Further Confessions of a GP. Benjamin Daniels

      Mrs Patrick tutted loudly and I was left wondering if she was more upset with me for not being Dr Bailey, or Dr Bailey’s wife for selfishly having a stroke.

      ‘Might I be able to help at all? What’s brought you into the doctor’s surgery today?’

      By this stage I was rather hoping that her obvious lack of faith in my abilities would lead to a short and easy consultation, but unfortunately Mrs Patrick sat glued to the seat for another 30 minutes. An endless array of intolerable sufferings were described in gruesome detail, but before allowing me to offer any possible solutions, she would curtly remind me that I couldn’t possibly help and how dreadful it was that Dr Bailey had left her in the lurch like this.

      Most of the morning’s patients offered a little more sympathy for Dr Bailey’s predicament, but none seemed to consider me a worthy understudy. By the time I drove off on my first visit of my new job, I was feeling thoroughly demoralised.

      My visit took me to a small house set back from the main road. An elderly gentleman with a warm face greeted me at the door with such an affectionate welcome that I was encouraged to believe that I might finally have met a patient who viewed me to be of some worth. As I reached out for a formal handshake, he clutched my hand in both of his and took an eternity to let go.

      ‘We so appreciate you coming out to see us what with it being your first day, Dr Daniels. My wife is upstairs. Are you going to bring her down?’

      ‘Erm, what do you mean bring her down?’

      ‘She can’t really manage the stairs these days, so Dr Bailey always carries her down to the lounge.’

      My face must have given away my surprise and the kind old gent apologetically attempted to take back his request. ‘Well if you’re not able to manage her, Dr Daniels, I’m sure …’

      ‘No no,’ I interrupted. ‘I’m sure I’ll manage just fine.’ I was determined to match the feats of the mighty Dr Bailey on at least one occasion today.

      Mrs Alexander didn’t weigh a great deal, but it wasn’t easy hoisting her up into a fireman’s hold and then navigating the narrow winding staircase. I’m fairly sure it wasn’t a technique advised on the ‘Lifting and Handling’ course I was forced to go on before I was allowed to qualify as a doctor. As I finally lowered Mrs Alexander on to the sofa, I tried not to look too exhausted by the whole ordeal.

      ‘Right, what can I do for you then Mrs Alexander?’

      ‘I’m all bunged up again, Doctor. I haven’t opened my bowels for two weeks.’

      As I started to list the various laxatives and suppositories I could prescribe, Mr Alexander politely interrupted me.

      ‘None of those work for my wife, Dr Daniels. That’s why Dr Bailey has to clear it out himself.’

      ‘Excuse me?’

      ‘We put a towel down on the carpet here and Elsie lies down on it. We’ve got some spare gloves and Vaseline in the cupboard and Dr Bailey just puts his finger in and clears all the hard stuff out. He says it’s the only way once it gets to this stage.’

      Before I could think of any way to object, Mr Alexander had neatly laid out the towel and Mrs Alexander was hitching up her nightie.

      ‘I think these gloves will fit,’ he said as he offered me a pair of medium-sized marigolds.

      I had smugly managed to avoid ever having to do a manual evacuation up until now. I can vividly recall the occasion when one of the consultant surgeons made all the medical students in his team stand in a line with our hands held out in front of us. He walked up and down inspecting our outstretched fingers, searching for the slimmest and daintiest of digits to clear out the particularly tightly packed rectum that he had waiting to be evacuated of its hardened contents. I can still recall the relief I felt as I looked down at my short podgy fingers and then compared them to the delicate little hands of the Japanese girl standing to my left. I could almost smell her terror growing as she realised that the consultant was studying her beautiful slim fingers with some excitement. As he led her away to meet her fate, I looked down at my ugly, portly fingers and offered them an instant and unconditional pardon for their fat clumsiness and for all the tasks of dexterity for which they had previously failed me.

      My luck had clearly run out though, today. There was no elegant-fingered Japanese medical student to save me this time, so I donned the gloves, took a deep breath and got stuck in. The urge to gag was almost overwhelming as I methodically used my index finger to pick out the rock-hard lumps that were blocking Mrs Alexander’s rectum. As I probed my finger further and further into the depths of her lower bowel, I finally managed to break through that last solid stubborn layer of rigid faeces. There was an ominous rumbling, an almighty stench and then the satisfying passage of soft stool leaking past my finger. I could see Mrs Alexander’s tight, distended abdomen deflating before my eyes.

      It was an oddly satisfying experience and I gave myself a metaphorical pat on the back for having finally matched up to the lofty achievements of the wonderful Dr Bailey. I made a swift exit, and as Mr Alexander got on with cleaning up the results of my handiwork, I hurried back to the relative sanctity of the surgery.

      As I walked through the door, the receptionist was holding the phone and covering the mouthpiece with her hand.

      ‘It’s Mr Alexander on the phone. He’s not very happy with you,’ she whispered.

      ‘Bloody hell! What more do these people want from me?’

      ‘Apparently Mrs Alexander is stuck in the lounge because you carried her downstairs but forgot to take her back up to her bedroom again before you left. You’ll have to pop back in on your way home tonight. They keep asking me when Dr Bailey is coming back …’

      That was over three years ago now. Despite my disastrous first day, when Dr Bailey decided he wasn’t going to return, the surgery offered to keep me on as his permanent replacement. Initially, I was reluctant to give up my nomadic locum lifestyle, but with advancing years, I craved some stability and decided to stay. I soon found this quirky little GP surgery and its patients growing on me, and I’ve been here ever since.

       Sarah

      When Sarah walked in she looked familiar, but I couldn’t work out why. It was only my first week at the new surgery, so she hadn’t been to see me previously as a patient. I was going to suggest that we might somehow know each other, but before I had the chance, she launched into a long monologue relating her constipation and dodgy bowel symptoms in some detail. Suddenly, I remembered where we had met before. She was the sister of a girl that my friend Pete had gone out with about 15 years ago. We had met a few times, and I can clearly recall that I once went to a party at her house and made a very drunken and unsuccessful attempt to chat her up. After being very unsubtly rebuffed, I’d decided to drown my sorrows by drinking some more and ended up vomiting into her empty bathtub. As if that wasn’t bad enough, for some reason I then concluded that despite the bath vomit I was still in with a good shot with Sarah after all, and made another doomed attempt to chat her up. A good memory is a must for a career in medicine, but at times like this I really wish my powers of recollection weren’t quite so efficient.

      With Sarah not appearing to remember me, it was tempting to ignore our previous acquaintance and continue the consultation in the normal way. However, I couldn’t believe that she wouldn’t remember me at some point and so I really needed to find an appropriate moment to mention that I wasn’t the anonymous doctor she thought I was. I was just considering how best to broach the subject when my hand was forced

      ‘Doctor, do you think you should have a look at them?’

      ‘Sorry?’ I had been miles away and completely missed the last couple of things Sarah had been telling me.

      ‘My piles, Doctor. I think you might need to take a look.’

      Now was the time, I really needed to come