Benjamin Daniels - The Complete Confessions of a GP

‘You’ve got to help me, Doctor,’ Mr Hogden pleaded with me as he watched me take in the horror of his predicament. Despite the terrible state in which he was living, this was the first time that Mr Hogden had called out a doctor in the last ten years. He had managed to get to the toilet and back up until now and he simply spent the rest of his time lying on his mattress watching a tiny television that was mounted on the wall of his bedroom. His sister brought him his meals and Mr Hogden had quietly grown enormous without bothering a soul. Until now that was. This was yet another of those moments where I felt completely useless and, like all good cowards, I fled. To be fair, what was I going to do? I could have crouched down and picked the maggots out of Mr Hogden’s groin creases but I would have vomited. The flies would have fed off the regurgitated contents of my stomach, only adding to his problems.

I called the district nurses. I felt bad. I did. Really. No, I did. I warned them what to expect and when I bumped into them a few days later, they were amazingly stoical about the whole clean-up operation. They put me to shame. I went back to see Mr Hogden the next week. The maggots were gone but he was still lying on the floor of his squalid little room. We had a chat and talked about how we were going to sort things out. His expectations were low. All he really wanted was to be able to spend his days sitting in the lounge on a sofa and watching the television like a normal person. He was too heavy for the current sofa – hence the filthy mattress on his bedroom floor.

I was feeling guilty about my near-vomiting experience during our first meeting so decided to make it my mission to get him a new sofa. I phoned round endlessly and eventually social services agreed to supply a specially reinforced sofa for the bungalow. I had absolved myself. A few weeks after the sofa arrived I received a phone call from a hysterical Mr Hogden. ‘Please, Doctor, come round, please.’ Worried that the maggots were back, I avoided lunch and headed over. Mr Hogden was sitting on his brand-new sofa and had been there since it had arrived. Unfortunately, the effect of now sitting upright meant that his huge weight was now all being placed on to one pressure point on his bottom. He had not moved from his sofa since it had arrived and had developed unpleasant pressure sores on his bottom. The material of the sofa had gradually begun to stick to the infected sores and Mr Hogden was phoning me to tell me that he was now completely stuck to the sofa and couldn’t move at all.

I couldn’t quite comprehend what he was telling me over the phone, but as I arrived I saw that he was quite right. The material of the sofa and the sores on his bottom had become one. It was impossible to see where Mr Hogden ended and the sofa began. It was not a pretty sight and he had the same pleading look in his eyes that I had witnessed during the maggot incident. He was in a great deal of pain and I was feeling helpless again. I couldn’t believe that he had let his sores get so bad without calling anyone. He really needed to go into hospital but this was easier said than done. The first job was to cut him out of the sofa, which required a fair bit of teamwork, a set of garden shears and a very strong stomach. The next task was the more difficult job of physically getting Mr Hogden to hospital. I had ordered a specially reinforced ambulance with a strengthened trolley but, unfortunately, despite best efforts, Mr Hogden just couldn’t be fitted through the door. Four paramedics, a nurse, a medical student (I had to bring him along to show him that general practice wasn’t boring), several of Mr Hogden’s neighbours and I all tried to find different angles or ideas to get him out of the bungalow. In the end the fire brigade had to be called to cut out a wider door. They were reluctant and made Mr Hogden sign a disclaimer promising that he wouldn’t try to sue them for damaging his bungalow. Eventually, we got Mr Hogden to hospital. The next day my placement ended and I’ve no idea what happened to him. I hope he’s lost some weight and perhaps gained some quality of life.

Drew was a very good-looking guy. He was in his early twenties with big muscles, perfectly chiselled features, blonde hair, blue eyes and a probably fake but nonetheless healthy-looking tan.

‘I’ve got a painful testicle, Doctor. Wondered if you’d have a look at it.’

I was the only male doctor to have worked at this practice for over a year and my first few days were spent seeing a queue of relieved men worried about their genitalia. Some had been worried about their ‘bits’ for months but had been too embarrassed to expose themselves to one of the female doctors.

So there I was, gently rolling Drew’s testes between my fingers, looking for lumps. It can be a slightly uncomfortable situation for the patient in every sense of the word, so I decided to try to make a bit of small talk to put him at ease.

‘So Drew, what do you do for a living?’

‘I’m a film actor.’

‘I thought you looked familiar. Have you been in anything I might have seen?’

‘That depends, Dr Daniels, I only really do gay porn.’

‘Ah, probably not then, no. You … erm … must have one of those familiar-looking faces I guess. Definitely wouldn’t have seen you in a film. Nothing against porn or anything, except the degradation of women and all that … well, not many women in your films, I should imagine …’

There was now only one person in the room who was uncomfortable and it wasn’t Drew. I really should remember to limit my small talk topics to the weather and city centre parking problems.

It is always drummed into us how important it is for us to keep clear, coherent and detailed medical notes. These are apparently real extracts from medical notes. They have been doing the rounds as an e-mail.

1 She has no rigours or shaking chills, but her husband states she was very hot in bed last night.

2 Patient has chest pain if she lies on her left side for over a year.

3 On the second day the knee was better, and on the third day it disappeared.

4 The patient is tearful and crying constantly. She also appears to be depressed.

5 The patient has been depressed since she began seeing me in 1993.

6 Discharge status: alive but without my permission.

7 Healthy-appearing decrepit 69-year-old male, mentally alert but forgetful.

8 The patient refused autopsy.

9 The patient has no previous history of suicides.

10 Patient has left white blood cells at another hospital.

11 Patient’s medical history has been remarkably insignificant with only a 40-pound weight gain in the past three days.

12 Patient had waffles for breakfast and anorexia for lunch.

13 She is numb from her toes down.

14 While in ER, she was examined, X-rated and sent home.

15 The skin was moist and dry.

16 Occasional, constant infrequent headaches.

17 Patient was alert and unresponsive.

18 Rectal examination revealed a normal-sized thyroid. ( Thyroid gland is in the neck! )

19 She stated that she had been constipated for most of her life, until she got a divorce.

20 I saw your patient today, who is still under our car for physical therapy.

21 Both breasts are equal and reactive to light and accommodation.

22 Examination of genitalia reveals that he is circus-sized.

23 The lab test indicated abnormal lover function.

24 The patient was to have a bowel resection. However, he took a job as a stockbroker instead.

25 Skin: somewhat pale but present.

26 The pelvic examination will be done later on the floor.

27 Patient was seen in consultation by Dr Blank, who felt we should sit on the abdomen and I agree.