Friday, August 24, 2007

All Aboooaaaaaard!

Suddenly this past two days all of Borchester is bathed in sunshine. It feels as though summer might actually be going to put in a somewhat tardy appearance, just on time for the annual Famille Jeste pilgrimage to the land of King Mark. Yes indeed, brothers and sisters, despite having been already absent from this desk for two weeks during what has till now been somewhat ironically termed the “Summer Holidays”, we have yet to travel more than 30 miles from home (saving one very soggy excursion to Legoland—the only Theme Park in Blighty the cadet branch of the family will tolerate, and none the worse for that…).

So this morning, in anticipation of this fact, I have been to the train station in Borchester to book my train ticket for tomorrow morning. You see our travels are to be a two stage process this year through the vagaries of cat care. The advance party leaves by car, well our Big Red Bus actually, this afternoon whilst I am still slaving over a hot surgery. I shall return to an empty nest tonight, ready to crate up our two untamed panthers (well they think they are, and who am I to disabuse them…) ready for their hol’s at the cattery, and having deposited them at same first thing tomorrow morning,* I shall be making my way south to join the remainder of the family on the train.

This weekend, as well as being the first truly sunny weekend in living memory, is a Bank Holiday weekend here, and the last gasp of the school summer holidays, so all of England will be on the move. Indeed form the look of the station first thing, the diaspora has already begun. I pulled up on the concourse to be greeted by a scene from the “Golden Age”. Long-nosed Tourers with vast sweeping wheel arches and running boards a yard wide were dropping off ladies in billowy dresses and improbable hats. Small boys in sailor suits, and girls in pinafores darted up and down the platforms to a clatter of marbles falling from pockets and hoops being batted along with sticks. Blue uniformed porters huffed along behind two wheeled trolleys piled high with hampers and trunks. Then I realized I had turned up at the Severn Valley Railway station by mistake and went next door to the “proper” one.

I even managed to book a ticket on the train I wanted, at the time I wanted, and be in and out of the station inside five minutes (leaving plenty of time to sit and ramble before surgery gets going as you can see). So whilst I am away for the week, once again I donate this space to you gentle readers to comment as you will, and also, this year, to set a hare running.

In a comment on the previous post the charming Orchidea has asked me to write on how it feels being a “Harbinger” where there is bad news to be imparted. I intend to give this some thought over the week and to post a reply soon after. So is there anything else you “always wanted to know about GPs but were too afraid to ask” ? **

Oh, and whilst I'm away would you all mind keeping an eye on Jest Acres for me, the Green Recycling Bin needs to go out on Thursday if it's not too much trouble, and there's a wee bit of milk left in the fridge if you want a coffee or anything...

Much obliged.

* I should probably have pointed out that I won’t be crating them up until it is time to go to the cattery, and not leaving them boxed up all night as my appalling sentence construction might have implied.

** with an affectionate (as in please don’t sue me) nod to the genius of Woody Allen.

Tuesday, August 21, 2007

Lesions of the Damned

First year in Med School you learn a lot of new words, and learn to redefine a few old ones. As an example, back in the playgrounds of the wild westcountry we used to use “acute” and “chronic” almost interchangeably to mean “really really bad” as in “I’ve got this acute pain in me side. It’s bin there for days an’ it kills” or, “that joke was chronic” *.

You learn that “infarction” means death of tissue deprived of oxygen and is not just a posh way of saying “infection”. And you learn to call anything from a pimple to a tumour a “lesion”, ( rhymes with legion, from Latin laesio “hurting”). It’s a useful word, lacking all precision as it does, thus allowing us to talk about any variation in appearance or texture of skin in erudite fashion without revealing to the punter whether they should be terrified or relieved about the particular “bit” under discussion. It stops callow juniors from blurting out the word “tumour” inappropriately when discussing minor blemishes, or too soon when discussing major ones.

So far this week I have seen one lesion from either end of the spectrum. First came Tony. Tony has been getting steadily worse over the past month or so. He has lost weight, had frequent bouts of diarrhoea and increasing problems with control of same. He looks and feels wretched. Examination sadly confirms a large “lesion” per rectum. It is a tumour, and I have to tell him so. He is expecting the news and takes it phlegmatically. After all he has already had one brush with malignant disease and seen it off. He has also lost one child to another form of malignancy, and, after the awfulness of this, nothing much even comes close. His principal concern is if any proposed investigation and treatment can be out of the way before next years holiday, planned to celebrate a significant anniversary. I do hope it will be.

After Tony came Jennifer, husband Brian in tow. Brian is a bit cross. It seems Dr Neighbour treated Jennifer last week for a “lesion” on her shin. The blemish in question was a small area of non-malignant sun damaged skin or a keratosis. Dr N zapped it with our favourite toy, the liquid nitrogen gun, last week. The thing, far from dropping off in four to five days as she had hoped, has blistered rather alarmingly (as they often do). It needs no further treatment since as the blister separates it will take the keratosis with it naturally. It is best left to do this on its own, but Brian is not at all happy. He wants it out of the way before their holiday in two weeks.

I toy briefly with the idea of introducing him to Tony.

*Paronomasia being after all an aquired taste, even in the playgrounds of the wild westcountry.

Tuesday, August 14, 2007

The Doldrums

August is a funny month.

Most of the partners at the Ambridge Surgery have school age kids still, and so tend to need to take some time off through July and August for child care / family holidays, which leaves us short handed pretty much all through this month and in to September. Then again, much of Ambridge itself, and indeed its environs, is also on holiday, so the workload also tends to go down. Particularly when our little corner of the midlands can’t compete with the likes of Stratford upon Avon (home of the Immortal Bard) or “Historic Warwick” (their own self appointed soubriquet), for the lucrative UK tourist market.

All in all, two days back from another week at home with the kids, I feel very much becalmed. Which is not so bad, giving as it does, valuable time for catching up on paperwork and preparation for appraisal and so forth.

The only slight problem, stranded as we are in these medical Horse Latitudes, is that we are hosting a new medical student this next few weeks, and there’s so far been nothing very interesting for him to see.

He’s quite an engaging lad really. A bit northern, but none the worse for that, and at least he’s not, as so many seem to be these days, (pause for dramatic effect) a Brummie…

So if any of you happen to be in the area, or are even thinking about passing trough, and could muster up an interesting symptom or two to offer the poor chap, I’d be eternally in your debt. And for once it appears you won’t have to worry about waiting for an appointment.

Wednesday, August 01, 2007

Postcard from the global village

Today the sun is shining. Summer has finally come to Ambridge and environs (though possibly not for long if the Radio 4 forecast is to be believed). Indeed we now have proper double digit temperatures for the first time in yonkers. Twenty-something in the shade mark you! (That’s in new fangled Centigrade obviously—after all we are not at the South Pole here—although recently one could have been forgiven for thinking so what with all the rains and floods and penguins).*

It’s so warm I’m sitting here in the lunch hour with BOTH consulting room windows open listening to the pulsing chink-chink of a reggae rhythm wafting in from the car park. There must be some law of nature that brings the reggae into full bloom as soon as there are more than four hours of uninterrupted sunshine and twenty-something temperatures if you ask me. In short, barring the absence of a suitably exotic cocktail, and the small matter of an afternoon surgery to be survived (chiz, moan, groan) all’s right with the world.

Which is good, because in the past few days much of the world has been calling in to visit us. So far this week, in no particular order I have seen Black South-Africans, White Zimbabweans, a Kiwi, a few Poles, a Russian, a guy from one of the Baltic nations (sorry can’t now call to mind which), an Uzbek, numerous Pakistanis and Bangladeshis, more than a few Jamaicans (one of whom regales me with a tale of woe about his erstwhile tenants, whom he took to be Chinese when they were in fact illegal Vietnamese immigrants) and even taken delivery of a box of Mangoes from a very kind and appreciative patient who imports them specially for me once a year.

Even ten years ago it would have been hard to imagine such a widespread mix of peoples visiting a sleepy suburban surgery in the heart of England, but nowadays such consultations are increasingly routine. The only thing missing from our little League of Nations is a coach load of Japanese tourists. Oh , no, hold on a minute, first appointment this afternoon, Mr Harunobu, bus driver….

* O.K so I made up the penguins.