More than just a bowel motion, a cry for help…

BMJ  Published 13 October 2001       Cite this as: BMJ 2001;323:875

If a tree falls in the forest and no one is there to hear, does it make a sound? One of a doctor’s unwritten roles is just to be there, to be a witness, a witness to pain and suffering, to grief and loss, to moments of great joy and great sorrow, but most of all a witness to body fluids.

Mrs Keogh arrived in the surgery in what P G Wodehouse would have called a dignified procession of one. “What do you think of that, doctor?” she asked, burping open the Tupperware container.

There followed a long, contemplative, and unexpectedly companionable silence; a golden, serene moment, a time for pause and quiet reflection, a time to stop and smell the flowers in a world that rushes ever faster. As the air grew steamy around us I could see little motes of dust sparkling in a stray gleam of sunlight through the window and hear far away in the distance a small aeroplane purring over the meadows.

The surgery had the spiritual ambience of a monastery chapel, and if C S Lewis and J R R Tolkien had walked in twittering gently on about morality and suspiciously androgynous fairies I wouldn’t have been surprised.

Eventually, and not without some feeling of loss, I surfaced.

“That is a very impressive bowel motion, ma’am,” I said slowly,

There was more silence from Mrs Keogh, only louder this time, and I felt an extra effort was required.

“This,” I said, ” is a very impressive bowel motion indeed, the very opposite of jejune, the apotheosis of the gold bar; an unforgettable bouquet, lines as sleek as a thoroughbred racehorse, and a colour deep and mysterious as a Conrad novel. If it could talk it would have the rich, fruity timbre of Anthony Hopkins, and it would tell us of a digestive system in excellent, nay, in exquisite shape, bespeaking a diet rich in all the fine things of this goodly earth. If this were the Olympics, we could hang the medal round its finely tapered neck right now.”

But Mrs Keogh had yet another surprise for me.

“It’s not mine, it’s my husband’s,” she said, her voice soft with tenderness (was that a tear in her eye?), “Isn’t it a beauty?”

Some married couples are just a little too close for comfort, I thought; “Love sees not with the eyes but with the mind/And thus is winged Cupid ever painted blind.”

“If you love something, let it go,” I paraphrased solemnly, “If it comes back to you, It’s yours; if it gets flushed away, you don’t want it.

“We’ll bury the little lad at sea.”

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