Practice Makes Perfect
Page 11
At number six you would have thought it was the middle of the evening, not three o’clock in the morning. In their civilised split-level living-room the lights were low, the drinks flowing, the music playing softly. Lionel, in velvet smoking-jacket, was leaning nonchalantly against the piano, Georgie, in a black polo-necked sweater, lay motionless on the orange sofa.
Lionel raised only one eyebrow ever so slightly at my appearance. I thought it was my rolled up pyjama legs and feet, which were none too clean; I then realised that I was still, like St George after the dragon, carrying the mop! I handed it to Lionel to punish him for his urbanity and kneeled by the suffering Georgie.
I felt for his pulse. He opened one eye and put his other hand over mine.
“I haven’t seen you before, have I, darling?”
I removed his hand.
“I thought you were supposed to be ill!”
“I am.”
“Well, I’m the doctor.”
He eyed my pyjamas and winked at me. “I’m Bluebeard!”
“George, darling,” Olivia said, “tell the doctor what you were complaining of before you passed out.”
“I still am,” Georgie said. “Complaining of it, I mean. Someone, I absolutely swear, has ignited the fire in the back of my neck which is slowly spreading to my arms and chest, I have difficulty in moving my jaw and my heart is beating like a tom-tom…”
“There’s no need to cry, darling,” Olivia said.
“I can’t help it. The tears just come.”
They were rolling down his face; he mopped them up with a black handkerchief.
Puzzled, and watched by an interested audience, I examined him. It was an odd collection of symptoms of which he complained and either it was the time of night when I was not feeling particularly bright or they didn’t fit in with anything.
Suddenly I had a brainwave. “How much have you had to drink?”
“About a pint. Wouldn’t you say a pint, Livvy?”
“It was you who insisted on another one,” Olivia said.
I eyed the litter of whisky bottles. A pint! My God.
“Horlicks,” Lionel said without moving, in the way that actors have.
“I beg your pardon?”
“Horlicks. Georgie doesn’t touch the hard stuff.”
“Of course.” I was stumped. The man was obviously in pain and with my stethoscope I detected a definite change in his heart rhythm.
“Look,” I said, “I just want to prepare something for him. Do you think I might pop into the bedroom for a few moments?”
“Of course.”
I picked up my case and followed Olivia up the stairs.
“Is it serious?”
“It’s hard to say at the moment,” I said ambiguously. “I shall be able to tell you more shortly.”
She shut the door tactfully. I looked round quickly and discovered to my relief that the gamble had come off. There was a telephone by the bed.
I dialled as quietly as I could.
“Good evening to you, man! This is your friend and physician speaking. In what way can I help you?”
I thought of the short shrift my patients got in the middle of the night and felt suitably ashamed.
“Fred?”
“No other.”
“Look, Fred, I need your help.”
“Where are you?”
“On Olivia Duke’s bed.”
“In or on?”
“It’s immaterial. Listen…”
I told him about Georgie’s symptoms and how in my mind they were obviously genuine but just didn’t add up to anything.
“Burning sensation in the back of the neck, spreading to arms and chest, tightness in the muscles of the face, lacrimination, palpitation, occasional faintness?”
“That’s right. What do you make of it?”
“Hush, man. Fred’s thinking.”
“Well, tell him to hurry up.”
I waited what seemed an age and guessed Fred had gone back to sleep, as I was wont to do when I answered the phone in the middle of the night.
“Fred! Are you there?”
“I’m here, man.”
“Well.”
“Kwok’s Quease.”
“Fred, please, stop mucking about.”
“Kwok’s Quease,” he repeated. “Chinese Restaurant Syndrome. Muscarine from mushrooms and poisonous fish have been put forward as causative agents; myopathy of the facial muscles can be induced when westerners try to use chopsticks. He is most probably sensitive to monosodium glutamate, a flavouring agent favoured by Chinese cooks…”
“Fred, you are being serious?”
“Of course, man.”
“Well, what do I do about it? What’s the treatment?”
“None, man. The symptoms will pass off reasonably quickly. If that’s all for now, man, I’ll say goodnight.”
I stared at the burping telephone receiver, wondering whether I could trust Fred. I decided to take a chance.
Georgie was now sitting up on the sofa, but still mopping at his tears with the black handkerchief.
With three pairs of eyes on me I put down my case with as much dignity as I could, considering my unprofessional appearance.
“Tell me,” I said, “Mr…er?”
“Georgie.”
“Er, Georgie. Have you by any chance been eating in a Chinese Restaurant tonight?”
“I said we should have gone to the Pink Elephant,” Lionel said.
“Yes, we have,” Olivia said. “Georgie insisted. He even tried to make us eat with chopsticks!”
“Aha!” I said, as doctors do in all the best films. “Just as I thought. In future I would advise you to give them a miss. You are suffering from a rare complaint brought on by eating Chinese food. It is extremely unpleasant at the time but the symptoms wear off very quickly…”
“I’m feeling rather better already,” Georgie said.
“In that case I shan’t need to give you the treatment I was preparing upstairs,” I said vaguely.
“What about Livvy and I,” Lionel said, “we all picked at the same dishes?”
“Fortunately this condition occurs only in some restaurants and in a tiny percentage of people. Georgie happens to be one of the unlucky ones.”
“Unlucky, darling! It was bloody hell.” Georgie stood up. “I thought I was gone; really gone. I’m not even forty until next birthday. Mother’s giving me her grand piano.”
“Lucky you were around,” Lionel said. “He certainly looked very nasty. We’re extremely grateful to you…”
“And think you’re frightfully clever. I mean guessing we’d been to Kwan Fu’s…”
I looked modestly at the carpet.
“I think,” said Lionel, “it’s time we introduced ourselves properly to the doctor and offered him a drink.”
There were introductions all round but I refused the drink, even some of Georgie’s Horlicks.
“I really would like to get to bed,” I said. “What with moving, then the washing machine overflowed…” I indicated my damp pyjama legs.
“Moving in can be absolute hell! We are extremely grateful to you though, aren’t we, Georgie? Perhaps we can settle up with you?” Lionel took out his wallet.
“Think nothing of it,” I said magnanimously, picking up my case and mop, “I was up anyway!”
It was nine o’clock when I awoke. Not that I would have woken then had it not been for Peter shaking me like a demon.
“For heaven’s sake, Peter, what’s the matter? There was no need to wake me, I didn’t get to bed till four!”
“Three,” Sylvia grunted. “What is it now? Six?”
“It’s half-past nine!” Peter said. “And the baby’s been screaming for hours.”
Sylvia rolled out of bed. “Why didn’t you tell me?”
“We didn’t hear her either but you can tell she’s been yelling, the cot’s all wet, at the top I mean. It’s crazy sticking her all those floors up, you can’t even…”
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“Why didn’t you wake Mummy?” I said, “there was no need to wake me, I didn’t get to bed till four o’clock.”
“Three,” Sylvia said, disappearing.
“I tried but she wouldn’t wake up. Anyway, I thought you had to go to the surgery.”
“Good heavens! So I have.” I sat up and closed my eyes against the pain in my head. “Put the kettle on, there’s a good boy.”
Looking at my unfamiliar surroundings, if that was what the foul mess in the bedroom could be called, I suddenly realised that it was no longer a question of falling out of bed and into the surgery, but that I actually had to get the car out and make the ten-minute journey. I would have taken it out on Sylvia had she not been three flights up, or was it four, feeding the baby.
I was backing the car out of the garage, half asleep still from my ropey night, when a voice from an upstairs window shrieked:
“Sissil!”
I looked up and down Church Row but there was no sign of his Lordship.
A comfortable figure in a woolly dressing-gown with rollers in its hair, clutching a tinfoil parcel, knocked on the window of my car. I lowered it.
“Good morning, Doctor. I’m Diana Pilkington. Sissil has forgotten his sandwiches, naughty man. I found them in the fridge, I wonder if you’d mind frightfully…he can’t be far down the road…”
I took the sandwiches. Our neighbours were nothing if not friendly. I could see we were going to be a tight little, right little community and only hoped they all had their own doctors and that there would be no more repetitions of last night.
I found Cecil, bowler-hatted and umbrella’d, halfway towards the station. When I say found I mean almost ran over. I had been looking for a pedestrian and recognised him only just in time as he managed to keep his stately balance, Times under his arm, on an ancient looking pedal cycle. He thanked me profusely for his lunch, manoeuvred the parcel into position with the umbrella and The Times (he appeared to have no saddle bag) and pedalled off down the road. I wondered whether we had moved into an Estate of nuts.
I expected Fred to be halfway through morning surgery. To my surprise, as I turned the corner, I found a disconsolate looking bunch of people sitting on and dispersed about the waiting-room steps and no sign of Fred. On inquiry I was informed in none too pleasant voices that the surgery was still not open, it being almost ten o’clock, and Dr Perfect, somebody thought, had appeared, then disappeared again.
I unlocked the waiting-room door with the keys which fortunately I had remembered to bring, and, while the patients trooped inside, went round to the house to find Fred.
I rang the front door bell but there was no reply. I rang again. I was mad. I should never have taken him into partnership; never have sold him the house; never have moved; never have… I peeped into the garage. Fred’s car was there. Inside it Fred was locked in tight embrace with Barbara Basildon!
Considerably shocked and furiously angry, I stalked through the waiting-room, into my consulting room and pressed the buzzer for the first patient.
By twelve o’clock, when we should have been well on our way through the visiting list, the decks were cleared. I was excessively tired and had a blinding headache, and when Fred had the audacity to stroll in, just stroll in, I let him have it. He leaned nonchalantly against my reproduction of Van Gogh’s “Orchard at Arles” until I came to the bit about making love to Barbara Basildon in the car.
“Making what?” he said, sufficiently roused to remove his hands from the pockets of his pea-green trousers.
“Love. I could have you struck off for unethical conduct!”
“Man,” Fred said, laughing, “you need a good, long sleep. I’ll cope with the rest of today. You get back to your little Bay Tree nest and let Fred see to everything.”
“Including Barbara Basildon,” I said, standing up.
He gave me a push. “Sit down, man, and listen to Fred.”
I put my aching head in my hands.
“At eight-thirty a.m.,” Fred said, “Sandra White perforated her appendix. I rushed out of the house and in my hurry slammed the door and forgot my keys, not being accustomed to carrying same. At nine-fifteen, having despatched her to hospital for emergency surgery, no easy task, man, I returned to find angry hordes outside the surgery…”
“What’s happened to Lulu?”
“Lulu has a migraine, her husband telephoned.”
“Carry on.”
“There seemed no way of getting into the surgery, so I decided to wait until you saw fit to roll up, man. Meantime…”
“Meantime?”
“I saw as many patients as I could in the car.”
I snorted.
“At the moment you decided to investigate,” Fred said, “I suspect I was dealing with Barbara Basildon.”
“I suspect you were! What exactly was she complaining of that needed such intensive treatment?”
“It so happens, man,” Fred said, having recovered his composure and returned his hands to his pockets, “that at that moment I was looking in her ear!”
Fourteen
Looking back it was really quite funny. But at the time I was in no mood to appreciate the humour of the situation. Neither was Sylvia.
When I got back to the Bay Tree House for the second roast chicken in two days, I could see that something was up. Sylvia had one of her “faces” on. It boded no good. I asked her what was the matter and she tossed her head towards the draining board on which was a magnum of champagne and the most enormous box of chocolates I had ever seen.
“Who’s that little lot from?”
“Olivia Duke.”
“Isn’t that sweet of her?”
“She said you were absolutely wonderful in the night.”
I started to remove the paper and ribbons from the chocolates.
“Did you hear what I said?” Sylvia asked.
“Sure.”
“What exactly were you up to in the night?”
“You heard what the lady said.”
“Where was I?”
“Asleep.”
She nodded towards the champagne. “What exactly did you do to deserve that?”
“Oh, one thing and another you know…”
To my surprise Sylvia burst into tears. Loud sobs reverberated round the kitchen. I hastily shut the window before they leaked out into Church Row.
“Look, Sylvia,” I said, “I was only teasing. They had a friend there, at the Duke’s, and he was taken ill. I was mopping up the hall you remember when…”
“It isn’t that!” Sylvia wailed. “You don’t understand.”
“What is it then?”
She sobbed hysterically into her handkerchief.
“You might as well tell me,” I said. “It’s obviously something to do with Olivia Duke.”
“She looked absolutely fabulous!” Sylvia wailed. “I was cleaning the light fitting in the hall…the front door was open…she thought I was the daily help…”
I put my arms round her. She was shaking with sobs.
“…she had on a little navy dress with a fabulous silk scarf at the neck, it must have been Dior…”
“I’ll buy you a scarf from Dior.”
“…and just stepped out of this dreamy car, and there was I…”
“Sylvia,” I said, “where are the children?”
“I sent them to the park.”
“Eugénie?”
“Asleep.”
I took her hand. “You and I,” I said, “are going to sleep too. We are fit for nothing at all.”
Strange to say, or I suppose not so strange, as anyone who has ever moved house could have told us, we did settle down. As if by magic, of the slower variety, the Bay Tree House evolved from chaos into what even I had to admit, was a really elegant order and we even got accustomed to the stairs. We evolved a plan. It was not a very tidy one but it did save our legs. The idea was Peter’s, who fancied himself as an innovator. At the top and bottom of each flight of st
airs we kept a waste-paper basket. Into these we deposited anything that had to be transported up or down. Whoever happened to be going up or down next took up the full basket and brought down an empty one on his next journey. The only member of the family exempted from this chore was Eugénie, who narrowly escaped at times being transported by waste-paper basket herself.
There was one repercussion of those first two nightmarish days which somewhat dispelled the gloom.
On my way back to the surgery in the evening, after the blissful sleep Sylvia and I had enjoyed, I ran into Olivia Duke, who was still wearing the navy dress Sylvia had described with the Dior scarf at the neck. I thanked her for the champagne and chocolates, assured her it was a totally unnecessary act of generosity, and asked her if she would think it was a terrible cheek if I asked her where she had bought her silk scarf, as I wanted to buy one for my wife. To my amazement she started to hoot with laughter. When she had recovered sufficiently she whipped the multi-coloured silk from around her neck and held it up in the street.
“Pants,” she said, “from Marks and Sparks. I couldn’t resist the colour!”
So much for the Dior “scarf”. It even restored Sylvia’s good humour.
As Sylvia had predicted, our move and Fred’s appropriation and decoration of our previous house made no difference whatsoever to the practice. Events, whether on a social or national scale, rarely did. It was strange really. Although the last twenty years had wrought immense changes in the Welfare movement of the country, the patients and their complaints remained relatively the same. We now had, or so we were told, an educated, expectant and demanding society. Our patients, enlightened from school age through the media of the press, radio and television, were well aware of the basic requirements and patterns of medical care. There had been considerable improvements in the quality and comfort of services received by patients at hospitals and in general practice. In many cases there was still room for improvement, yet within medicine, despite the improvements and advances in the scope of care, the expectation of life for those who had reached middle-age had not really increased.
In our waiting-room the group of ailments looming largest was still respiratory tract infections, emotional problems, degenerative disorders and skin troubles. The cases we most referred to hospitals still remained the big six; tonsils and adenoids, chests, cancer, peptic ulcers, coronary heart disease and hernias. Heart and liver transplants might make the headlines but the most urgent problems that faced us daily were still the unending round of common and undramatic diseases.