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Most doctors were brought up with the aphorism 'If you don't put your finger in it, you'll put your foot in it'

Dr Phil Hammond
Monday 19 May 1997 23:02 BST
Comments

I've had a bit of tummy trouble ...

There's a lot of it about ...

So I went to see my GP and he said ...

"It's probably a virus ..."

Look, will you shut up. He said I had "Query Appendicitis."

To you?

No, in the letter I took to hospital. "Dear Surgeon. This irritating man complains bitterly of right-sided abdominal pain. Query Appendicitis."

Well, it serves you right for opening it.

But what about the Freedom of Information Act? I'm allowed to read my notes.

Yes, but only after we've censored the insults.

Well, I wasn't happy about Query Appendicitis. Is that the same as Gay Bowel Syndrome?

No. Gay Bowel Syndrome is a presumptive medical term for symptoms that can result from anal penetration (pain, bleeding, infection, poor wind control), irrespective of the sex of the recipient. Query Appendicitis means that your GP thought you might have appendicitis, but wasn't sure. It's normally written as ?Appendicitis.

Shouldn't that be ?Appendicitis?

Perhaps. But too many ?s can look as if the doctor knows nothing, rather than not a lot. So we tend to economise.

I'll say. I had to wait four hours for a doctor and six hours for a bed. In fact, the only thing they didn't economise on was the internals.

Yes, that's one perk of being a doctor. You can stick your finger in somebody's backside within a minute of meeting them. And they'll be grateful.

I wasn't. And I'm not sure it was necessary. I mean, I was hurting in my right lower abdomen not my rectum, so why put me through that?

Most doctors were brought up with the aphorism "If you don't put your finger in it, you'll put your foot in it."

I know you people have got to learn, but I draw the line ...

Meaning that it's easy to miss something important. For example, 60 per cent of colonic cancers occur within one finger reach.

So they were checking if I had cancer?

No. In your case they were checking to see if you had had an inflamed appendix in a pelvic position, which would make the rectum tender high up on the right-hand side.

It was after the fifth time.

That's teaching hospitals for you. To be fair, there are realistic plastic models of the pelvis that allow medical students to feel a rectal growth or a large craggy prostate without troubling real patients, but alas there's no model that says "Ooh, it hurts, doctor." "Where?" "High up on the left- hand side." "Your left or my left? "Your left, my right." "Well, actually I'm behind you, so your right is my right and your left is my left. So which is it ... ?"

But why do it at all? I felt grotty. I was flushed, I was off my food, I had a temperature, it hurt to move, my tummy was acutely tender over my appendix - it was fairly obvious I had appendicitis.

And did you?

No. But the point is that I was sick enough to need opening up under anaesthetic without being sullied while I was still awake.

There are some doctors who think internal examinations aren't necessary in the diagnosis of appendicitis, and certainly many GPs don't do them.But that's because we GPs are kindly souls, and we think that if anyone does it, it should be the person who has responsibility for opening you up.

Him and his four mates. And even then, they got it wrong.

Well it's a very difficult diagnosis to make. Half of those who are told they have appendicitis don't, and half that are told they don't, do.

They told me mine looked normal, but they took it out anyway and sent it to the lab. And the lab said the tip was inflamed but not infected.

That's because the surgeon will have squeezed it with his forceps to try to trick the pathologist into thinking it really was appendicitis and he hasn't opened you up for no reason.

Well they said all my internal organs looked healthy, so I suppose that's something.

And what did you say the diagnosis was?

They weren't sure. The letter to my GP said "Appendix Normal. ?Viral."

See, I told youn

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