Further Confessions of a GP

‘Right, what can I do for you then Mrs Alexander?’

‘I’m all bunged up again, Doctor. I haven’t opened my bowels for two weeks.’

As I started to list the various laxatives and suppositories I could prescribe, Mr Alexander politely interrupted me.

‘None of those work for my wife, Dr Daniels. That’s why Dr Bailey has to clear it out himself.’

‘Excuse me?’

‘We put a towel down on the carpet here and Elsie lies down on it. We’ve got some spare gloves and Vaseline in the cupboard and Dr Bailey just puts his finger in and clears all the hard stuff out. He says it’s the only way once it gets to this stage.’

Before I could think of any way to object, Mr Alexander had neatly laid out the towel and Mrs Alexander was hitching up her nightie.

‘I think these gloves will fit,’ he said as he offered me a pair of medium-sized marigolds.

I had smugly managed to avoid ever having to do a manual evacuation up until now. I can vividly recall the occasion when one of the consultant surgeons made all the medical students in his team stand in a line with our hands held out in front of us. He walked up and down inspecting our outstretched fingers, searching for the slimmest and daintiest of digits to clear out the particularly tightly packed rectum that he had waiting to be evacuated of its hardened contents. I can still recall the relief I felt as I looked down at my short podgy fingers and then compared them to the delicate little hands of the Japanese girl standing to my left. I could almost smell her terror growing as she realised that the consultant was studying her beautiful slim fingers with some excitement. As he led her away to meet her fate, I looked down at my ugly, portly fingers and offered them an instant and unconditional pardon for their fat clumsiness and for all the tasks of dexterity for which they had previously failed me.

My luck had clearly run out though, today. There was no elegant-fingered Japanese medical student to save me this time, so I donned the gloves, took a deep breath and got stuck in. The urge to gag was almost overwhelming as I methodically used my index finger to pick out the rock-hard lumps that were blocking Mrs Alexander’s rectum. As I probed my finger further and further into the depths of her lower bowel, I finally managed to break through that last solid stubborn layer of rigid faeces. There was an ominous rumbling, an almighty stench and then the satisfying passage of soft stool leaking past my finger. I could see Mrs Alexander’s tight, distended abdomen deflating before my eyes.

It was an oddly satisfying experience and I gave myself a metaphorical pat on the back for having finally matched up to the lofty achievements of the wonderful Dr Bailey. I made a swift exit, and as Mr Alexander got on with cleaning up the results of my handiwork, I hurried back to the relative sanctity of the surgery.

As I walked through the door, the receptionist was holding the phone and covering the mouthpiece with her hand.

‘It’s Mr Alexander on the phone. He’s not very happy with you,’ she whispered.

‘Bloody hell! What more do these people want from me?’

‘Apparently Mrs Alexander is stuck in the lounge because you carried her downstairs but forgot to take her back up to her bedroom again before you left. You’ll have to pop back in on your way home tonight. They keep asking me when Dr Bailey is coming back…’

That was over three years ago now. Despite my disastrous first day, when Dr Bailey decided he wasn’t going to return, the surgery offered to keep me on as his permanent replacement. Initially, I was reluctant to give up my nomadic locum lifestyle, but with advancing years, I craved some stability and decided to stay. I soon found this quirky little GP surgery and its patients growing on me, and I’ve been here ever since.

Sarah

When Sarah walked in she looked familiar, but I couldn’t work out why. It was only my first week at the new surgery, so she hadn’t been to see me previously as a patient. I was going to suggest that we might somehow know each other, but before I had the chance, she launched into a long monologue relating her constipation and dodgy bowel symptoms in some detail. Suddenly, I remembered where we had met before. She was the sister of a girl that my friend Pete had gone out with about 15 years ago. We had met a few times, and I can clearly recall that I once went to a party at her house and made a very drunken and unsuccessful attempt to chat her up. After being very unsubtly rebuffed, I’d decided to drown my sorrows by drinking some more and ended up vomiting into her empty bathtub. As if that wasn’t bad enough, for some reason I then concluded that despite the bath vomit I was still in with a good shot with Sarah after all, and made another doomed attempt to chat her up. A good memory is a must for a career in medicine, but at times like this I really wish my powers of recollection weren’t quite so efficient.