'Delicious, sir.'
'Aren't they? Old Mrs Crockett's varicose ulcer produces them year after year.'
When he had finished eating, Farquharson lit his pipe, pressed down the burning tobacco with a metal tongue spatula from his top pocket, and went on, 'The work's pretty easy round here, I suppose. There's hardly enough for two, especially this time of the year. But I'm glad enough to have someone to yarn to-I'm a bit of an old bore, you know. I was out in West Africa a good deal of my life. I settled down here because I totted up the ages on the gravestones across the way, and averaged out that this village has the lowest death rate in the country. I find plenty to interest myself in the natural history of the countryside-which includes the inhabitants. And in a couple of years the Government's going to chuck me out as too old and incompetent for anything except sitting on my backside and drawing my pension. God knows what I'll do then. But I'm rusty all right. Can't understand half the words in the Lancet these days.' He slapped me on the knee. 'You can put me right on all that, my lad. I suppose you know about these drugs they're bringing out like editions of the evening papers? You must give me a lecture on 'em some time. I'm just an old fogy of a country G.P.' He pulled a large gold watch from his pocket. 'I'm off to see a couple of patients before surgery. Settle in, and I'll see you for supper.'
Supper was cold salmon (the squire's gall-stones), cream cheese (the postmistress's backache), and to celebrate my arrival a glass of port (the vicar's hernia). Farquharson chatted entertainingly enough about West Africa, neatly comparing his native and his present patients, but I realized that he was as out of place in modern medicine as a jar of leeches. There were clearly several points on which I should be putting him right.
Within a week I discovered that medicine in the country is wholly different from medicine practised anywhere else. In the first place, most of the patient suffer from diseases totally unknown to medical science. At St Swithin's I examined my patients confident that their condition could be found somewhere between the green morocco covers of French's _Index of Diagnosis;_ but in the country I puzzled over the significance of symptoms like horseshoes pressing on the head, larks in the stomach, and ferrets running up and down the spine at night. Even Dr Farquharson's former diagnoses were obscured by the patient's helpfully remembering the name, it taking me some time to recognize, for instance, that the woman complaining her child had been attacked by the infant tiger meant that he was suffering from impetigo.
Secondly, the visit of the medical attendant in most households provided less relief for the sufferer than entertainment for the rest of the family. The cry of 'Coo! it's the Doctor!' brought children running from their corners as powerfully, as the smell of baking cakes. Arriving in the sickroom, I found it difficult to place the finger-tips together and demand with dignity, 'And how about the bowels?' when half a dozen small boys and girls were staring at me as though I were the hanging scene in a Punch-and-Judy show. When I insisted on having them shooed away they continued the enjoyment by taking turns to peer round the door, and my careful assessment of the pitch of a percussion note was often ruined by the awestruck whisper passing down the corridor, 'He's punching poor mummy all over the chest.'
In houses where there were no children, the patients reflected the more leisurely life of the country by using their attack of gastritis or summer flu to give the doctor a resume of their life story and their opinions on their relatives. A brisk 'Good morning! And what can I do for you?' as I approached the bedside generally brought a contemplative folding of hands across the abdomen, a faraway look, a deep sigh, and the reply, 'Well, Doctor, in the 1914-18 war I was standing in a trench at Vimy…' or, 'I haven't been the same, Doctor, since that night me 'usband joined the Buffaloes…'
When I mentioned these discoveries to Farquharson after supper one evening, he said, 'Oh, folk need to unburden themselves a bit. They don't like boring their friends, and their relatives won't listen to 'em any more. They're scared of the parson, so the doctor's the only one left they can pour their hearts out to.' He began to scrape out the bowl of his pipe with a scapel he kept on the, mantelpiece. 'I've got old-fashioned ideas, but that seems to me part of the doctor's job. That's something they never took into account when they got up this Health Service. Bloody silly, isn't it? Ask any G.P., and he'll tell you half his job is sympathizing with people, and that's ten times as difficult as treating 'em. Did you use the thermometer?'
'I couldn't-there's only one in the surgery, and it's broken.'
'It's broken all right. If I can't tell when a patient's feverish, I'm not much of a doctor. But shove it under their tongue, lad, and you've shut 'em up as long as you like. Or you can stick your stethoscope in your ears-it's not much good for anything else round here, because half of 'em think they'll drop dead if they take their vests off. Or you can take their pulse and scowl at 'em while you wonder what the devil's the matter. That shuts 'em up good and proper. You don't even need a watch. I couldn't afford a watch when I qualified, so I used to stare at my cupped hand instead, and nobody found out for eighteen months.
'As for the audience, always give 'em something to do. The public loves to see the vomit coming up or the baby coming down, but they love it even better playing the nurse. Get them to boil water-pots of it. When there aren't any saucepans left you can always start them tearing up the best sheets for bandages.' He lit his pipe, and went on reflectively, 'Never start off by asking a patient, "What are you complaining of?" They'll say, "I'll have you know I'm not the complaining type, not like some I could mention", and start some rigmarole about their sister-in-law who's been living with them since Christmas. Don't try "What's wrong with you?" because they like scoring one over the doctor and they'll reply, "I thought that was what you were here to find out." That starts the consultation on the wrong foot. And never ask, "What brought you here?" because ten to one they'll tell you the tram or the ambulance. Always listen to a patient's story, however long it is and however much you want your dinner. Usually they've come about something quite different, and they're too embarrassed or too scared to bring it out. And always give 'em a bottle of medicine, even if you and the whole Pharmaceutical Society know it's useless-even a straw's a comfort to a drowning man. Never tell them they're an "interesting case". Patients have got enough sense to know the only interesting cases are the ones we don't know anything, about.
'You can diagnose half your patients as soon as you, step through their front door, with a bit of practice. Brass gongs on the wall and tiger skins on the floor mean high blood-pressure. Box of chocolates on the piano and a pekinese on the mat-that's obesity. Bills on the dresser and cigarette ash on the parlour carpet look like a duodenal ulcer upstairs. I've found aspidistras and antimacassars generally go with constipation. It's common sense. If you keep your eyes open you won't need the curate's legs sticking from under the bed to spot a case of female frustration. And never be squeamish asking about insanity in the relatives. I always start off, "How many in the asylum?" and you'd be surprised at the answers I get, even in the best families. But I'm rambling,' he said apologetically. 'You talk for a change. Seen any good cases today?'