But still no nice brass bedstead
Sir: John Rowan Wilson commented (September 11) on a remark made at a recent intervieW by Dr Pat Byrne of the Department of General Practice at Manchester University. But let us consider contemporary conditions. In the first place the brass bedstead is only to be found in the home of the wealthy — it is period piece and unlikely to be available at a resting place for the general practitioner. His home visits have a cony pletely different environment — lie is summoned by telephone to attend Mrs C. He knows that her trouble can only be dealt with bY some means quite unrelated to his medical skills. However, should he refuse the visit he lays himself open to abuse, complaints to the Executive Council, a disciplinary committee and much comment al, the local press. Mrs C's husband contributes to the National Healrrli Service and demands his pound 0) flesh. (Although in fact in the fool, of Mrs C he has several pounde, more than his share.) The general practitioner therefore takes his beg and presents himself. He presseS the bell which chimes tunefullY and two small C children pres,e, their noses against the glass panei, of the door and chorus "It's Ira. Their mother opens the doof inadequately clad in a diaphanotie garment quite unsuited to her size and age and ushers the unfor tunate doctor into the living roon3. This means that he has to steP carefully over an accummulatioa of expensive toys, brushing asidcel the collection of house plants, aa, settle himself precariously on wb,e; may well be a pregnant -chair. Ti Spectator, September 25, 1971 colour telly — full volume — provides sound accompaniment Mrs C's quite comprehensive list of symptoms, obviously culled from a medical programme on the telly the previous evening.
Conscientously the doctor opens his bag, which is immediately appropriated by the Younger Cs, whose mother smiles indulgently at their undisciplined, and, as she explains, "fascinated curiosity about all things medical." His efforts to listen to mother's chest are complicated by the noise, his apprehension about his bag and her continuous account of her symptoms. She condescendsto take out the cigarette drooping between her lips long enough for him to examine her throat, and darts out a yellowing tongue for his inspection. He explains that no doubt her troubles arise from the i Pressures of life and her family n particular and she promptly reinforces this opinion by explaining that her daughter of fifteen is now five months pregnant and her seventeen year old son is on probation. The doctor can only say " Ah " — what else can he say? He sadly writes a prescription for yet another tranquillizer and continues on his way. But still no nice brass bedstead on which to rest awhile. His next Patient is a student whose accommodation is somewhat inadequate. The cramped circumstances are further limited by the fact that every possession of the patient is deposited on the floor in great confusion.
Stifling the nausea provoked by the smell of unwashed bodies, Stale tobacco, decomposing food and other indefinable odours, the doctor, mindful of his duty, Pursues his routine examination of the patient. The symptoms are such that this is quite unnecessary Q s the cause of the trouble is Obvious, and nothing that could not be remedied by fresh air, personal hygiene and a balanced diet.
Where, oh where is that beautiful brass bedstead? The next call involves a hazardous journey from the front gate, alas no longer in evidence, to the front door on Which some rather vulgar words have been written in chalk. The path is strewn with old bicycles, a headless doll, an unstuffed teddy, a Plastic pot, odd items of clothing and a few old cans and empty bottles. Before the doctor can reach the bell he is commanded to enter, The hallway is not inviting and he pauses uncertainly — a nice from above directs his 1,00tsteps. On the upper landing `1,vn grubby children eye him susPlciously and point to an open boor. Within is a bed, but no brass — this is a sort of ruptured mivan and here under a collection 91 kittens, dog and tatty magazines ne finds the patient. She is very Pregnant and complains of an ach –Ing back, which is not al9gether surprising. By the time Ihe doctor has completed his exnination practically on his knees ne shares her backache, although not for the same reason. One more call and then he must f,,t back to surgery. The patient time is in the garden sunning 9iniself with a newspaper over his nice. His symptoms are so astounding that no obvious diagaosis presents itself — he is " not Mrnself." Who he is and what difference it makes is not clear except that normally he is a chap who works in the bank and now he 's a chap sunning himself in the
garden. However there Is no doubt that the imperative thing in the circumstances is a certificate to satisfy his employer that he is not in a state to be employed for a couple of weeks.
It would seem very obvious therefore that the Department of General Practice should immediately research the technique required to deal with visiting under contemporary conditions, and in the meantime might I suggest that a 'brass bedstead' instead of a chair should be provided immediately for a professor researching the subject.
Helen Ower The Central Surgery, 2 The Strand, Goring-by-Sea, Worthing.
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