Zara Aziz: Farewell, preconceived medical ideas

The telephone call came late in the afternoon, after I'd already had a very long day. M reported that she was experiencing really bad abdominal pains.

Unfortunately, this particular patient has had every investigation under the sun and the GI consultants have blacklisted us both because of repeated referrals.

I sigh as she requests a home visit. Apparently, the boiler man is also due to call on her and it is imperative that she sees us both today, although preferably not at the same time.

It is some 40 minutes later that I finally land on her doorstep, in the pouring rain. I have taken some wild detours en route after a major satnav malfunction (Baby being the likely culprit - he was chewing on it yesterday).

I resemble a drowned rat and M (true to her namesake) peers at me rather suspiciously as she folds her arms across her chest.

'Who are you?' she asks, frowning at the puddle of water I am depositing on her bedroom slippers.

'I'm your GP, you called me,' I explain, helpfully.Recognition flits across her strained face as she walks unsteadily back down the long hallway into her lounge and all but falls back onto the sofa.

Suddenly I notice that she is looking pale and not her usual perky self. Less than five minutes later, I am genuinely worried and dialling for an ambulance. M is hypotensive, tachycardic and tender all over her abdomen.

'How bad is it? Tell me the worst.' M's cold fingers tremble as they clutch my hand, while the paramedics strap her onto a stretcher.

'It looks like it's your appendix, but I think you'll live,' I reassure her.

'Cheerio doctor and thanks for coming to see me,' she replies. 'As soon as I come out, I want one of those care plans that you did for Jean across the road. I'm sure she's not as sick as me.'

I give her a half smile as I nod my head.

The drive back to the surgery only takes me 10 minutes but it seems like a lifetime. I feel shaken (but not stirred). M is not supposed to have an acute abdomen, but she does.

She is the hypochondriac who never has anything wrong with her. My wall of preconceived medical ideas has just come tumbling down.

  • Dr Aziz is a GP partner in north-east Bristol.

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