Friday, June 25, 2010


Spike came in this week for a chat. Nothing special in that really. We meet four or five times a year now to tweak his meds, catch up with the doings of the clever doctors in his various clinics, and the not so clever apparatchiks in the DWP.

Mostly what he needs me for is certificates to verify his status and the odd re-jig of his painkillers. The interesting bit is his status. You see Spike is a Revenant.
O.K. not the sort you need to fend off with garlic. Indeed Spike can walk quite happily abroad in the daylight. He can do it in Blighty too, and does, mostly, though not without a constant reminder of his if not unique then certainly uncommon circumstance. Oh and you can see him in mirrors too, in case you were wondering.

The difference between Spike and those other more spooky returners from beyond the veil is how he got here. Some time ago he was working in a factory. Having worked there pretty much all his adult life he reckoned he knew what he was doing, so when colleagues needed a hand unloading something big and hefty and made out of steel (sorry my grip of the technicalities here is perhaps a tad fuzzier than would be ideal), he stepped up, like always, and lent them a hand—in fact both hands and the whole rest of himself—as he had countless times before. This last time things went a little less than well, and in no time Spike found about half of himself pinioned under the hefty thing. In took something over an hour, cranes and such, and expert paramedics to extricate him.

In that time Spike drifted away for a while, and when he came too he was hooked up to all sorts of exciting contraptions which were re-expanding the lung that his rib fractures had collapsed, holding his leg back together, and supplying the pain relief he was going to need pots and pots of before he would be ready to try to move at all. Nobody said much at the time, but for a little while he had been what,in less technically gifted times might reasonably be called a bit dead.

It’s taken a while, but he’s now back on his feet and this week we got to discuss the various absurdities of his current position. Like anybody left disabled, either by health or injury, Spike has had to be assessed, and has become, like Schroedinger’s celebrated cat before him, a thing of percentages. Apparently, to the DWP he’s now only roughly 33% of his former self and in a bizarre twist, according to his employer’s solicitors he’s responsible for being so in a roughly similar proportion, since it wasn’t in his job description to help out his mates, and he wasn’t wearing the approved safety kit.

All Spike knows is it hurts him to walk now. Not much, but enough to stop him getting out and about like he used to. He can walk the dog, a bit, and do the garden, sometimes, but as for getting back to work, he’s still a long way off. Then there's sleep. Between nightmares he’s fine, and no he wouldn’t like sleeping pills and no the counsellor lady hasn’t helped a lot. And as to the hospital, a nice sister in ITU who had seen him through the worst asked him last month if he realized how lucky he was to have cheated death, like this was something to be instantly and unhesitatingly grateful for, despite loss of livelihood, and severe limitation of many of the functions he suffers that we all take for granted.

Spike knows, in a sense, he has been lucky, or at least luckier than he might have been, but her well intentioned comment really hasn’t helped. He now feels guilty about the bitterness and the sheer panic that sometimes overwhelm him when he’s transported back to his time on ITU or worse to the day it all happened and his old life ended.

So I tell him that’s o.k. and that for 1/3 of a Spike he’s doing pretty well and day by painful day he’s getting better. Who knows, soon he might even make a 1/2 Spike, and even now in his diminished and revenant state he’s still more of a man than some I look after who are notionally whole. And so we decide that this afterlife isn’t so bad after all, but he’s quite right when he says we should all be so lucky...

* I know this is a bit of a reach, but Virtual Hob Nob on offer if you link post and title-- you all know the drill by now I hope;-)

Tuesday, June 22, 2010

Of coffee and Hob Nobs.

So, I managed to keep this blog entirely free from politics all through the election... admittedly by the simple expedient of failing to comment on anything at all for the duration, and all through the tawdry aftermath for good measure. In all honesty things are a bit grim in Ambridge right now, so there’s not been a whole lot worth sharing, and really no time for sharing it all with you poor long suffering souls.

So colour me astonished when I received, through the comments of this shambling mess of a “journal”, a request from a publisher to review a book about my craft, written by an esteemed colleague known to probably nearly the entirety of the UK GP community. Consider the foregoing a declaration of interest. What follows is not exactly a paid endorsement, but I did receive, and am thoroughly grateful for, a copy of the said volume. All that said, I took this assignment with more than a little trepidation.

The thing is the author, one Dr Tony Copperfield (actually a collaboration of two practising GPs) is well known for his bi-weekly column on the back page of our Trade Paper “Pulse” where his worldly wise musings on the absurdities of the job, the relentless push for “evidence based medicine”, the inanities of the Contract, the Departmental Diktats and the lunacies of the PCTs (our immediate managers) never fail to raise a wry smile and a sardonic chuckle. But to let him loose on an unsuspecting public—would this be wise? I had my doubts.

I suppose at this point I should mention the book in question, “Sick Notes. True stories from the front lines of medicine.” It’s published by Monday Books and you can find it here.

Having received and devoured my copy I’m happy to say that this collection of Dr Copperfield’s writings strikes just the right note. The wit and the sardony (I know it’s not a proper word but it definitely should be) are still there, but leavened with stories of old friends and worthy adversaries in the form of Airfix Man (I defy you to read this snippet without at least the beginnings of a lump in the throat) Mr Nickleby (guess where Dr C goes for many of his pseudonyms), and Rebecca Bagnet, along with snipes at the political dimensions of health care, the PCT, the profusion of forms and hoops and brain dead rituals that seem solely intended to stop us doing the job. Along the way you will discover the central role of coffee and Hob Nobs to the functioning of any well regulated family practice and you’ll learn a lot about how UK General Practice operates... er, consults.

If you read this book you’ll discover why your GP adopts that strange far away look when you take him or her a little list, or begin with “I don’t see you often...” or end with “While I’m here....” . Dr C is indeed divulging some trade secrets, but he’s giving you a user’s guide to your GP into the bargain. Or at least he is if you live in this sceptered isle. Because Dr C practices here in Dear Old Blighty his descriptions of our working environment and the challenges it presents are very time and place specific, but the stories he tells of his patients and their woes are universal. And though the style is tongue in cheek the book is billed as a work of non fiction, and so it is. Not all of the events portrayed may have happened exactly as presented, but however much they stretch the credibility, believe me when I tell they happened, and they’ve almost certainly happened to your GP too. (I would have dearly loved to have been at the meeting where he and his partner presented the PCT with their newly “imagineered” Universal Referral Form.)

I suspect this book will be regarded as something of a niche market publication, but I hope it manages a wider circulation, and if I have one wish it is to make it compulsory reading for all PCT managers and Chief Executives. Indeed I’m thinking of passing my copy on to our own Beloved Leader, assuming it’s still in a fit state when my partners have done with it. I get the feeling there is a real gulf of understanding between our two disciplines, and I think Tony Copperfield might have give us a means of bridging the divide. So if you’re an NHS administrator, a politician in or aiming for the Health Department, or if you’re remotely interested in the workings of our shared profession, you owe it to yourself to read this book.

And the next time you’re in the surgery why not take along a packet of Hob Nobs for the troops? Tell them Tony sent you.

They’ll understand.