Richard Gordon - DOCTOR AT LARGE

'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?'

'There was an unusual psychiatric one. A farmer came in complaining that he experienced a strong sexual sensation every time he blew his nose.'

Farquharson stared at his burning tobacco. 'Well, now, that is interesting. What did you say?'

'Nothing much. I'm not well up in psychiatry. What would you have done?'

'I should have told him' said Farquharson without hesitation, 'that some people get all the luck.'

For the first time it occurred to me that Dr Farquharson knew much more medicine than I did.

During my month in the practice I gained six pounds in weight, took on a deep sunburn, and learned more practical physic from Farquharson than I had gained from the whole staff of St Swithin's. The remaining gaps in my education were completed by the village constable, who was the fattest policeman outside pantomime, and seemed to have the single duty of supervising the nightly closing of the Four Horseshoes from the inside. After a pint or two he would unbutton his tunic and solemnly recount the medico-legal history of the countryside. 'It was but a year ago, as I recall,' he would begin with the air of a surgeon discussing a grave case with a colleague, 'that we had an indecency down at Smith's farm.' He frowned as he took some more beer.' I can't remember off-hand whether it was _a gross_ indecency, or just an ordinary one. But you'd be surprised what goes on round 'ere, Doctor. Why, we gets at least an indecent exposure once a week.' He continued to describe some of his recent cases in the odd anatomical terms used only by the police force. 'Mind you, it's hard work, Doctor,' he added proudly. 'You've got to be sure of your facts. It was only at the last Assizes there was an 'ell of a row because we had a case concerning a mare, and the barrister got hold of the idea it was one with a gold chain round his neck what we meant.'

A few days before I was due to leave, Grimsdyke paid a visit.

It was clear at once that he had enjoyed a change of fortune. He roared up in a bright sports car, he wore a new tweed coat and a clean waistcoat, his shoes shone, his face was plumper and better shaved, his hair was tidy, and he had a brand-new monocle with a fine sparkle to it. He carried a pair of yellow gloves, and a bulldog puppy leapt at his heels. He looked like the young squire after a good day at the races.

Although Farquharson began by asking him how the devil he had got qualified and when was he going to start a decent job of work, Grimsdyke still seemed to imagine himself the favourite nephew. Only when his uncle's conversation had been reduced to a string of grunts he suggested the pair of us went out to the Four Horseshoes.

'The market seems to be doing well of late,' I observed, as we entered the bar.

'The market? Oh, yes, yes, of course. It's bouyant. By the way, I believe there's a few bob I owe you. Care for it now? Don't mind taking fivers, do you, it's all I've got? Cigarette-I suppose you like these black Russian things? Now let's have a drink. What can I get you?'

'A pint of bitter.'

'Beer? Nonsense! We'll have champagne! This is an occasion-the beginning of a great medical partnership. You know, Banting and Best, Florey and Fleming, Orth and Pettenkofer, and all that. I'll explain in a minute. Landlord! Your best vintage!'

The effect was lessened by the landlord of the Four Horseshoes having only a beer licence, so we had some Special Christmas Brew instead.

'Now what is all this,' I began firmly, wondering what trouble Grimsdyke was concocting for me and determined to stay clear of it.

'Have you had a go at the Primary yet?' he interrupted.

'Yes. The examiners were very undiscerning.'

'If you must wear a hair-shirt,' he said chidingly, 'you deserve to be tickled. Didn't you find out where they printed the examination papers? Some of these printer chaps'll do anything for a few quid.'

'I thought I'd better fail honestly, at least.'

'Quite right. I've been a great believer in professional honesty myself since old Moronic Maurice told me how he got through his surgical finals. At about the eighth shot, I might add. You know, those cases they got up for the exam-all the old chronics, the harvest of every out-patients department in London. Maurice spent a couple of months nosing around the teaching hospitals until he was pretty confident he'd seen all the old familiar faces. Of course, he sneaked a bloody good look at their notes to see what was wrong. He went into the exam room knowing he'd already examined and diagnosed every case in the place, which he said gave him a wonderful feeling of confidence.'

'There's nothing very honest about that.'

'But wait a minute. The examiner grabbed him by the sleeve, and to his horror started dragging Moronic Maurice towards the one patient in the place he didn't recognize. Maurice realized it was the moment for honesty. "Sir," he said solemnly, "I feel I must inform you that I have already had an opportunity to examine this particular case in the hospital." "Very truthful of you, my lad", the old boy said. "Come and have a look at one of these over here instead." So he got through.'

'Quite. Now if you'll explain what new villainy you're up to-'

'By the way, I forgot to mention we're both out of debt to that trio of sabre-toothed tigers, Wilson, Willowick, and Wellbeloved.'

'Both?'

'I strode in there the other day to fling their filthy lucre in their faces. It was such a pleasant experience I flung a bit more for you, too. Here are the IOUs. We might have a pretty little ceremony burning them in the Piccadilly Bar, don't you think?'