Monday, 11 February 2008

Two pipes

It may be hard to believe, but the computer program we use during our consultations (EMIS) still uses a 24-line text terminal display. As a result not much information can be shown on the screen at once, and viewing all the information you need during a consultation may require a blizzard of key presses. Sometimes I just can't be bothered, and it's quicker to ask the patient than the computer. And so it was that I asked an old friend whether he smoked, and heard a little story.

As a young man he decided that smoking might be fun, and bought a pipe and some tobacco. When he got home his mother said “it's not meant to sit in your pocket, you're supposed to smoke it”. So he duly lit the pipe and puffed away and shortly afterwards, as his mother had no doubt intended, he felt very unwell. He was due to take his girlfriend into town that evening, but they had to walk around a local park for two hours until he felt better. (This evidently didn't put her off him because they are about to celebrate their golden wedding.) He gave the tobacco to a friend and threw the pipe away.

Something very similar happened to me as a teenager. I had arranged to go on a holiday with some friends on a canal boat, and bought a pipe and some aromatic Dutch tobacco (whose name I can no longer remember) so that I should look the nautical part. On the first evening I puffed away in the cabin, and shortly afterwards became better acquainted with the canal bank than I had intended. Ah, the follies of youth!

This evening my surgery finished with a paediatric flourish, as I saw five youngsters under the age of eighteen months. A pair of ear infections, a brace of conjunctivitides, and a feeding problem. This last was the most interesting, for the young baby is thriving and yet the start of each feed is a battle, with the baby going rigid and screaming. The problem was that she is grumpy by nature, and is also picking up that her mother is now highly anxious at every feed. After establishing and demonstrating that the baby is physically well, my task was to tell the mother that all she needs to do is relax. This is not easy without making her feel even more helpless and incompetent. I think I got it about right, we talked about how to approach the problem and she's going to ring me tomorrow to tell me how things are going.

At times like this I find it helps to have had children of my own. Our first was a delightfully good baby, the second was a grumpy little terror as an infant. So I have a bit of insight, and of course I mention my own experiences casually during these consultations. Afterwards my good friend the practice nurse expressed surprise that I had kept my cool, and even enjoyed this mini baby-clinic. Regular readers will know that this is because I love babies.

But I couldn't eat a whole one.


Fiona Marcella said...

What's the Read Code for "grumpy"?

Dr Andrew Brown said...

Closest I can find is 1B15 - "irritable". :-)

The Little Medic said...

Having had 6 weeks of experience of EMIS I hate it and like it at the same time. Its very cumbersome but quite versatile. It annoys me but at the same time I enjoy it.

I'm a freak.

Anonymous said...

Clan? Holland House?

The Shrink said...

Two pipes
I was expecting something about ureters or the like!

". . . this is because I love babies."
My youngest is now teething. 2 to 3 hours sleep a night for me, when I'm not on call. Tolerating sleep deprivation reasonably, so far, I guess this is what the 1 in 2 House Officer rotas prepared me for!

Dr Andrew Brown said...

Little Medic: you may be a freak (though you don't give that impression), but your opinion of the EMIS system is shared by me and (I suspect) many others. I once heard it described as "the least complained-about GP system" and I wouldn't be at all surprised.

Dearieme: Hmm. "Clan" sounds about right. Lovely tobacco, but we didn't get on. :-)

The Shrink: You are indeed a lucky man!

cogidubnus said...

I used to smoke Clan in rollups until 5 or 6 years ago when I gave up god that was a smoke and a other tobacco got near it!

Anonymous said...

You need the newer EMIS!! It's much better than most even in the old incarnation though...