This is of course a mixed blessing. Yesterday Fred, aged 89, strode into my room, announced he had swollen up since I changed his tablets, whipped out his scrotum and plonked it on the table.
Judging scrotal volume and titrating it against diuretic dose is, I feel, a skill unique to general practice.
‘Oh dear,’ I said, ‘I see what you mean.’
Fred, however, was unimpressed. He treated me to a hard look. ‘My previous doctor didn’t make ’em swell,’ he said, and stubbornly refused to accept that I had, thus far, altered no aspect of his medication whatsoever.
‘Here,’ he declared, slapping two identical boxes of atenolol on the table beside the scrotum, which quivered expectantly like a disturbed jelly. ‘Here’s what you gave me, and here’s what he used to give me.’
‘I know,’ I said, ‘and they are the same, largely due to your stubborn refusal to let me change your atenolol for something far more likely to have a positive impact on your life expectancy.’
‘Bloody hell,’ said Fred, scooping himself back into his undies with a practised flick of one hand, ‘no point living to be 90 with balls like a football.’
I could see his point, wondered briefly about his frontal lobes, checked his mini-mental score and was treated to a tirade on the multiple failings of Tony Blair.
No points towards aricept there, I thought, and he humphed out through the waiting room with a gait like John Wayne.
‘She’s okay,’ I heard him say to the patients in the waiting room, ‘bit young though. About 40.’
He went up in my estimation at that point, did Fred, as did Myrtle who followed him. ‘Spot on with your age, dear,’ she said, ‘but what the heck was up with his goolies?’ I do enjoy this job.
Dr Selby is a GP in Suffolk. You can write to her at GPcolumnists@haymarket.com