Am I good at making decisions? Yes - and when I am cross I make them quickly too. Like that trouble with the parking-meter woman last year. I decided to go and my foot just slipped off the clutch - that was another accident. But I leapt out immediately to try to give first aid. I think that everyone has to be prepared to go for what they want, but since we’ve begun to talk I’ve realised there are things I should do better. Brian, I’m sure you could help me to find out a lot. And the flowers that you brought are lovely - they do brighten up my room!
Please can you let me go to Penny’s trial? Could you come with me? It would be just wonderful to have a trip. Penny was really unfortunate about that old man’s mishap during a routine bondage work-out. I am sure the jury will sympathise and she will get off. Please, please, let’s go together. Oh, by the way, I’ve found another spot or two but they are less easy to reach. I hope that you will have a look at them some day.
Bye Bye, dear Brian, I’ll see you tomorrow.”
Thursday, Day 9
“Hello Brian, More lovely flowers - thank you. You think we may be able to see Penny tomorrow! You are kind.
My work this last year? When Mike died, I had to find more work and went to the big house hereabouts. The pay was poor but it was inside cleaning work and not very difficult. When you’ve picked potatoes by hand in the rain and wind, you appreciate working in the dry. The mistress was OK, but I was paid every week from the estate office, where they would try to reduce my wage if there was any excuse or if I was only a few minutes late. The woman in there took pleasure in screwing me down, the bitch.
Then one Monday when I checked in at the office, she said that a valuable plate had been broken in a room I’d dusted on Friday. I knew I had not touched it - the special plates were in a display cabinet. I was told I must have looked inside and bust it, and the cost would be deducted from my next six months wages. If I left the job I would be taken to court. So I carried on - what else could I do?
At home things became more and more difficult, and I ran into debt. Finally there was a dispute over something different and they reduced my pay even further. That day I waited until the mistress had gone out to play Bridge, and went down to the cellar to have a think and a smoke. I decided that I would leave, so I stubbed out my cigarette, went up to the kitchen, and walked home. It’s just my bad luck that the house went up in flames. I heard the fire engines as I opened my front door. Anyway, how was I to know that the owner and the woman from the office had gone upstairs together, though I can’t say I’m sorry about either of them? I have seen the lady once since then, who said she didn’t know about my pay - and she was sure I hadn’t broken the plate. Personally I think she was well rid of him. She got the insurances.
Well, yes, I was upset. They should have treated me better. I didn’t start the fire, but I’ve been blamed for it and that’s why I’m here. My solicitor hopes that a good assessment by you will help to clear me. Thanks for the beautiful flowers. ‘Till tomorrow then.”
Friday, Day 10
“Dear Brian - I can see from your smile that you have decided we can go to Penny’s hearing today. We won’t need an escort, shall we? Good. What a lovely man you are. I put my smartest things on, because I had faith in you. The lipstick? Glad you like it - it’s called nightshade.
I have a key to Penny’s flat - the police have probably raided it, but she has a very nice room. Can we go and check that it is all right please? I think her gear will still be there, which might interest you professionally.
I’m terribly excited about coming with you to London. Thank you for fixing it. I’ll find the best way I can to show you how grateful I am. Oh, can you just help me with this button please? I was going to ask you about my spots again - they are a little bit itchy - but they can wait ‘till later. And we’re going in your car! That’s really nice.”
Monday, Two Weeks on.
The Director, bronzed from a fortnight’s conference in Barbados looked up from the file to his assistant.
“Brian, thank you very much for your report and views. A little transference often gets to the bottom of things. You say that our blonde lady had a difficult upbringing, has a very kind heart, and has suffered from a long and complicated sequence of misfortunes. But you feel they might happen to anyone living in the countryside. Well, I hope you are right, though she has been associated with rather a lot of deaths. It was very odd about the one in the room next to hers last Friday while you were both away. Anyway, here are a few results - please would you file them. They seem all right. Is there an HIV report? My word - look at that!
Too hot in here, Brian? Would you like to sit down?”
THE SPECIALIST VISITS AT HOME - HARD WORK.
A short play about communication for two people plus a non-speaking wife and a dog. Events occur one winter evening deep up-country in Herefordshire near the Welsh border. The setting is the living room of a small cottage. There is a bed in the room. An unshaven man and a large dog sit in front of a television set. The medical specialist enters, ushered in by the unshaven man’s wife.
Doctor. Good evening. Are you Mr Jones? Good. Your GP Dr. Thomas asked me to see you. I’m Dr. Watson from the hospital.
Patient. Oh, Come in. I’m very glad to see you, Doctor. Down Tiger! Down! Down Boy! Don’t be alarmed – he likes to chew things but he never draws blood. Oh dear – and I think we have run out of our sticking plaster, but of course you will have your own supply. Would you like to wash your hands in the bathroom? Ignore the ferret in the box please. And the rabbit in the sink was gutted yesterday. It may be a bit smelly.
D. (from bathroom) Dr. Thomas was going to come, but sudden family duties called him away.
P. Oh. That’ll be his fancy woman I expect – or one of them. She went into labour this morning I hear. Now, anything I can do for you, Doctor?
D. (emerging and sitting down) Dr. Thomas asked me to see what I could advise about your illness. He said that you had severe pains and episodes of weakness and could not get out of the house. He had not found a definite cause. Now that I have switched off the television, perhaps I can start by asking you what’s the main trouble?
P. Well, that’s for you to find out. That’s your job isn’t it?
D. Yes, I’ll try. But first tell me – what is your main symptom?
P. Doctor says I’ve got angerophobia, and I also have palpitations sometimes and pains, like you said doctor told you.
D. Did you say angerophobia?
P. Oh Doctor – when Tiger does that he’s just being affectionate. He gets bored staying inside with me all day. And your hand is bleeding again. Mother! Mother! Bring some of those cobwebs from the kitchen – they’re capital for cuts.
D. Thank you, I think I’ll just use my handkerchief. Now – this angerophobia?
P. Can’t go out you see – I get pains and then Tiger goes wild – don’t you? Mother - Doctor doesn’t want the cobwebs. Never mind, save them – we may need them later. Mother, tell doctor about my angerophobia and also about your varicose veins. Chronic they are.
D. I’d sooner just hear from you to begin with. So, Mrs. Jones – perhaps it would be best if you excuse us for a time please – and I think you can put those cobwebs somewhere safe.
(Mrs. Jones leaves reluctantly.)
D. When did all this start?
P. Oh, quite some time ago, doctor.
D. Do you mean weeks or months or years?
P. It was a good time ago – I think before Martlemas.
D. Could you put that into months, then?
P. I reckon about three months regular, like, but before that now and then for another goodly time.
D. If I had seen you a year ago, would you have been well then?
P. God bless you – No. I’ve always had some of them there screws.
D. But these particular symptoms?
P. No, mostly these are in the last twelve months – though Mother could tell you better.
D. And what exactly d
o you notice?
P. It’s difficult to describe, like. Mother could tell you better.
D. But Mr. Jones – do you have a pain?
P. Well here and there, now and then.
D. Just now at this moment?
P. Well a bit – it’s all according, like.
D. Where is this pain?
P. It be variable – but it’s real chronic sometimes.
D. And what sort of a pain – is it like a cut, or the pain of a burn or of a bruise? Is it very bad – would it make you sweat?
P. Well, yes and no.
D. Is there anything you do which makes it worse?
P. Going outside and sometimes the telly.
D. The telly?
P. Yes, the telly.
D. How?
P. When I had my bed in the other room I used to carry the telly through – it’s real awkward and my back kills me.
D. Does anything relieve the pain when you’ve got it?
P. It’s all according - Yes – tablets sometimes, or my embrocation, or I kick the cat.
D. What tablets?
P. It’s a big ginger tom and it’s not supposed to come in here.
D. No, what tablets?
P. They’re mostly white ones.
D. Do you know what they are?
P. Yes – they’re chemists’ tablets.
D. Have you got them here?
P. I’ve just finished them.
D. Have you got the bottles or packages?
P. Mother’s thrown them in the fire.
D. But do they help you?
P. Well, I’m not really sure.
D. Have you had any serious illnesses in the past?
P. Oh yes, doctor. Would you like a larger piece of paper? When I was a boy I had croup, and whooping cough and then mumps …..
D. Let’s concentrate on the last few years. Have you ever been in hospital?
P. Of yes. Several times.
D. Why?
P. Well my Aunty Jane - No it was Julia - had a series of fits. We thought she had the staggers. I visited her a number of times because she’d gone to hospital with her keys and I had to feed the pigs.
D. Have you ever been a patient in hospital yourself?
P. Oh, no, Doctor. I don’t much hold with that.
D. Has anyone in your family had anything like your troubles?
P. Well, not exactly, but then not so very different.
D. Tell me please what you think might be wrong with you?
P. Well, I don’t know but it is regular chronic.
D. Is your appetite all right?
P. Middling.
D. Bowels?
P. Middling – sometimes like sheep droppings and sometimes like cows – but generally middling.
D. Waterworks?
P. Middling – the peeing’s a bit slower sometimes.
D. Cough?
P. Middling
D. Do you smoke?
P. Used to.
D. When did you stop?
P. I ran out of fags this morning.
D. Do you take alcohol?
P. Yes, when I can get it.
D. Do you sleep well?
P. Middling.
D. Headaches?
P. Middling.
D. I think I’d better examine you. Please put this thermometer under your tongue and keep it there until I tell you to take it out. Don’t say a word and be sure you don't swallow it.
D. Thank you, Mr. Jones. I’m pleased to say that I’ve not found any signs of a serious physical disorder. I’ll suggest a few tests which Dr. Thomas can arrange if he’s not done them already. Let me take this thermometer out now. Good – temperature normal.
P. So you don’t know what’s wrong, doctor? You don’t think I’ve got twin lamb disease?
D. No – not at your time in life. Now, listen - I have concentrated on looking for a physical disorder – but sometimes symptoms do not have a physical cause. I’m delighted that, so far, the news is good. I’ll wash my hands and be on my way. Mrs. Jones may like to take her varicose veins to Dr. Thomas.
P. Well thank you doctor. And while you’re here, what do you think about this embrocation? It’s grand stuff and made by an old lady in the village – with oats, sloes, sheep dip, goose grease and pig fat. I get Mother to rub it in each day. Do you think there is anything better you could prescribe?
D. Did you say sheep dip?
P. Yes, it’s good stuff – I haven’t had a big tick on me for years, and Tiger’s fleas never affect me, though our visitors complain something awful. Would you like some?
D. Thank you. I’ll write to Dr. Thomas. May I strongly suggest you don’t use the embrocation for the present - but I’ll take a small bottle of it back to the laboratory for testing. Good day, Mr. Jones – I’ll let myself out. Please hang onto Tiger.
And the two morals – If you persist even the most difficult person may possibly tell you something useful in the end, and sheep dip is best reserved for sheep at the right time and place.
BASIL MILES - PHYSICIAN AND NATURALIST
When Bridget and I returned to Hereford in 1971, Basil Miles was Senior Consultant Physician. The Department of Medicine had three consultant physicians, Basil Miles, John Ross, and me. As part of that trio I enjoyed some of the happiest years of my professional life
Basil Miles had various sayings. “A country physician may be hopeless at diagnosis but is jolly good at reversing.” “Teaching is unimportant - it’s the students who matter.” “When I had a bad cold I used to go and examine all the oldest patients.” “I go round the hospital every Sunday to escape Church.” “Things are going to the dogs.”
Nobody would take these comments literally, but all had a grain of truth. Behind the awful black pipe, the streak of melancholy, and his blimpish aphorisms there sheltered a cultured, almost Renaissance man. Basil Miles’ heart had been in academic medicine, doing original research in New Zealand. Then he came to Hereford to join Charlie Walker, an outstanding naturalist and larger-than-life character, as the second NHS consultant physician in the county. Those were days of visiting cards and due deference, so he delayed purchase of an electrocardiograph until Charlie retired. Basil always had particular responsibility for endocrinology and diabetic patients and he developed the diabetic clinic at the Hereford hospitals. He taught well, despite his quoted views, obtained a dietician for the hospitals, and began lipid clinics and coronary rehabilitation programme. And almost every Sunday morning Basil’s car would be in the hospital carpark (along with John Ross’s and mine). If questioned he would claim it was to avoid attending church. When visiting teams of academics came to Hereford to lecture, he would entertain them royally at home where his hospitality, and the overwhelmingly generous gins poured at The Clyst, his house in Hampton Park, were famous in professorial units for hundreds of miles around.
Basil served through most of the first 35 years of the NHS. He helped to teach generations of doctors in training at the Hereford General and County Hospitals, and he gave the best available advice to many thousands of patients in Herefordshire, especially those with diabetes. He was kind and thoughtful, with a penetrating analytical view of medicine and events outside, and with a self-deprecating, dry sense of humour. We all liked and admired Basil.
For many years he was the recruiting officer for junior house physicians, keeping a warm link with St. Thomas’ Hospital where I believe the student allocation officer had preserved a soft spot for him. At the Hereford General Hospital the junior doctors’ accommodation included a small lodge by the gate with rooms for three pre-registration house physicians or surgeons whose appointments were for six-months. Basil always gave careful thought to placements, and claimed some credit for at least two romances and marriages.
He served in the 1939 to 1945 war and was injured in North Africa, but rarely alluded to those years. However, when possible disruption threatened the hospitals in the 1970s, he and several other ex-servicemen responded like old war-hor
ses, beginning to paw the ground, snort, and make contingency plans which fortunately never were tested.
He brought a dry sense of humour to work and pleasure, and sharp appreciation of the ridiculous. He would relate his visit to a stately home in Stoke Edith where he began to examine the obese flabby abdomen of the titled Lady of the Manor as she lay in her feather bed. His palpating hand slipped round to the left side searching for enlargement of spleen or kidney, to be bitten by an outraged small dog hitherto concealed by mounds of fat.
Outside work, his passionate interests were natural history, especially moths. His moth trap, like a flying saucer, was in action most nights and he would examine and record the catch. Trees, birds, plants, fossils and geology were other interests, and he was a fascinating companion in the countryside, especially on his beloved Woolhope Dome. He would show specimens to friends and their children with enormous enthusiasm. Field glasses stood at the window, especially after his wife Sadie and he moved to a bungalow overlooking the River Wye. He published many articles about Hereford, its naturalists, and its natural history and was a long-standing member of the Woolhope Society, and worked with the Nature Trust to manage and protect their properties until he became too frail in his early eighties. He began the tradition of The Easter Monday Walk whereby hospital staff met for breakfast on the top of the Black Mountains. Possible this was to escape one of Sadie’s Easter services, but it was an splendid tradition which has prospered for over forty years, long past his retirement.
At home, Sadie ruled. She had an unshakeable belief in the “droit de seigneur” of the senior consultant’s wife, and would arrange holidays and other important matters without either consultation or warning. She was a very small, chesty, thin, chain-smoking, devout Catholic Irish Republican who took care of all domestic and financial matters. Basil knew in theory how to boil water and make tea, but probably never attempted either until Sadie became very ill after which he gradually learned a number of simple domestic arts. There were no children, a great sadness for which Basil always blamed himself. A specialist in endocrinology, he had not noticed that Sadie was gradually developing myxoedema. This shortage of thyroid hormone is notoriously difficult to diagnose in close contacts or relatives because it comes on so insidiously, but that was no comfort. Sadie and he adopted a baby called Mary. She proved to be a very tough intelligent girl who won a place at Oxford and led them a considerable dance.