Liberating the ingrowing toenails of a nation

I have always had a sensitive disposition. I don't like touching people, you never know where they have been. Anyway, all this physical examination stuff is over-rated; it's for theatrical purposes only (to show how much we care) and quite unnecessary; I'm a great believer in the primary of the history.

'Listen to the patient,' said some old fogey, probably an emeritus (whatever that means) professor, 'and they will tell you the diagnosis.'

So it's no surprise that I have always viewed ingrowing toenails with some distaste, and it was during my stint in casualty that I learnt how to manage them appropriately. I'd seen them done, of course, (the main message seemed to be never use enough local anaesthetic, screaming in agony is a good sign, it means that they're still alive), and every week we had a short surgical list: excising sebaceous cysts, pulling fractured radii (that was one generation of Dubliners who never played the piano again, I'm sure) and toenails.

When the toenails were wheeled in, I'd inspect the nail carefully, prod it hopefully, maybe take a melodramatic sniff, as if sampling the bouquet, and then say in a disappointed tone: 'I don't think it's quite ripe yet, but another course of antibiotics should do it; come back next week.'

By which time, another poor sod would be on duty.

As this technique worked so well I continued to apply it in general practice. Not quite ready, I'd say, come back in five days, and hey, quelle surprise, Dr G will be here that day; that's a lucky break for you, he's brilliant at these, he has a gift they say, but for his love of the old sod he could be performing heart surgery in the Mayo Clinic.

My partner, while immensely flattered by how his reputation has risen across the countryside (although the folk songs were a bit over the top), has over the years often felt that it was time he shared with me this glorious bounty of toenail surgery. I have resisted his generosity up till now, but a few weeks ago, when, on the 20th anniversary of our partnership, he presented me with a metre-tall replica of the Statue of Liberty, constructed from the 20 years' worth of toenail clippings, I realised he was serious.

So I applied for a one-day course in minor surgery and I now have a certificate; sorted.

Dr Farrell is a GP from County Armagh. Email him at GPcolumnists@haymarket.com .

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