Thursday 30 October 2014

When labour pains and demon drink prove too much

When labour pains and demon drink prove too much for the delivering doctor, Maurice Gueret says call the midwife

Published 11/08/2014 | 02:30

Maurice Gueret

I like to try most Irish writers out. For a few pages, anyhow. Back in the mid 1990s, I picked up a book called The Bend for Home and it hooked me on the opening page with the story of a home birth.

The family doctor strolls into the bedroom, taps the expectant mother's belly, and informs the dutiful husband - who wears the trousers of a garda uniform - that he will be in the pub. Some hours later, the pains of labour quicken and intensify. The doctor is fetched from the hostelry. He palpates the abdomen, times the heaves, and then asks the lady to move over in the bed. She does so, obligingly, as one does for the doctor. She then receives the surprise of her life when the GP unlaces his shoes and climbs in beside her! He says she should call him when she is ready to deliver and promptly falls into a deep drunken sleep. The level of snoring reaches such a crescendo that the poor off-duty husband is advised to fetch the local midwife. She arrives on the bar of the husband's bicycle and delivers the child at three in the morning. 
The lie of the doctor is 
not recorded. Nor is his name. But the author of 
this wonderful memoir of life in County Westmeath and beyond was Dermot Healy, who passed away 
at the young age of 66 
this summer. A savagely good writer.

While on the topic of house calls, a friendly doctor has been regaling me with stories of some of hers. She once asked a patient to describe the pain and the best answer she got was: "Well, it's kinda sore." Doctors often forget that they are the only ones with interrogation training, and it may not occur to patients that the site, the frequency, the severity, the things that help it, and the things that make pain worse, are the kind of details that diagnostic doctors like to receive. My rural GP friend also despairs sometimes of house-call directions. A sat nav is not much good when you are told to "go on up the road and ignore everything for five miles". Needless to say, she got lost. For another home visit, she was left written directions, which said "three miles past convent. A road. Some trees and a house". Needless to say, she found it straight away.

As predicted, young Leo Varadkar received the patchwork mantle of health in the recent cabinet reshuffle. There is much speculation already in medical circles as to how the gasun will do. The novelty of having a doctor in charge of healthcare has long worn off, but it should be noted that the last Trinity College medical graduate to be put in charge of the sick list was a certain folk hero by the name of Dr Noel Browne. Browne lasted barely three years in his job, but by the age of 36 he had secured a popular and long-lasting reputation as somebody who made a difference. The problem for Dr Varadkar is that if he really wants to do something with the health brief, he hasn't got time. There is barely a year and a half before election-postering, and the wise money says that, barring catastrophe at Hawkins House in the next 18 months, Leo will then be leading his party. It will then be in his own gift to present the health portfolio in turn to somebody he doesn't like. It's a pity. Proper reform would need a single-minded person without political ambition to be in charge for a full decade. Preferably somebody with a thick hide, who puts sick patients before the whinging of fellow career politicians, every time. That ain't Leo.

Impenetrable hospitals continue to infuriate our patients. Mrs R was at the Mater trying to locate a dying relative and found the experience quite awful. Finding the entrance to the underground car park was only the start of the woes, and she wonders why we spend millions constructing things, but won't spend a few pence pointing them out to ordinary people. Inside the hospital, she had a major problem with the lack of signs, and the confusing nature of those that were there. She only found her destination with the aid of a mobile phone and a visitor, who had already found the room. Another trip to the St James's campus ended up, for her, like a marathon race. Minuscule lifts that barely fit mobility vehicles, entrance barriers and endless corridors were the order of the day. She suggests that when hospitals send out appointments, they should take a leaf out of airport courtesy, and include estimated times of walks from front door to various clinical destinations. Sensible lady. Of the sort who should be in charge.

The new Whitty building at the Mater Hospital continues to be a bugbear. Described variously as stunning and minimalist, I am hearing stories about people being trapped in various parts of the new hospital. One man found himself in a corridor which could only be exited with a staff smartcard. He was a long time stuck before a rescuer arrived. A lady took a lift to the basement by mistake. She got out of the lift, could advance no further in the basement, and then could not get back into the elevator without a swipe card. She had to wait until a cleaner arrived 
down to be rescued.

Finally, a reader is prone to split skin on her fingertips and wonders if anyone has a remedy. A German-made liquid plaster did help, but it is no longer manufactured and she finds liquid-spray plasters pretty well useless. A minor condition usually, but painful nonetheless. They can run in families and are worth mentioning in passing to your doctor. I'm happy to field remedies at mgueret@imd.ie.

Dr Maurice Gueret is editor of the 'Irish Medical Directory',

drmauricegueret.com

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