It's nice to be nice, isn't it?

According to Spike Milligan, his dad used to tell him a story about World War One.

His dad had been apparently been giving water to a wounded enemy soldier, but when he turned his back, the enemy soldier shot him from behind. 'And that's gratitude for you,' his dad would conclude, so Spike grew up thinking that gratitude literally meant 'a shot in the arse'. 

We GPs could sing a few bars of that tune. I remember a few years ago saving a patient's life; it wasn't one of my own patients, I just happened to be handy.

For reasons of confidentiality I can't divulge any more details but suffice to say that because I am sometimes a good doctor, I had all the requisite equipment and performed all necessary procedures in the appropriate manner. A few months later, this same patient passed me in the street and didn't even bid me the time of day.

'That's gratitude for you,' I thought. I wasn't actually shot in the arse, but the pain of my unrecognised heroism was just as acute.

That is just one example; I've lost count of the number of times I've been in the wrong place at the wrong time; on a plane, at a train station, at a dinner dance (after your first Heimlich manoeuvre the rest are easy), at a football match, while being gang-banged by a secret Masonic society. Though the clinical presentation has varied, one common thread runs though all of them; no one has ever sent me a bunch of flowers or chocolates or tickets to the Big Fight.

Unfortunately, despite all these interventions, I've never had an opportunity to perform the piece de resistance of the emergency doctor; the emergency tracheostomy. Be honest, haven't we all dreamed about it?

In terms of melodrama it doesn't get any better; the victim usually a little golden-haired and unmistakably adorable Aryan child, a little blood but not too much, the satisfying and theatrical gleam of the scalpel, the gasps from the mandatory crowd, someone shouting: 'It's a million-to-one chance, but it might just work,' and then the instant and miraculous recovery and the plaudits of the crowd.

The doctors on TV shows seem to do them all the time; there is a 100 per cent success rate, and then they get off with the little girl's older sister by the end of the show.

Now that's what I call real gratitude.

Dr Farrell, a GP from County Armagh. Email him at

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