Richard Gordon - DOCTOR AT LARGE

As Dr Farquharson was still on his rounds I was shown into the empty consulting-room by his housekeeper. This was a small, dark apartment tucked into the back of the house, containing a dirty sink, an old-fashioned sterilizer heated with a spirit lamp like a coffee machine, and an examination couch covered with white American cloth that looked as uninviting to lie upon naked as a fishmonger's slab. In one corner was a bookcase untidily filled with medical text-books, mostly by Scottish authors and all out of date; in another stood a dusty pile of old copies of the B.M.J. and Lancet. I shook my head sadly. Looking round, I could see no haemoglobinometer, no erythrocyte-sedimentation-rate apparatus, no sphygmomanometer, no microscope, no ophthalmoscope, no centrifuge, no auroscope, no patella hammer, no spatulae, no speculae, no proteinometer, no pipettes…It seemed to me impossible for anyone to practise medicine in the room at all.

Dr Farquharson turned out to be a tall, bony Scot with thick white hair, gold-rimmed spectacles, and big nobbly hands. He was dressed in a pair of patched tweed trousers, a black alpaca jacket, a striped shirt, a wing collar, and a spotted bow tie.

'Afternoon, Gordon,' he said dryly, as though we had parted just an hour ago. 'So you've come to help out an old fogy in the depths of the country, have you? How's that rascal of a nephew of mine?'

'He seems very well, sir.'

'How the Good Lord ever let him qualify I don't know. He hasn't half a brain in his head, and the rest of his cerebral space is filled up with a mixture of laziness and lubricity. Let's have a cup of tea.'

Tea was served under a mulberry tree in the garden by the housekeeper, whom Farquharson introduced as 'Mrs Bloxage, who's painstakingly kept my feet dry and my socks darned since my poor wife succumbed to _phthisis desperata_ eighteen years ago.' We had raspberries and cream, tomato and cress sandwiches, brown bread and honey, buttered toast and home-made strawberry jam, scones and shortbread, and three kinds of cake. 'One of the few advantages for an out-of-date old man like me practising medicine in the back of beyond,' Farquharson continued, helping himself to more cream, 'is that the patients still bring you a little something out of the goodness of their hearts. They're simple souls, and haven't tumbled to it that the doctor's now a Civil Servant, like the Sanitary Engineer. What do you think of these raspberries?'

'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.