We did a great deal of home visiting in those days. This was expected by the patients and accepted by the doctors. There was, however, one family that tried us sorely. They lived in an isolated cottage and had no transport. At least once a week they would call around 4 00 pm asking for a visit to one of their numerous children who was usually found to have a cold. They wanted the doctor to come within the hour so that there would be time for father to cycle to the chemist before it closed. They resisted all suggestions that they should change from prescribing to dispensing and whichever doctor made the visit found on returning to the surgery that several patients had endured an extra 45 minutes’ wait while he had been away. The problem remained unresolved despite several requests that calls should be made earlier in the day if a visit was needed. Finally, at a partners’ meeting it was decided that the next doctor to see the family should tell them that we proposed to transfer their care to another practice which was based slightly nearer to their home. Three days later I found myself driving to the cottage rehearsing this valedictory message. The door was opened by a child of about 6 with a runny nose and impetigo. The subject of the summons was a younger brother aged 15 months. He lay perfectly still and eyed me reproachfully. He had signs of acute appendicitis, which even 40 years ago was an extremely rare condition in one so young. Meanwhile his mother lay on a sofa silently watching. She looked dreadful. She had acute rheumatic fever. Mother and child were taken to hospital in one ambulance.
As doctors we learnt several lessons from that afternoon, the chief being that you should never jump to a conclusion without seeing the patient. The family too seemed to benefit from their experience because they remained on our list and made no more late afternoon calls.
Footnotes
We welcome articles up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for “Endpieces,” consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.