To fight the good fight

BMJ Published 07 October 1995, Cite this as: BMJ 1995;311:955

I have some good news: our profession is still revered and respected, our authority not to be lightly flouted, nor our wishes blithely scouted.

I was called the other night to a domestic scrap, the bait being a possible head injury; patients know just how to yank our chain. The phone message was gutteral and almost incoherent, allowing no negotiation: “You’d better come quick, Doctor, he’s real bad.” In the background I could hear screams, breaking crockery, and the merry clink of bottle on skull, softened almost into music by the distance.

South Armagh hasn’t yet become used to the availability of a police force, so other authority figures are mandatory at these spontaneous gatherings; either ourselves or the church, or both, although only doctors have a contractual obligation to attend. When I arrived—suppressing a strange desire to say “Well, well, what’s going on ‘ere, then?”—I realised that there were in fact multiple combatants, but the melee parted gratifyingly before me, like the Red Sea before Moses. There was skin and hair flying; blood, sweat, tears, and beers everywhere.

Looking for the injured party, I wandered through the fracas untouched (there are certain conventions which must be observed, even in the fiercest brawl) like Tony Curtis during the custard pie fight in The Great Race. I idly noticed that, despite the almost complete devastation of the rest of the house, the television and video remained miraculously intact, irrefutable evidence that the violence was not mindless, and that there were no psychoses involved. I was accidentally jostled only once. “Sorry, Doc,” said the offending protagonist.

“No problem, Jemmie,” I reassured him. “By the way, come and see me in the morning and I’ll sew your ear back on.”

I eventually located the nominated casualty. He had that combination of clinical features which GPs and casualty officers all over the world would instantly despatch to Room 101: the smell of alcohol, a scalp bump and abrasion, and the merest suggestion of a hint of loss of consciousness. We know in our heart of hearts that this guy is going to end up in a hospital bed—if not, Sod’s law will ordain for him a fractured skull, an extradural haematoma, and a lawsuit. I knew there was nothing wrong with him, of course, but sometimes nothing can be a real cool hand, and he was stretchered out in a shroud of martyrdom, pursued only by the lamentations of his women. His admission would legitimise the injury (“He had to go to hospital!!”) and ensure that the feud will continue way beyond our own seed, breed, and generation.

Eventually, and to my total astonishment, by holding up my hands, flapping them in a vague sort of way and shouting “now, now,” I was able to quell the disturbance, although I then had to listen magisterially to both sides’ justification for their misdemeanours. Finally the owner of the house appeared.

“By the way, Doctor,” he inquired civilly, “who was it that called you out?”

“I believe it was the gentleman next door,” I replied.

“Really? Thank you very much,” he said, excusing himself politely from the company.

I heard his heavy tread going down his own steps, then up his neighbours’ steps, the vigorous rap on the door, the door opening, and then, thunderously:

“If you’se ever call the doctor to my house again, I’ll be dug out of ye!” followed by a dull but satisfying thud.

Although, of course, I abhor all violence, I allowed myself a discreet smile of approval.

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