A home visit at Halloween; Death, where is thy sting?

BMJ October 2003 Cite this as: BMJ 2003;327:877

I’m an old fashioned general practitioner; Dr Finlay and I would have got on famously, gone out drinking together, maybe clubbing in Ibiza, etc. I still enjoy home visits, and value the precious insights gained from enjoying cups of tea and big slices of home made apple pie in the kitchen with Granny Arbuckle, before drinking quarts of cider and sneaking off for a quick shag with her buxom niece Sally amid the fields of barley (OK, I made the last bit up; it seems such a logical progression).

But house calls aren’t always fun, especially at a spooky time like Halloween. When the sun goes down, and the night is falling like blood-dark wine, not so much falling as sharpening it’s claws, and all good men and women retire to bed after an honest day’s toil, terrible things emerge from their sleep and seek soft flesh and hot blood, the true people of the night, vampires, zombies, burglars, embezzlers, muggers, whores and, of course, doctors.

We family doctors are far away from the comforting nipples of the general hospital, and alone we must face the cold indifference of this imperfect world. “What hath the night to do with sleep?’ said John Milton, and I know just what he was talking about; just call me Dr Acula.

The cottage was deep in the woods. As usual, on calls where the welcome is uncertain, I parked facing away from the house and on a down-slope, and left the engine running, all to facilitate a quick getaway.

The countryside, so familiar during the day, seemed now veiled and threatening, and the menacing eyes of sheep loomed up on every side. You city folk think sheep are cuddly and innocent, but get between a pack of sheep and their prey, and you’re in for a stomping.

The farmyard was guarded by a three-headed hound carrying a knife and fork, which struck me as curious yet apt. It snarled at me affectionately, but I placated it by stuffing my fingers up its nostrils until it suffocated; animals respond to kindness, don’t you know.

I knocked, there being a huge knocker on the door, and entered.

The skeletal figure of Death sat in front of a waning fire. He pointed a bony finger at me.

“I have a task for you, doctor,” he said in a voice both sepulchral and nasal. “I have an awful cough, and I thought maybe… an antibiotic.”

He hawked noisily and, I thought, a tad theatrically, and spat generously into the grate, only lightly spraying me on the way. There was a whoosh and sizzle, and the dying embers wrought their ghost upon the floor a month earlier than usual.

My clinical instincts are always alert and I noticed from the specks on my silk cravat that his sputum was non-purulent. I explained firmly that he had a viral illness, and he should rest and take plenty of fluids.

He sagged in disappointment, then perked up again, “My back’s giving me gyp,” he said, “what about an X-ray?”

“At this time of night,” I said, “There’ll only be a skeleton staff on duty.”



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