I say, anyone for a game of bladder tennis?

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The Independent Online

The man with three hands is down to one again. He had two, lost one, got another sewed on but became, as he put it, "mentally detached" from it. Then he became physically detached from it after getting the transplant doctor to do the job backwards, and amputate it.

The man with three hands is down to one again. He had two, lost one, got another sewed on but became, as he put it, "mentally detached" from it. Then he became physically detached from it after getting the transplant doctor to do the job backwards, and amputate it.

No wonder everyone's so exasperated. The medical opposition said the whole operation was a folly; the anti-rejection drugs would make the patient ill. The patient claimed that the body has rejected the hand, although it had worked for the first year. He denied doctors' claims that the hand had been rejected because he had failed to take proper care of the limb. After he stopped taking the medication (to overcome a bout of flu Mr Hallam claimed), the hand withered and became hideous, the tendons fused. So, for four months, the patient lobbied for its removal. And finally, even though it was all done privately, no one ever got paid for it.

It's a modern medical morality tale.

The details of the Hallam case are one thing, and I can't comment further on them, but it raises some issues of general importance. It seems that our expectations of medical science are more or less infinite. Our disappointments, when we are disappointed, are correspondingly large. We want, we expect, we don't get, we go into patient-rage. Or patient-sulk. Or at the very least, patient-impatience.

It's no wonder that doctors are different. They can tend to become "mentally detached" from their patients in much the same way that Clint Hallam became mentally detached from his hand. They have to protect themselves from us - from our fear, our disappointment, our grief, our impossible expectations, our ignorance, sloth, stupidity, loneliness, neglect and general hopeless helplessness.

The professional culture starts early, in medical school. Anyone who knows medical students will know from the games they play that they are not as other people. St George's Hospital in Tooting is said to excel in what is called Bladder Tennis. Students join themselves at the urethra with a two-way catheter and exert their bladder muscles. The object of the game is to force your urine into your opponent's bladder. Girls play, too. There are no winners, in the end, only victors.

There was also a game that they took from army recruits, called Hide The Shit. A piece of human waste was hidden round the house somewhere, and flatmates had to search for it over the weekend. The winning hiding-place turned out to be underneath the yellow stuff in a tub labelled I Can't Believe It's Not Butter.

And of course, there are the stories from the pathology labs. These almost certainly aren't true. The hand that was smuggled out and tied to an Underground carriage's commuter strap. The penis that was removed from a corpse and hung out of a student's fly: when reprimanded by a policeman, the student whipped out a scalpel, and sliced off the offending member. Collapse of one very stout policeman. Under a bus.

Or the nurse who came into the room of a woman who had recently been diagnosed with terminal cancer. "Ooh, what a lot of flowers in here," she trilled. "It looks just like a funeral parlour, doesn't it!"

And my favourite, because it happened to us. A tiny male midwife at Queen Charlotte's Hospital, in west London, had put a stethoscope on my wife Susie's tummy and said: "That's odd, I can't find a heartbeat. Just wait there." He tripped back after 10 endless minutes with a larger machine and announced that he'd found the heartbeat. "Thank god for that!" we gulped.

"What!" he said, "What? You didn't think...? You've made me feel really awful, you have now." We didn't apologise. You don't often get a chance to get one back on the medical profession.

simoncarr75@hotmail.com

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