matter of cigar ash! So, after every few stitches I had to remove my gloves, tap off the ash, and restart the stitching. Not something you see in modern TV medical dramas – but I like to imagine that the patient was as relaxed as one could be under such circumstances.
Ironically, a few weeks later I was woken in the middle of the night by an urgent phone call; the ‘cigar lady’ had apparently, or so said the voice on the phone, tried to end her life again! I rushed to her house, which was, not surprisingly, in total darkness. Her bedroom window was just too high to look into so I stood on my trusty old black medical bag and peered through the open window – and looked straight into my patient’s shocked face! My noisy efforts had obviously woken her up. “Doctor! What are you doing here?” My stuttered reply: “Just checking on you. Are you OK?” must have sounded extremely lame, but the good woman nonetheless opened the front door in her dressing gown and made me a cup of tea while I explained about the telephone caller. It did not help matters when I admitted that I had no idea who had actually called. Oh, well, she took it all in good grace, but I felt a complete idiot.
My little black medical bag of magic has stood by me in many a tight spot, but recently let me down badly when I was faced with an unpleasant emergency and nothing in the bag was of the remotest help. Some unfortunate man had caught his genitals between the slots of a plastic chair and was in all sorts of agony. (I have subsequently been told that this not an uncommon ‘home accident’, so be warned!) Fortunately, a bystander had fetched a large side-cutter and hacksaw blade and after ten minutes of panic I could free willy and his side-kicks. I’m still not sure how this could have happened, but there you are, it certainly did. Trust me, I’m a doctor.
Then there was the old man who complained, or at least his wife, the designated spokesperson, did, that he was chronically fatigued. I spent ten minutes questioning him about respiratory, abdominal and cardiac symptoms and would have continued in this vein if the wife had not thrown in this priceless little titbit of information: “You know, doctor, he’s never quite been the same since he was struck by lightening recently!” Chronic fatigue indeed; he was lucky to be alive.
Another incident from my early days of practice involved an old man who just refused to respond to the usual emergency asthma treatment. I had already exceeded the safe level of intravenous medication, without any visible improvement. Explaining to his anxious wife that waiting for an ambulance would be dodgy, I flung the gasping man into my MGB sports car and sped to the nearest hospital. A short distance from his house we hit a deep pothole in the road and the little car went airborne, coming to earth with back-breaking thump – certainly hard enough to drive the last remaining air out of the poor patient’s lung – and, fortunately, a thick plug of obstructing mucous as well! “Hey, Doc, I can breathe again,” said the man. Five minutes later his surprised wife had her cured and smiling husband back at home. A medical twist to the old ‘Let’s hit the road, Jack’.
I wish all readers a prosperous 2014, drive safely and remember to pack a side-cutter and hacksaw blade in your first-aid kit!
By Pete Reinders