Liam Farrell: What goes around, comes around

It was funny at the time. There was pandemonium in the labour ward: a slow breech delivery; a distressed, grossly overweight, grand multiparous woman with her feet up in stirrups; an exasperated nurse holding her hand; and blood, sweat, tears, liquor, meconium, and other less salubrious body fluids flying everywhere.

My colleague was a tall, handsome, effortlessly charming (or so he thought) Australian. We were waiting at the business end; we had been very concerned about fetal distress, and had almost reached panic level, but the clinical picture had suddenly improved and the crisis seemed to be over; we could just about see the breech coming down.

'Can you see my baby yet?' cried the woman to the nurse.

'No,' she replied soothingly, 'but doctor can.'

'Don't worry,' said my friend encouragingly, with what he obviously considered to be a disarming smile, 'I can see baby coming; she's got a lovely little bottom'; he paused theatrically and winked at me, making sure I was ready for the little bon mot. 'Just like you, ma'am.'

That might seem a bit insensitive, but hey, we docs enjoy a joke as much as anyone.

As the eminent psychiatrist Dr Frasier Crane said: 'If you can't laugh at your patients, what good are they?' and we've all heard even more inappropriate examples; in the heat of battle, no subject is taboo. Humour is just one way of coping with the frequent lurches into tragedy that are an integral part of a doctor's life.

We can't be afraid of something we have just made ridiculous, and comedy and tragedy are so far apart that, if certain unconventional theories about the structure of the universe are true, they are practically next door.

And what goes around, comes around; patients are not mere ciphers, passive participants to be yanked back and forwards at our whim. They can knock a bit of fun out of us in return.

We run a first-come first-served surgery on Saturday morning and when I checked the waiting room Joe and Padge were deep in what seemed to be a very important conversation, heads together, and obviously resentful at the interruption.

'Who was here first?' I asked.

'We kinda burst in through the doors together,' said Joe.

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