BMJ  28 September 2002   Cite this as: BMJ 2002;325:723

How do you define the good doctor? How do you solve a problem like Maria? Being kind and compassionate is all very well but we need more, the rage to achieve, the pride not to accept defeat; like Milton’s Satan, our vices are indistinguishable from our virtues. The qualities demanded are multiple, and they fluctuate with time and circumstances.

Jennie had an unusual form of high-spirited and happy dementia, and just as I arrived at the farm she was bolting out through the door, over the wall and across the fields. Her family came tumbling out after, but seeing I had arrived they stopped and looked at me expectantly, like the Council of Elrond looking at Frodo and thinking, “Here comes a real sucker, problem solved.”

But being a Good Doctor, I accepted the metaphorical baton and set off in pursuit, leaping the wall and tipping over the other side, though luckily my fall was cushioned by some broken bottles. I could see Jennie in the distance, a glimmering girl fading in the brightening air among long dappled grass, dodging behind the dread vista of a fine herd of Jersey cows.

The cows represented a serious escalation. If you are ever hunted by the law, and have to escape across the fields, choose a field with cows.

City folk mightn’t appreciate this, but cows are intelligent creatures and get bored standing around in the field all day. During the Troubles, when the British Army were on patrol, taking cover at the side of a field, the cows would wander over to have a look. So anytime you saw a line of cows staring into a ditch, you knew where the soldiers were hiding. An exciting chase is even more welcome diversion, so the herd galloped over for a better look. The avoidance of stampeding cows is not something we are taught in medical school.

I swiped at them ineffectively with my black bag, and then, distracted, trod in a cow pat so large and liquid that a small boy could swim in it, a triumphant digestive mound that would have felt quite at home in the Augean stables. The quarry may not mind running through cow dung, but the sartorial demands of our profession leave us ill-equipped for this task. And once dung gets on your clothes, the smell will endure forever; trust me on this point.

I caught Jennie at the far end of the field.

“Ah, doctor,” she said playfully, as I grabbed her desperately by the ear, “I thought you’d never catch me.”

A good doctor is a doctor who can run fast and is not over-fastidious regarding personal hygiene. QED.


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