Dr gordons casebook, p.1
Dr Gordon's Casebook, page 1
Richard Gordon was born in 1921. He qualified as a doctor and then went on to work as an anaesthetist at St Bartholomew’s Hospital, and then as a ship’s surgeon. As obituary-writer for the British Medical Journal, he was inspired to take up writing full-time and he left medical practice in 1952 to embark on his ‘Doctor’ series. This proved incredibly successful and was subsequently adapted into a long-running television series.
Richard Gordon has produced numerous novels and writings, all characterised by his comic tone and remarkable powers of observation. His Great Medical Mysteries and Great Medical Discoveries concern the stranger aspects of the medical profession whilst his The Private Life of…series takes a deeper look at individual figures within their specific medical and historical setting. Although an incredibly versatile writer, he will, however, probably always be best-known for his creation of the hilarious ‘Doctor’ series.
BY THE SAME AUTHOR
ALL PUBLISHED BY HOUSE OF STRATUS
The CapTain’s Table
DoCTor anD son
DoCTor aT large
DoCTor aT sea
DoCTor in Clover
DoCTor in love
DoCTor in The house
DoCTor in The nesT
DoCTor in The nuDe
DoCTor in The soup
DoCTor in The swim
DoCTor on The ball
DoCTor on The boil
DoCTor on The brain
DoCTor on The Job
DoCTor on ToasT
DoCTors’ DaughTers
The FaCemaker
gooD neighbours
greaT meDiCal DisasTers
greaT meDiCal mysTeries
happy Families
The invisible viCTory
love anD sir lanCeloT
nuTs in may
The privaTe liFe oF Dr Crippen
The privaTe liFe oF FlorenCe nighTingale
The privaTe liFe oF JaCk The ripper
The summer oF sir lanCeloT
surgeon aT arms
Doctor Gordon’s Casebook
Richard Gordon
Copyright © 1982, 2001 Richard Gordon All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form, or by any means (electronic, mechanical, photocopying, recording, or otherwise), without the prior permission of the publisher. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages.
The right of Richard Gordon to be identified as the author of this work has been asserted.
This edition published in 2001 by House of Stratus, an imprint of Stratus Books Ltd., Lisandra House, Fore St., Looe, Cornwall, PL13 1AD, UK.
www.houseofstratus.com
Typeset, printed and bound by House of Stratus.
A catalogue record for this book is available from the British Library and the Library of Congress.
ISBN 1-84232-517-5
This book is sold subject to the condition that it shall not be lent, resold, hired out, or otherwise circulated without the publisher’s express prior consent in any form of binding, or cover, other than the original as herein published and without a similar condition being imposed on any subsequent purchaser, or bona fide possessor.
This is a fictional work and all characters are drawn from the author’s imagination.
Any resemblance or similarities to persons either living or dead are entirely coincidental.
For, if a doctor’s life may not be a divine vocation, then no life is a vocation, and nothing is divine.
STEPHEN PAGET
JANUARY
1 JANUARY
This year I shall keep a diary. Surely the reflections of a busy GP will be as valuable for future scholars as other hand mirrors held to history?
The doctor trespasses into the lives and thoughts of his patients deeper than Parson Woodforde into those of his parishioners, Fanny Burney those of the Georgian beau monde or Mr Pooter those of Gowing and Cummings.
As Jean-Paul Sartre perceived, doctors know men as thoroughly as if they had made them.
My only problem is a style to dress yesterday’s memories roused each morning with the discipline of a bugle-call. Like Pepys, ‘Up betimes and to the surgerie, dispatched many vexatious patients with sundrie draughts, which methinks doth acte onlie on the minde… ’ Or like Gilbert White,
‘The inhabitants enjoy a good share of health and longevity; and the parish swarms with children, mostly maladjusted.’ Future scholars may find as instructive as Selborne my Kent market town of Churchford, seen for a quarter of a century through the wise and compassionate eyes of a dutiful journeyman doctor.
Unfortunately, I have such an appalling hangover after New Year’s Eve on my friend the major’s single malt, I shall defer my first entry till tomorrow.
8 JANUARY
I must make a second entry, to inform future scholars that I haven’t had a hangover for a week.
1
riCharD gorDon
10 JANUARY
I really must keep up this diary. I am haunted by the crass idiocy of my son Andy, a mere house-surgeon at ancient St Botolph’s Hospital in London, where I am unashamedly proud that he followed me. He arrived home this Sunday afternoon in a brand-new scarlet Alfa Romeo sports car, which he is buying on HP. When I observed that in my houseman days we were lucky to own a second-hand Morris Oxford, he replied flippantly,
‘You lot weren’t sharp enough to do the old Arthur Scargill act on the bosses for a living wage among junior doctors. Clocking 120 hours a week makes the old Umties’ – he meant Units of Medical Time – ‘tick up like a taxi in a traffic-jam. Now I’m into geriatrics and cremation fees,’ he ended with relish, ‘the ash-cash alone can buy a fortnight with a bird in Marbella.’
When I expressed sadness at such venality, more expected of the dockers than the doctors, he assured me cheerfully, ‘Come off it, Dad, medicine is far too difficult to be complicated by idealism.’ He seems happy, but a man who is not happy as a hospital houseman never will be.
11 JANUARY
I shall divorce my wife. She burst into morning surgery between patients in a state of excitement because the washing-machine programme was stuck and it was giving a continuous performance. A man exercising his profession at home, within the sound of his children squabbling and the smell of his lunch cooking, must be quarantined from domestic ills.
I demanded if Rembrandt, Beethoven or Leonardo da Vinci would be dragged from their work by a leaky washtub. She responded that I groused intolerably about washing-machine repairs costing more than Harley Street consultations, and that Leonardo would certainly make a better job of do-it-yourself than I did. We had macaroni cheese for lunch, which I detest, and accused Sandra (wife) of using it to get her own back. She replied tartly that it was cooked long before I was so rude. I have no knowledge of such things, so could not retaliate, which put me in a worse temper.
2
DoCTor gorDon’s Casebook
In the afternoon, to the public library ( Doctor on Call label invaluable for parking). Unlike most medical people, who read nothing but BMJ
(probably only the obituaries) and either Amateur Gardening or the Yachting World (depending on whether GPs or consultants), I retain contact with culture, if but a toehold. Find in ‘Philosophy and Religion’ Freud’s Wit and its Relation to the Unconscious, will be fascinating to the Englishman enjoying national sense of humour.
Book stamped by Miss Fludde, my patient, a solemn, pale, dark-haired, large-eyed girl, suffering from mammary hyperplasia, what the laity call big tits. She, much concerned these are abnormal, and from cynosure of every eye in bus, supermarket, Torremolinos, etc., has recently enquired at surgery if whittling operation possible. Gave reassurance that what seemed to owners as obvious as dome of St Paul’s is really as unnoticeable to passers-by as the lamp-posts. Advised against belittling Nature’s bounty, many women as dead envious of it as of the Princess of Wales, must complain of skimpy endowment, have operations with silicone bags, can go wrong, embarrassing case of striptease artist developing starboard flat tyre during act.
Miss Fludde said she sensitive to young men regarding them through sweater as did ravening Tantalus the fruit-laden boughs forever swaying from his grasp (being well read), wishes to be loved for personality and intellect. Luckily suffering also from sprained knee, could dismiss her to the General for course of physiotherapy, which should temporarily take her mind off the tits.
Take book, tactfully averting eyes from relevant organs, though difficult.
13 JANUARY
Our daughter Jilly is a preclinical (bodies, biochemistry, bugs) student at St Botolph’s, where I am ridiculously proud that she has followed me.
Being Wednesday afternoon (traditionally free for games, study in library) she appeared on her Honda. Churchford convenient for London, was a country town when Mr Pickwick and Mr Winkle cavorted through Kentish lanes, but now inhabited mostly by executives, graded by expense 3
riCharD gorDon
of obligatory document-case on platform in morning, leaving their ladies all day to clean house, tend garden, play bridge, slim, have lovers, grow neurotic.
I like to interest Jilly in clinical medicine by relating my simpler cases.
Like failure of the sympathetic nerves in the neck, Turner’s syndrome. She laughed, ‘Daddy, that’s Horner’s syndrome. Turner’s is a sex chromosome anomaly, non-disjunction of the X, if you must know.’ I r eminded her that I had been qualified so long that I could remember prescriptions in Latin, a language which the patients could not understand, no more than the doctors. We had a warm argument, ending with her slamming the door, like the day she brought an Italian dentist home from Rimini.
Searched for Price’s textbook of medicine to confront her in black and white, unfortunately discovered she was correct. I do so muddle names these days. I cannot even remember if Brearley or Botham is still captaining England.
Decided on amende honorable over tea and biscuit, but she snapped, ‘Don’t go on about it, I didn’t come home for a viva.’ She exclaimed a few seconds later, hadn’t I noticed anything different about her? Am lost, she with same hair, scruffy jeans, etc. Jilly burst out, she is engaged to an accountant called Terence. I protested no physical sign of this condition, such as diamond ring, she responded no time yet to choose one, they met only at the Student Union Ball last Saturday. Jilly left for London digs as soon as wife returned from Friends of the General meeting, Jilly irritatingly disgruntled, though suspect less from non-appreciation of enhanced status than from bringing week’s washing on back of Honda for Mum and finding the machine on the blink.
Anxiously discussed Terence with Sandra, age, colour of hair, colour of skin, etc. Sandra says an accountant OK, they treat other people’s money with skilled detachment as I their diseases, grow wonderfully rich.
Settling with single malt before evening meal when Windrush at the General, who like all pathologists has a tediously juvenile sense of humour, telephoned with complicated joke about the colour, consistency and chemistry of mid-stream specimen I’d left at his lab. Apparently, hastily handed-in screw-top jar was wife’s home-made lemon curd, 4
DoCTor gorDon’s Casebook
intended for church bring-and-buy. Wonder what purchaser made of similar pot originating from bank manager.
24 JANUARY
Sunday. 10 a.m., still in bed. Bright, cold, Cambridge blue day. Heard Sandra busily bumping round house. All alone. Andy on call, Jilly presumably on passionate weekend with Terence. Reread colour supplement.
‘Richard!’ Sandra entered, shocked. ‘Don’t forget we’re going for Sunday morning drinks to those awful new patients with the Rolls.’
‘I’m ill.’
Tender concern. ‘You poor darling! What’s the matter?’
‘Brain tumour. Trigeminal neuralgia. Cranial arteritis. I’m not certain.’
‘How can you continually scoff at your patients’ medical myths,’ she continued severely, ‘when persisting in believing, after an evening at the Hatchetts’ (professional colleague) ‘that single malt whisky never gives anyone a hangover?’
I rose, to seek aspirin in medicine cupboard in bathroom. This a converted dressing-room and freezing. We live in redbrick Victorian house with every modern inconvenience. Exclaimed, ‘God! How did we manage to collect all those bottles with peculiar coloured stuff running down the outside? All those pitifully deformed tubes? These little brown containers, showered by the government on its lucky sick like confetti? It looks like an arsenal for chemical warfare. What’s this mixture, ∑ΙPOHION AΓ
ENHΛ KA∑? It seems you have to ΛEΓΠEPIEXEI ∑ΟXΟP∑ΖΘΓ
with it.’
‘Surely you remember, dear? You developed d & v in Rhodes four summers ago.’
‘Oh, yes! That funny little chemist’s beside the retsina shop…our first holiday unbothered with the children since our honeymoon. There seems enough athlete’s foot powder here for the entire Olympic team,’ I noticed.
‘And why all these oils and ointments for bunions and callosities?’
5
riCharD gorDon
‘Have you forgotten that enormous Dutch au pair who grew so hysterical about her feet?’
‘Of course! Always – as I used to say – in tears amid the alien corn-cure.
Wasn’t that fifteen years ago? How time flies. Vitamin tablets! Quite disgraceful. No normal person needs vitamin tablets.’
She took the little drum tenderly. ‘I swallowed those when I was pregnant with Andy.’
‘So you did dear,’ I remembered. ‘Twenty years in the past. And you’ve hardly changed.’
‘Nor you, Richard,’ she responded touchingly, ‘apart from no longer needing this bottle of hair conditioner. Oh, look! Jilly’s Mary-had-a-little-lamb medicine glass, when we had drachms and scruples like £sd.’
‘Medicine went metric with far less fuss than the grocery trade.’
‘These yellow capsules…’
I seized them. ‘They shouldn’t be in the cupboard at all.’ I could not suppress a gulp. ‘Poor James was taking them when he died.’
‘Oh! So he was…only three, the little dear.’
‘You know, I still blame myself for his death. It’s a hard thing to say, but I didn’t diagnose his infection early enough, I didn’t take him to someone who knew more about it than I did.’
‘You mustn’t suffer remorse about it for the rest of your life, darling.’
‘Yes,’ I agreed. ‘I suppose it’s a good twelve years now since James started barking and wagging his tail in Heaven. What’s this? “To pep up your rechsteineria Leucotricha.” I know my anatomy’s a bit weak, but where is it?’
‘In a pot in the living-room.’
‘Now, these things like green Smarties are the remains of that double-blind trial for the university, using doctors as guinea-pigs. It should be enormously reassuring for the public, the care we take testing new drugs.
Not only the patient, but the physician, doesn’t know whether the identical tablets are real or only placebos.’
‘But you knew that every month’s course they sent you were placebos.’
6
DoCTor gorDon’s Casebook
‘Yes, it soon got round the profession that the placebos floated when you chucked the lot down the loo. Look! My old jockstrap. Sad. Moths.
Who needed these tranquillizers?’
‘I did, dear,’ Sandra told me crisply. ‘During our crisis. When you nearly ran off with that twenty-year-old receptionist.’
‘H’m. And I suppose this calamine was for the seven-year itch? Odd, you can tell the history of a marriage from its medicine cupboard. What’s this? Drops for earwax?’
‘When I nearly left you, because you never seemed to listen to a word I said.’
I read on a pink label, Comprimés pour les Névralgies, Migraines, Grippes, Courbatures Fébriles.
‘We can chuck this old tube out.’
She snatched it. ‘No you don’t! We brought it on our honeymoon at Cannes.’
‘I hope you didn’t have all those things?’
‘Oh, no! Well, not all at once.’
‘We’ve enough liquid paraffin here to move the bowels of the earth,’ I discovered. I uncorked a corrugated blue bottle, sniffed and sneezed. ‘This liniment’s a bit strong.’
Sandra smelt it gingerly. ‘For rubbing on Jilly’s horses.’
A fond memory suffused me. ‘Remember that wonderful P G
Wodehouse story?’ I asked. ‘ “Much has been written about the accident of birth” – the Master wrote – but had the Earl of Emsworth been born a horse he wouldn’t have gone screaming round Blandings at midnight after treating his sprained leg.’
Sandra dropped her eyes. ‘Do you know, Richard… I was laughing over that page on a dull night-duty when we first met at St Botolph’s.’
‘I can see you now, my sweet.’ I replaced the liniment in the cupboard and kissed her.
‘Richard! That was quite passionate.’
‘I’m feeling passionate. It’s either the memories, or something escaping from one of the bottles.’
‘But it’s breakfast time!’
7
riCharD gorDon
‘In France, it’s the most popular hour for love. That’s why they all gobble a quick croissant, instead of sitting down to bacon and eggs.’
‘Oh, Richard, darling… ’ She snuggled against my pyjama buttons.
The phone rang.
‘Damn!’ The telephone continually mars the intimacies of a medical household, and is recognized in the profession as a leading cause of coitus interruptus.
‘I’ll answer it,’ said Sandra.
She generally did. It’s as unproductive for a doctor to be exposed to the patient direct as it is for a politician to the voters on a phone-in.
I poked through the cupboard. Pink tablets, to be taken as directed.
