Further Confessions of a GP

It was 8.30 on a Friday evening, and the blessed end to a long day and a tiring week. Amazingly, I found both of my children fast asleep when I got home, and the house relatively tidy. There was a can of beer in the fridge, a surprisingly good film starting on the TV, and, most importantly, we were due a delivery from my favourite Indian restaurant. With my money at the ready, I was sitting on the sofa impatiently waiting for the doorbell to ring. I could just picture being handed over the large brown paper bag weighed down by tarka dal, chicken korma, pilau rice, naan bread, and a bag of poppadoms that had been thrown in free of charge. All of which were guaranteed to elevate my Friday evening mood even further. When the doorbell rang, I sprang to the door like Usain Bolt out of the blocks in a 100-metre final.

To my overwhelming disappointment, it was not the curry delivery man ringing our bell; it was Tom who lived across the road. Tom was in his late 60s and lived alone. He seemed to spend an unfathomable amount of time pruning his front hedge and complaining about the council’s management of residential parking permits. He was friendly enough, but although I like the general notion of being neighbourly, my natural instinct was to attempt to avoid him at all costs.

‘Hello Ben, I’ve been having a few problems that I thought might interest you what with you being a doctor. You did always say to come over any time if I needed anything.’

Keen to avoid just such a scenario, I have never admitted to being a doctor to any of our neighbours, but I suspected Tom had spotted the doctor’s parking permit in my car window, giving the game away. When I had said that Tom could pop over at any time, I meant to borrow the lawn mower or a cup of sugar, not to use my house as an all-hours walk-in medical centre.

‘It’s my bowels, see, Ben. Something dreadful they are. Shocking it is. It’s just coming away from me like an erupting volcano. All yellow and the smell really is just something else.’

‘Oh,’ was all I could muster as a reply. Having happily lapsed into a post-work haze of relaxation, I just didn’t feel capable of switching my brain back into empathic doctor mode. I should really have interrupted Tom straight away and explained the importance of firm boundaries between my work and my home and between neighbours and patients. I didn’t. Instead, I stood on the doorstep in frustrated silence inwardly willing Tom to go back home. Tom was blissfully unaware of my ebbing mood and terrible lack of empathy. If he had come to see me just an hour earlier while I was still at work, I would have listened intently and offered support, reassurance and maybe even a diagnosis. But in my head I was now off duty and I just couldn’t manage any level of compassion at all.

Some of you might imagine that as a doctor I am always on duty, continually seeking out the opportunity to fight disease. The truth is, I’m not. When I’m at work I’m a doctor and mostly quite a good one. When I’m not at work, I’m a dad and a husband and someone who likes watching football on a Saturday afternoon and eating a curry on a Friday night! The only exception to this rule is a true medical emergency. Then I will step in and help if I can. I have performed chest compressions on a beach and helped at the side of the road after a car accident. Any doctor would do the same. Tom didn’t have a medical emergency. He had a bad case of the squits and my ‘passion’ and ‘love’ for my job definitely didn’t extend to spending my Friday evening off listening to the extensive details of his bowel movements.

About 10 minutes into my doorstep consultation, the takeaway delivery man arrived and I was optimistic that this could facilitate my exit strategy. I began to start making my excuses, but before I could interrupt Tom, my wife nimbly squeezed past me, snatched the £20 note still grasped in my hand and exchanged it for the takeaway. Before I knew it she was back in the lounge tucking into her supper, while I was still left on the doorstep with Tom, grumpily listening to his woes.

Finally, after 20 minutes, enough was enough.

‘Erm, Tom, I think you need to give it a couple of days to settle down and if it’s no better go and see your own GP.’

With that I finally managed to close the door and return to my relaxing Friday evening. But, despite my relief at getting rid of him, I felt an instant guilt about my indifference to Tom’s distress. Over the years I’ve been amazed at how many of my patients are cared for by neighbours. I’ve witnessed some amazing acts of compassion and kindness between people whose only connection is proximity of habitation. Tom was a lonely guy who had simply wanted some neighbourly support and reassurance. He assumed that as a doctor I would be only too willing to offer that.