Tuesday, April 24, 2007

Lost April?

So I look up and another twelve days appear to have gone by just like that. (Doffs fez and does the Tommy Cooper wobbly hands thing for emphasis).

I dunno where they went I’m sure. Ok at some point in those days yours truly got “another year older and deeper in debt” as the songsmith might have it, but the boat wasn’t actually pushed out that much so there’s no excuse there. It must be one of those Agatha Christie type lost week thingies, only without the mysterious hotel in Harrogate or wherever it was supposed to have been. Who knows. Perhaps in years to come there will be a great “Dr J’s Lost April” urban myth. Or perhaps not.

Moving on, we have noticed, here at the Ambridge Surgery, that there was a definite upsurge in “The Madnesses” over the past couple of weeks. Literally two of our long term but stable psychotic patients chose this past hot spell to drop a few of their collective marbles of their respective trays, to end up in need of hospitalizing. And there’s a whole couple of others who are simmering under.

Suddenly Ambridge begins to feel like New York (only with fewer bagels and homicides). Temperatures soaring into the thirties and all at once the entire population gets the seven year itch, cracks up or otherwise goes to pot, and we poor soles, we few, we happy few, we band of brothers, and, increasingly, sisters, are here manning the barricades and manfully (er – and womanfully) picking up the pieces.

Thank heaven for the past day’s rains. Perhaps that will help dampen their ardour and we can get back to proper General Practice*. In the meantime I’m off to buy an almanack just in case. After all it might pay me to know when the next full moon is due. And whilst I’m at it I think I might invest in some garlic and silver bullets.

* you know the sort of thing, peering into sore throats, doling out verruca creams and prying into peoples sex lives….

Thursday, April 12, 2007

In which we meet some birds.

Though not in a retro 1960's kitsch philandering way. Oh no. I mean real, honest to goodness, Hitchcock inspired, avian type, feathered friends. Two specific individuals to be precise.

Permit me to ellucidate.

The lanes leading to Ambridge are now firmly in the grip of Persephone. Hedges hitherto brown and stick-y have burst into a varihued emerald filligree. Trees of the proper sort (note botany is not one of Dr J's strong suits here) are busy wrapping themselves in pink or white candyfloss. Bluebells tinkle in the woods and Daffodils and Tulips nod their stately heads in the gentle morning breeze.

Indeed, since HMG so callously nicked an hours kip from us a week or two back, the usual morning drive has taken place to a backdrop of golden skies tastefully underlit by the newrisen sun. God is in his (or her) heaven, and all's very right with the increasingly warmer world. This also appears to be having an effect on the behavior of Borsetshire's avian inhabitants. At least on the basis of this morning's events.

And no I don't mean that behaviour, this isn't that sort of blog you know.

Scene 1 (a lane on the outskirts of Ambridge- a quaint English village. 08.03. In dappled sunshine) The big red bus sweeps gracefully round a languid left bend to be confronted by a cock pheasant. The aforesaid pheaseant is standing tall, owning the left hand side of the road. Stood in profile its black beady eye, surrounded by a piratical flash of red, fixes our hero with a look redolent of Saturday Night Chucking Out Time. "Come and have a go if you think you're hard enough" it declaims to the world at large and our protagonist in particular.

Ungentlemanly language can be heard as the big red bus swerves sharply to the right and away from the Pheasant's revolt.

Scene 2 ( the same lane, a little further on, past the crossroads and just along from the pub. 08.11. More dappled sunshine) the big red bus negotiates the crossroads with unaccustomed grace and elegance, instead of the normal ten minutes queueing and chuntering- Ambridge School is closed for the Easter Hol's- and glides on down the hill to the hollow, slowing and dropping in to third for the tight right hander at the botom of the dip. Taking the corner with the applomb of a rally driver at the height of his powers our hero is again confronted by an aggressive avian encounter.

This time he is mooned by a lady mallard.

Fade out to the sound of near hysterical laughter from within the big red bus....

Tuesday, April 10, 2007

In which Dr J is indulgent

Ok. I forgot it was about to be Easter, and blogging from home never seems to work, so I'll try again with the whole "normal service" thing.


Since not much has happened in my own little version of Ambridge lately, (unlike the "real" thing-- regular listeners will know what I mean and the rest of you really don't need to know, at least not for the purpose of this post...) I have been musing on a subject close to my heart, and thought this might be a good time to share the result of my deliberations.

Oh yes, the subject: Chocolate.

More specifically the purported healing properties thereof.

When I was a lad chocolate was indisputably bad for you. Even BAD for you according to some of the more virulent anti-choc' propagandists. It made you fat*, gave you spots and rotted your teeth.

Happily we now live in more enlightened times. Divers authorities would now have us believe chocolate is beneficial in all kinds of ways, reducing the risks of both cancer and heart disease, supplying vital minerals, elevating mood, even, they aver in hushed tones, enhancing the sex lives of women**-- and thereby presumably also of their companions...

It has even been shown to contain an ingredient (theobromine for those of technical bent) better at relieving cough than most commercially available remedies (though cramming it down so fast you choke is less likely to help that particular syptom-- Jesterly offspring please note!).

Given our posession of all these incontravertible scientific facts I now believe there is an unarguable case for putting liberal ammounts of chocolate on the NHS drug tarrif, to be delivered "free at the point of delivery" for the alleviation of all ills. To that end I am now shamelessly soliciting comments in support of my case for submission to the relevant authorities.

* An argument I believe I disproved in an earlier post-- neither will chocolate cause spottiness or tooth decay if used responsibly. So there.

** Could this be the origin of the mythic "Easter Bunny" of song and fable?

Wednesday, April 04, 2007


It would be fair to say the old batteries have been a bit flat lately. Work and home contrived both to be busy at once, leaving little time for contemplation. So much so that even dear old Radio Four hasn’t managed to get me going at all lately. Still things appear to be calming down a bit now, so, for the time being at least, normal service might be set to resume (in so far as there ever was “normal” service here).

Today I have to tell you about one of those weird juxtapositions that throws the absurdity of what I do every day into stark relief. Please forgive me in advance if parts of this narrative come across a little more jaundiced than intended, as I said earlier it’s been a tough couple of weeks….

Just over a week ago Mrs. Snell arrived in surgery. She is a regular attender, sadly all the more so in recent months. Around a year ago she developed an annoying symptom. Neuralgia. Several times a day she is gripped by a sharp but enduring pain in her jaw, akin to the “mother-of-all-toothache”. This pain will last for minutes at a time, sometimes hours, and has no reliable preventative remedy. Capricious pains of this nature are also hard to manage with painkillers since the pills will take anything up to thirty minutes to kick in unless taken all the time, and in this time the pain will often have abated anyway. Medically the problem has a considerable nuisance value, and to Mrs Snell it is a torment that is slowly but surely driving her crazy. However it remians essentially trvial.

In the past six months she has seen a variety of dental, anaesthetic and alternative practitioners, taken their conflicting advice to heart, juggled with a complex regime of analgesics (up to and including Morphine), anti-epileptics and anti depressants, all of which form a part of the standard armamentarium of neuralgia treatment, and none of which are affording her lasting relief. At this consultation, as at several in the past I have had to advise her she might need to withdraw one of her several medications since it seems the side effects are outweighing any slight benefit it initially seemed to offer.

And every time we have to do this she gives me “The Look”. You know the one. It’s the look that says “I know what you’re really doing is trying to kill me”.

On any other day this would have been part of the normal cut and thrust. Sadly not on this last occasion. That same day was the day that Grace had died.

Grace came to see me around sixteen years ago, not that long after I had arrived at the surgery. She had gone through menopause six or seven years before that, and was a little put out to find she was bleeding again. One urgent referral, an admission and a lot of tests later she emerged from hospital with an inoperable gynaecological cancer. Undaunted she allowed herself to be put through the rigours of radio and chemotherapy, lost all her hair, but was put into remission. (And yes her hair did then grow back again).

As with all cancer diagnoses, especially when inoperable, she was then watched by her oncologist, initially every three to six months, then, after five years or so, annually, for evidence of recurrent disease. Sure enough, eventually, around eighteen months ago it happened. Despite poor odds, and the threat of repeated hair loss (no small thing for a lady at any age), Grace cheerily submitted to one more pulse of radiation and several courses of chemo, but by New Year it was apparent the treatment was no longer helping. She began to experience significant and increasing pain. In the end she bowed to the inevitable and accepted that paracetamol on its own was not going to see her through, and a couple on months ago she finally accepted a tiny dose of opiate analgesia, and we made one small increase in her dose a couple of weeks after. From that time on she told us she was pain free (though I have my doubts). She remained alert and coherent to the day she died, and only took to her bed in her final few days. Her outlook throughout was as positive as poor Mrs. Snell’s has been negative, and she achieved the best ending possible for herself and her family.

I know full well that knowledge of this would help Mrs. Snell not at all with her current problem, and am left fervently hoping that she will never be tested as Grace was.