The Fishwhacker Swindle?

The Accident & Emergency Department, Shipmanville General, four in the morning. My shift was finishing at nine, and as I’d been on my feet from when I’d started at nine in the evening until about an hour ago, you’d have thought patients would have the good grace to stop coming in or at least to wait till morning. No such luck. Sister Griselda, let’s call her, poked her head round the door of the mess, a rictus of glee on her grotesque features. (Actually, she wasn’t bad looking, but this is my story and the hell with ‘facts’, damn your eyes.)

‘You’re going to love this one,’ she cackled.

I considered having a tantrum but I’d already breached my quota for that week, so I tossed my polystyrene cup at the bin, forgetting it was still half full, so that the wall above the bin was left looking like a cell wall after a dirty protest, and followed her. ‘What is it?’ I asked. ‘A PFO? A PDE? A FUBARBUNDY?’ Those are, respectively, Pissed and Fell Over; Pissed, Denies Everything; and Fucked Up Beyond All Repair But Unfortunately Not Dead Yet. At that hour of the night little else tends to come in.

‘None of the above,’ Griselda grinned. ‘It’s a GROLIES.’

Oh Christ, that was bad. A Guardian Reader Of Limited Intelligence in Ethnic Sandals. I didn’t think I could handle it and began to weep like a baby but Griselda took a firm grip on my arm and propelled me into the cubicle, backing off and drawing the curtain like the backstabbing coward she was. Witch. The GROLIES was sitting up in bed and the first thing, the first thing she did was look at her watch. I’d probably breached some item of human rights legislation by keeping her waiting five minutes. I saw from her notes that she was 30 but she looked ten years older, which probably had something to do with the pigeon’s nest she had on her head instead of a hair style and the lines slashed into her face, the stigmata of the chronically aggrieved. An older man in his fifties sat by her bed, looking weary. Sure enough, folded beside her was a copy of The Guardian.

‘Hello, I’m Dr Eater,’ I said brightly. ‘What can I do for you?’

The GROLIES doubled over in pain and dribbled saliva into a kidney dish. After a time she sat up and said, ‘I need an X-ray.’

‘Please tell me where the pain is,’ I suggested.

‘It’s my appendix,’ she said.

‘Whereabouts exactly is the pain?’

‘In my abdomen where the appendix are [sic].’

‘When did it start?’

‘Look, I’m in pain, will you just send me for a fucking X-ray?’

I persuaded her to let me examine her abdomen, and asked if she would prefer her father to step outside. She stared at me in wonder.

‘He’s not my father, he’s my partner.’

I glanced at the man who nodded, eyebrows raised, as if to say What can you do?

‘He’s a lawyer, you know,’ she added.

Back and forth we went, I trying to go through the time-honoured process of taking a history, performing an examination and making a diagnosis, she demanding that I stop wasting her time and send her for the X-ray to which she was apparently entitled according to some Act of Parliament or other. I got the I know what’s wrong with my body better than you do spiel, and the you’re paid with my taxes so I get to call the shots lecture. Finally I’d gleaned enough to pronounce on what was wrong.

‘It’s period pain’.

No, no, it wasn’t. I listened while I was blamed for never having experienced menstrual cramps myself and therefore having no idea of what they felt like; then I endured a diatribe about my crass incompetence and impending removal from the medical register. So I did what any strong-willed, principled professional should.

I gave in.

I ordered an X-ray, an abdominal ultrasound, a slew of blood tests and urine analysis. They all came back negative, and the patient stormed out with a fistful of painkillers, most put out that she wasn’t iller than she was, and with no harm having been done apart from several hundred pounds’ worth of wasted taxpayers’ money.

I sound like a callous bastard with this story, and just the sort of arrogant, couldn’t-give-a-damn physician that you may have had the misfortune to come across yourself. I’m not normally like this. Please understand that these were special circumstances. The patient was a GROLIES. The GROLIES are everywhere, and they’re the offspring of an illicit and unholy congress between government and media. They’re characterised by ignorance, querulousness and self-righteousness in equal measure. They have right-wing counterparts in the as yet un-acronymed types who come to hospital clutching the Daily Mail. They’re what soon-to-be-ex-Health Secretary Patricia Hewitt would be if she were a patient. They’re enough sometimes to make me consider going to my employers and telling them where to stick their job, except then the next day the Halifax would be telling me where to stick my mortgage application, the gas company would be telling me where to stick my bouncing cheques, and Harry ‘Mashed Potato’ Reeves, the local debt collector, would be telling me where to stick my excuses. And probably showing me, too.