WHAT DOES THE DOCTOR THINK THIS MONTH?
September 2008
Ian brings us his delightful off the cuff view on this month's happenings
Conundrum of the month - Why do horses, which can easily jump 6 foot high fences, stay in a field with a 4 foot fence around it?
This conundrum fell flat on its face when I discussed the matter with those who know about horses, Apparently, a horse will stay in its field while life in the field is good, with lots of food, etc. However, if a testosterone-driven male sees a female he fancies or if a horse hears a friend in trouble, he will take off immediately, scaling the fence as if it was not there! All the horse experts I spoke to had tales of runaway horses and their efforts to recapture them. This reminded me of an incident in 1970 when I was a village doctor in Sussex and had a friend who was the village vet. One Sunday afternoon, his tiny little Shetland pony ran off and was grazing contentedly on the golf course. The vet was operating at the time so his wife asked me to help. It would be easy - she handed me a bucket of horse nuts (food, that is) and said that she would "drive" the pony towards me. I would then hold out the bucket of nuts and, when the pony put his head into the bucket to eat, I would grab him by the neck collar and the job would be done! It took an hour for the pony to put his head in the bucket and for me to grab his collar. It took the next 5 seconds for me to fly 20 yards horizontally through the air after he nonchalantly threw me to one side with a flick of his neck! Another hour passed before we finally caught him. The vet found all this hilarious; I did have a little fun at his expense when, one morning, I saw him walking up the road with the pony, two sheep and a goat on leads when he should have been on his way to work. I expressed a preference for dogs as walking companions which caused him to explain, through gritted teeth, how the whole lot had escaped during the night and he had just finished rounding them up.
The Bluebell Catastrophe - Score: Bluebells 1 - Nisbet 0
Management frequently tells me to "Get a Life and stop prattling on about bluebells". Having discussed my victory over the bluebells a couple of months ago, when I had obtained managerial permission and a certificate allowing me to pull up the dead stalks before they seeded and to dispose of the greenery, I really thought that would be the end of the bluebell discussion for this year. However, they had their revenge! I was doing a bit of industrial weeding under some big bushes at the bottom of the garden when, too late, I spotted some really dried out bluebells with seed pods gaping. Suddenly, the freshly turned soil was covered with hundreds of shiny little black bluebell seeds, each one grinning and laughing at me, totally impossible to remove. Needless to say, I shall be watching that area like a hawk next Spring!
My other arch enemy is convolvulus or bindweed. I think I am winning the battle in the garden by a combination of digging it out and using a translocating weedkiller. However, I know that it is out to get me and, when I am gone, it will take over the garden. We share an old cruiser with Judith and Ken Griffen. At the boat club, there are 30 moorings. Suddenly, one of the moorings has become swamped by bindweed - OURS!
He's paranoid, I hear you shout. Well, remember the old saying "Just because you are paranoid, it doesn't mean they are not out to get you!"
What did the doctor mean? Peter Cooper of Feltwell handed me a cutting of an article describing how phrases used by doctors are often misconstrued by patients as a "brush off". The first and most obvious one is "It's a viral infection". The patient hears "I have no idea what is wrong with you". Not that many years ago, some patients refused to believe in the existence of viruses, accusing doctors of making up their existence to make consultations easier. I used to have some electron microscope pictures of viruses in my desk to show such patients. While studying the other day, I came across three enormous new books which gave details of all the known viruses, how to treat them, etc. Most viral infections in healthy people (except AIDS) are harmless and self-limiting and it is reasonable to withhold antibiotic treatment.
According to the article, "I'm sending you to a specialist" is often interpreted as "I've had enough of you". In fact, I have never been aware of patients thinking like this and I am sure most have been pleased to be referred. GPs have a very broad base of knowledge but specialists know a great deal about an individual topic. The combination provides a very safe system of medical care.
Let's have some fun: When asked by the airline stewardess whether or not he would like dinner, the passenger asked "What are my choices?". The reply was "Yes, or no". A teacher, whose pupils had an important exam the next day, warned that he would accept no excuse for absence short of nuclear attack or a death in the family. A clever lad at the back, showing off, wondered whether utter sexual exhaustion would count as an excuse. Much sniggering and laughter in class. "No" said the teacher, "You'd have to write the exam answers using your other hand!"
Best wishes to you all
Ian G. Nisbet