Tuesday, January 27, 2009


… and Boom.

Or so it would appear. It’s been a nervous six months for the denizens of Ambridge. Light industry hereabouts had evolved to serve the needs of the midlands car makers through the boom years of British manufacturing industry. Those few that are left are all teetering on the brink of the much bruited recession, resulting in increasing uncertainty, lay offs, redundancies, short time working, and downwardly spiralling incomes for the majority of folk.

Add to that rising fuel costs and the coldest winter on record (well o.k. not quite perhaps, but certainly one of the chilliest I can recall) and it all adds up to a pretty miserable picture. Or so I thought until yesterday morning.

You see, we Yeomen of Borsetshire are a sturdy breed. When the chips are down we rally round and make the best of things, and when, as this year, there’s no cash, no heat and nothing worth watching on the telly, we can make our own entertainment. And it seems we have been. Rather enthusiastically.

And the upshot of all this “entertainment” was made manifest not once, nor twice, but three times in the space of one surgery yesterday morning. On each occasion in strode a confident looking woman (one with sheepish partner in tow) with a particular half-smiling expression. These days I hardly need to ask, but do so, just to observe the formalities, thus;

“Now what can we do for you Ms….?”

And they reply “I’m” (or once “We’re”) “pregnant!”

There follows a round of congratulations, followed by one (well, yesterday three) of the most joyful consultations you can get in this line of work. With the obvious exception, I’m not sure there’s a better way of spending a morning ;-)

Thursday, January 22, 2009

On being pleasant.**

It’s been an odd week again. The ongoing Ambridge Lurghi hasn’t helped, to be sure, but there’s more random weirdness abroad at the moment to go along with it. A case in point is young Elwood, a precocious little four year old who can already spell “Triceratops” and who has a friend who follows him everywhere, name of Harvey*. Elwood’s ears have been feeling a bit sore lately, so Granny brought the two of them in today.

“Harvey’s been poorly” chirrups the lad as Harvey takes his accustomed place seated beside his bestest friend. Elwood’s feet dangle over the edge of the chair, but as I round the desk I am careful not to step on the altogether larger paws of poor old Harvey.

I mime lifting aside a long lop-ear and gaze into space through my auroscope, a good two feet above the upturned face of young Elwood.

“It’s o.k.” say I “Harvey’s looking fine today, now how about you?” and then little Elwood proffers his own ear for inspection.

“Hmm. Not quite as good as yours I’m afraid,” I address the remark to the spot Harvey’s face should occupy. “I think the lad needs and antibiotic, just to be on the safe side.” We all three nod (Elwood assures me so), and off the two friends go, hand in paw, Granny in tow, clutching a script for Elwood, and the invisible carrot I proffer for Harvey’s trouble. I have a special jar of them on the desk, just for Harvey’s visits. Fortunately, being invisible it doesn’t take up much space.

* names changed to protect the innocent. The Triceratops, however is real.

** E-V-H-Ns (TM) on offer for the derivation as usual.

Monday, January 12, 2009

Learning to take the smooth with the rough.

Such is the perversity of human nature that I am starting to fret a little. I’ve become accustomed to a more or less steady diet of woe and misery over the last couple on months. The problem has been another winter of intractable cough bugs, with flu like illness chasers, that seem to have been doing the rounds in Ambridge for ever—or at least since early November.

There’s no denying they have been pretty miserable for the poor blighters who have been afflicted. Problem is they’ve also been pretty un-amenable to medical remedy. This has two effects. First it fills surgeries with a lot of miserable people, all lining up to be told, in so many words, there’s nothing we can do for them. Second, and almost more pernicious, it leaves one with a gnawing feeling of clinical impotence which, left unchecked, can lead to an appearance of uncaring dismissal when presented with yet another poor bastard with the lurghi.

The end result of such a downward spiral is a whole bunch of miserable patients and their miserable medical attendants, all moaning to and about one another. So if there’s anybody out there with a miracle flu remedy they can share there just might be a hob nob or two in it for them from this oppressed and downtrodden GP at least.

And then, today, for no clear reason that I can fathom, all the punters have been being especially nice. You know the sort of thing…

“You’re looking well today Dr J, have you lost weight?”

“I swear you’re looking younger now than the last time I saw you!” (Which was five years ago by the way).

“Thank you for your time. I feel so much better just for talking…”

So why do I sit here waiting for the next bombshell I wonder?

As an aside I heard on dear old Radio 4 at the weekend that the good burghers of Brisbane are teaching relaxation technique to toddlers. I feel vindicated. Someone in Oz has obviously been listening to my inane ramblings. Just remember, you heard it here first. Dr J the visionary!

Monday, January 05, 2009

Did you just hear something then?

So that’s it then. New Year rung in in suitable style at Jest Acres after trip to the Panto, New Years Eve banquet in the great hall to follow, concluding with the now traditional sybaritic orgy that is the chocolate fountain, and Jools on the telly in the other room Hootenannying for all he was worth. All in all it went rather well, though the return to a duty surgery on Friday the 2nd was a suitably sobering return to earth.

Still the New Year is off to a suitably surreal start, that if nothing else shows the perils of “copy and paste” correspondence. For a long time there have been parallel moans in U.K. health services. The hospitals moan that GP letters are often a bit sketchy, frequently penned in haste at the bedside as they are, and so are inclined to leave out essential titbits, such as the patients inside leg measurement and so forth. In turn GPs have moaned that the discharge letters thrust into the hand of homecoming patients tend to lack vital, or at least legible, information on trivia like diagnosis, treatment and follow up arrangements. This has, to my knowledge been a settled and steady state for at least three decades. I suspect even poor old Hippocrates had young whipper snappers moaning about the appalling state of the handwriting in his wax tablets down at the Kos DGH.

But over the past three or four years we have moved to printing a lot of the more relevant patient data onto an encounter sheet to attach to our urgent referral letters, and the hospitals have moved to IT generated discharge summaries which are way better than the pro-formas of yesteryear. The problem comes when these IT generated documents are pre-formatted for routine entries of common data, and not edited for those that do not apply, as happened today. Or at least I very much hope that that was the case. Otherwise we have a patient who died in hospital, but was found to have a normal temperature, blood pressure and respiratory rate on discharge from the ward to the mortuary…..

Must go now, it’s dark and there’s a strange tapping sound at the window.

Errr Hello!

Is there anybody there………….?