Further Confessions of a GP

Sometimes I wish that I too believed in God so that I could justify some of the terrible things I’ve seen as simply being a divine will.

However much pain and hardship Wesley has caused Karen, I’m 100 per cent sure that she wouldn’t for a moment wish that he hadn’t been resuscitated. While resuscitated babies are left with varying degrees of disability, others make full recoveries. I would like to think that we should value the lives of all these children, but I sometimes wonder if there might be a point when quality of life would appear so limited that we question the ethics of artificially maintaining life. As a doctor, I can’t give an answer to when this point should be any better than anyone else. Wesley is now nearly two years old and he is still at the developmental stage of a newborn baby. Karen tells me he seems to like it if she plays him music and gently rubs his tummy. Is that a quality of life worth all the suffering? Karen would say yes. I’m not so sure.

Notes

Several reviewers of my first book suggested that the funniest part was the section on medical notes. I could be a little offended, as this was the only chapter in which I made absolutely no creative contribution. However, given its popularity, I thought I would offer a few more humorous excerpts apparently extracted from genuine medical records:

1. The patient left the hospital feeling much better, except for her original complaints.

2. Patient’s fluid intake is good, mostly beer.

3. Patient has neck veins distended down to ankles.

4. I will be happy to go into her GI system; she seems ready and anxious.

5. The patient states there is a burning pain in his penis that goes to his feet.

6. Her leaking occurs with coughing, sneezing, and exercise such as running. She would like to do more exercise, but the incontinence inhibits her. She does, however, carry on water sports.

7. She has been informed that she is pregnant by her GP.

8. Kindly see four-year-old James, who has had a cough since yesterday. Also, the family pet dog has had a similar barking cough for the last few days.

9. I should be grateful if you could see Mrs Y, who has halitosis of both great toes.

Nurses I

I had just arrived for my A&E shift, and to my pleasant surprise the department looked relatively calm in comparison to a normal Friday evening. There were no trolleys in the corridor and even some of the cubicles were empty. ‘Doesn’t look too bad,’ I remarked to Sian, one of the nurses. ‘Don’t jinx it,’ she said. ‘I really need to finish on time tonight. It’s my daughter’s 10th birthday and I promised her I would be home before she goes to bed. I always seem to be working on her birthday.’

The evening wore on and it was just how I like it: a constant stream of patients coming in and out but none of the frantic chaos that so often accompanies working in the emergency department. A couple of hours into my shift I was asked to see Bill, an elderly gent who was confused and agitated. Clara, his worried daughter, was trying to calm him down, but in his confusion he was just mumbling a few words and continually trying to pull off his oxygen mask. Clara had been trying to persuade her dad to see a doctor for months but he had steadfastly refused. He had been stoically ignoring a horrible-looking infected ulcer on his foot. But it had got so bad that the infection had taken hold and he was now too unwell to object to being brought to hospital by the paramedics.

Bill was dehydrated; I needed to put in a drip so that we could give him some fluid, but every time I thought I had calmed him down enough to put in the needle, he would jerk his arm away at the vital moment causing the needle to burst his vein. Searching his arms, I realised I was running out of good veins. I was going to need some help.

‘Sian, could you just give me a quick hand?’

‘Sorry, Ben, my shift finished 10 minutes ago and I really need to get away on time tonight.’

I quickly scanned the area, but there was no one else free.

‘I just need you for two minutes. I can’t get a cannula in this patient. Could you just hold his hand and keep his arm still?’

‘Two minutes!’ Sian repeated sternly before she reluctantly followed me into Bill’s cubicle.

Ten minutes later I was still trying to find a decent vein to cannulate. Thankfully, Sian was doing a sterling job keeping Bill calm and, most importantly from my point of view, holding his arm still. She was even chatting away warmly to his daughter Clara and helping to distract her from how poorly her father was. To all of our relief, I finally got the needle into the vein and gently slid the cannula in place.

‘Thank you so much, Sian. Just keep his arm still for 10 seconds longer while I find some tape to really secure this cannula – I don’t want him to pull it straight out.’

Just as I began to turn round, Sian grabbed my arm. I twisted back to find Bill had suddenly slumped forward and let out a gasp. His eyes, which had previously been shut, were now open.