Further Confessions of a GP

His wish made me think about the poor people who had donated their bodies to my medical school. Perhaps they too thought that their remains would offer great benefits to the world from which they had departed. Little did they know that instead they were being left mercilessly in the hands of a horde of incompetent first-year medical students. Every Thursday morning we would prod away at bits of body with very little clue as to their anatomical whereabouts, often while nursing a terrible hangover. Looking back, I wonder quite what I gained from the dissection experience. It did help desensitise me early on to the brutality of being faced with a dead body, but I always found it easier to learn my anatomy from the anatomy colouring book rather than from poking around inside real dead people. I just hope that a few of my more studious colleagues achieved greater enlightenment and inspiration from the experience.

On reflection I decided that Donald deserved more encouragement for his decision: ‘I think it’s really great that you are willing to donate your body to medical science, Donald. Well done you. Are you on the organ donor list too? Wouldn’t it be amazing to have one of your organs live on in someone else’s body and keep them alive when you are no more.’

‘Yeah, I thought about that, Dr Daniels, but I’ve had to say no on that one.’

‘Oh, why’s that?’

‘Well, what if my organ went on to help someone who I didn’t agree with?’

‘What do you mean?’

‘Well, what if part of my body was given to a terrorist or a suicide bomber or something? I wouldn’t want that.’

‘I think a blown-up suicide bomber would probably need a little more than one of your kidneys to keep them alive, Donald.’

‘Well, yeah, but you know what I mean. What I’m saying is that I would want some sort of clause on my donor card to say that my organ wouldn’t go to a religious extremist or a paedophile or someone like that.’

‘Isn’t being an organ donor about just helping someone else regardless of who they are? It’s about giving a complete stranger the gift of life. A stranger to you – but for someone else, a beloved father or daughter or wife. Through your generosity, you could extend someone else’s life for potentially decades to come.’

Donald paused.

‘I can sort of see what you’re saying, Dr Daniels, but I just couldn’t die peacefully knowing that one of my organs could live on in a Manchester United fan.’

Gastric bypass

‘It’s this gastric band. It’s not working. Something has to be done, Doctor!’

I’d never met Donna, the woman sitting in front of me, before, but I recognised her. Every morning I pop into the local Tesco Express near my surgery to grab a sandwich for lunch. Normally this task is carried out in a foggy blur of early-morning grogginess; I rarely notice my fellow shoppers. However, today had been an exception. And now, the patient facing me in my office, I realised, had been in front of me in the check-out queue that morning. She had caught my attention because she’d bought herself an entire chocolate cheesecake for breakfast and proceeded to tuck into it even before she’d left the shop. Please don’t think that I am some sort of evangelical health-food fanatic; chocolate, cheese and cake are three of my favourite things. A chocolate cheesecake is a thing of great splendour, something in which I have indulged on many occasions, but this was 7.45 on a Monday morning. Who eats a chocolate cheesecake for breakfast?

‘What’s been going on then?’ I asked Donna.

‘Well, when I eat, I always feel sick. I think there’s something wrong with the gastric band. I’m not even losing weight.’

Even without a gastric band I think that eating an entire chocolate cheesecake for breakfast would have made me feel a tad nauseous. Thanks to a bariatric operation, my patient had a band restricting her stomach to only a quarter of the normal capacity. If today’s breakfast was representative, of course she was going to feel sick after meals.

‘Who put the band in?’

‘The NHS wouldn’t do it so I had to go private, but I can’t afford to go to see them again. It cost me a bloody fortune to do it in the first place. What a waste of money.’

Looking through the notes I could see that Donna had come in many times over the last few years requesting help with weight loss. A previous GP had referred her to have a gastric band fitted on the NHS, but the request had been rejected because she didn’t fulfil the criteria: patients need to have spent at least two years trying to lose weight through exercise and diet programmes. Clearly not prepared to wait, Donna had found the money to get the op done privately.