Doctor at Large

_'Adiposa familiars,' _I said brightly, as they entered.

'What's that?' the mother asked sharply.

'A Latin expression. Medical terminology. You wouldn't understand it.' I waved them towards the two chairs jammed beside the desk, placed my finger-tips together, and began, 'Now, what's the trouble?'

'Where's the doctor?' the mother asked.

'I am the doctor.'

'No, the real doctor.'

'I assure you I am a perfectly real doctor,' I said calmly. 'Surely you don't want me to produce my diploma?'

'You're Hockett's new boy, are you?'

'I am Dr Hockett's most recent assistant, certainly.'

She assessed me for some seconds.

'Well, I can't say I like the idea much of you meddling with our Eva' she declared. Eva was meanwhile staring at me malevolently, saying nothing, and picking her nose.

'Either you want me as your daughter's medical attendant or you don't,' I said emphatically. 'If you don't, you can take your National Health card elsewhere. I assure you I shall have no regrets about it whatever.'

'It's the chest,' she said, nodding towards the girl.

'What's wrong with the chest?'

'Cough, cough, cough all night long she does. Why, I never get a wink of sleep, I don't sometimes,' she added indignantly.

'And how long have you had this cough, Eva?' I asked, with my best professional smile.

She made no reply.

'Very well,' I said, picking up my stethoscope. 'I'd better start by examining her, I suppose. Off with your things, now.'

'What, you mean take all her clothes off her chest?' the mother asked in horror.

'I mean take all her clothes off her chest. Otherwise I shall not be able to make a diagnosis, we won't be able to start treatment, Eva will get worse, and you won't get any sleep.'

Eva said nothing as her mother peeled away several layers of cardigans, blouses, and vests. At last her chest was exposed. I laid my stethoscope over the heart, winked at her pleasantly, and said with a smile, 'Big breaths.'

A look of interest at last illuminated the child's face. She glanced at me and grinned. 'Yeth,' she said proudly, 'and I'm only thixteen.'

***

The morning passed quickly. The patients came steadily to my cubby-hole, though every time I began to think of lunch and peeped outside there seemed to be as many waiting as ever. I was relieved to find that my work was reduced through most of them not needing a full diagnosis and treatment, but only a 'Sustificate, Doctor'. I signed several dozen of these, certifying that people were in a state to stop work, start work, go to the seaside, stay away from court, have a baby, draw their pension, drink free milk, and live apart from their relatives. I gained confidence with every signature, and was beginning to feel I had a flair for general practice when I came against the case of the cheerful old lady.

'Hallo, Doctor,' she began. 'And how are you this fine morning?'

'I'm extremely well,' I said, delighted to have a pleasant patient. 'I hope we'll find that you are too.'

'I'm not so dusty. Especially considering. Do you know how old I am, Doctor?'

'Not a day over fifty, I'll be bound.'

'Go on with you, Doctor!' She looked coy. 'I'm seventy next birthday, that's a fact.'

'You certainly don't look it,' I told her briskly, feeling it was time to start the professional part of the interview. 'And what's the trouble?'

'Trouble?' She looked startled, as if I had asked her whether she wanted lean or streaky. 'There ain't no trouble, Doctor.'

'Then why-forgive me if I ought to know-have you come to the doctor's?'

'To get another bottle of me medicine, of course.' 'Ah, I see.' I put my finger-tips together again. 'And what sort of medicine is this?'

'The red medicine, Doctor. You know.'

'I mean, what do you take it for?'

'The wind,' she answered at once.

'You suffer from the-er, wind?'

'Oh, no, Doctor!' She was now humouring the teasing of a precocious child. 'Haven't had the wind for years, I haven't.'

'And how long have you had the medicine?'

'Oh-let me see-I first 'ad it the year we went to the Isle of Wight-no, it couldn't be that year, because our Ernie was alive then. It must have been the year after. Except it couldn't have been, because we had our Geoff with us, and he's been under the sod a good fifteen-'

'Quite,' I interrupted. I saw before me as clearly as the eyesight chart hanging from the wall the Ministry of Health circular on extravagant prescribing. 'Well, I'm afraid you can't have any more medicine. You're as sound as a bell, really, and you don't need it. Take a walk in the park every day instead. Good morning to you.'

At first she didn't believe me. Then she said in a sad faint childish voice, 'But I must 'ave me medicine, Doctor.'

'You really don't need it.'

'But I always 'ave me medicine, Doctor-always. Three times a day regular after meals-' Then she suddenly burst into tears.

'Now please control yourself,' I said anxiously. I began to wish I had taken the Hospital Secretary's advice and chosen the. Army. 'It's nothing to do with me. It's simply a Ministry regulation. If it was up to me you could have a dozen bottles of medicine a day. But we doctors have to cut it down.'

'I want me medicine!' she cried.

'Dash it! Do you wish to unbalance the Budget and ruin the country? Please be reasonable.'

Suddenly her grief became anger. Beating the desk with her umbrella she shouted, 'I want me medicine! I know me rights! I've paid me National 'Ealth like everyone else!'

'I will not stand for this,' I said, wondering if there was anything in the Hippocratic Oath against losing your temper. 'Kindly leave the surgery.'

'You thief! You robber! That's what you are! Taking all them shillings every week from poor folk like me what can't afford it! I know what 'appens to them insurance stamps! I know! Lining the pockets of the doctors, that's what! I want me medicine!'

She left the cubby-hole, but repeated her demand to the patients who had been listening intently outside, inciting them to riot. I held my head in my hands. For five years at St Swithin's I had probably ruined my health through overwork and deprived my parents of the last comforts of their declining years-for this. It would have been easier to face if I had eaten a nourishing breakfast.

'Sit down,' I said dully, hearing another patient enter. 'Name, age, and occupation?'

'Wilkins. Twenty-one. Trades union organizer.' A youth in a tight blue suit sat down, still wearing his hat. 'But I ain't a patient. At least, not at the minute.' He spoke softly and slowly, as though demanding my money and valuables in an alley on a dark night. 'You've upset my mother you 'ave.'

'If that lady outside is your mother, I'd be obliged if you'd kindly take her home.'

'Under the Regulations for the Conduct and Control of the National Health Service,' he continued, staring at the ceiling, 'a patient what receives inefficient service from a doctor can state a case before the local Executive Council, who, if they shall decide the facts proved, shall deduct an appropriate fine from the doctor's remuneration.'

I lost my temper.

'Get out!'

'Take it easy, Doc., take it easy,' he continued in the same tone. 'I'm not saying nothing against you-I'm only quoting regulations, see? It just happens that I know 'em.'

'And I suppose you go round making a damn good thing out of it?'

Picking his front teeth with a matchstick, he continued, 'I'd be careful what I was saying, if I was you, Doc. There's a law of libel in the land, don't forget. As a matter of fact, I've had five cases against doctors. Won every one. All fined. I'm worth near a thousand quid a year to the Executive Council, I'd say.'

'Now look here, Mr Watkins-'

'Wilkins.'

'I don't care who the bloody hell you are or what you intend to do, but if you don't get out of here at once I'll kick your ruddy coccyx so hard-'

'Violence won't get you nowhere,' he said imperturbably. 'I could lay a complaint before the General Medical Council in that case. That you was guilty of infamous conduct in a professional respect.' He rose. 'Don't forget the name, Doc., Wilkins. You'll be hearing more from me.'