BMJ 03 January 2008Cite this as: BMJ 2008;336:48

It must be tough being an emperor penguin; not only are you being constantly harassed by film crews, who love the fact that you can’t fly away or strafe them with guano, but Morgan Freeman is always popping up from behind an iceberg and global warming is increasingly degrading your breeding grounds and food supplies.

And global warming is no picnic for general practitioners either; it has irrevocably altered the aesthetic of wintertime home visits, a cherished part of general practice since the day Asclepius stared glumly into his amphora and said, “Art thou sure thou can’t come in to the surgery?”

Gone forever are the days of snow-covered hills, frost coldly riming the meadows, rich beds and bright fires and hot whiskeys, big mugs of tea and freshly baked scones, what Ratty and his little furry life-partner (before coming out of the closet) would have called midwinter’s homely comforts. House calls then were a wonderland, like being in a Disney movie starring Dr Finlay and James Herriot, and getting jiggy with Julie Andrews by the final credits.

But now all is utterly changed; it’s just mud and misery from October to April.

So instead of tapdancing through the farmyard on a crisp magical white carpet of freshly fallen snow, I was in muck to the knees, and it wasn’t just non-organic muck; the mandatory herd of cows had added their enthusiasm to the mix, the result being a cocktail of steaming malodorous ordure that would have given even the mighty Hercules pause for thought; “Not more bloody cows,” he’d have said.

I squelched to the door.

“Now is the winter of our discontent made summer by this glorious . . . ” I began, as a bit of scholarship always goes down well with our stout yeomanry, but I was interrupted; the usual warm Irish welcome had become, with bitter irony, much colder.

“Are you the f***ing doctor?” I was asked.

I was slightly taken aback, but didn’t want any misunderstanding, so I explained carefully that I was just the ordinary doctor; to be a f***ing doctor required a further qualification, many years of arduous postgraduate study at Cambridge University culminating in a demanding final examination in which the most critical element was, for obvious reasons, the oral, after which you were awarded a magnificent diploma and a jar of anti-fungal foot cream.

Patient confidentiality forbids me describing the consultation which followed; suffice to say it was short and concluded with a prescription for antibiotics, just to show How Much I Care.

Global warming or not, some things never change.

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