We’re all going on a Summer Holiday….

At last – a week at the beach. Sun, surf, and sand; and when I feel energetic a bit of fishing. After the Christmas rush I need a break. Just me, Adele, the kids, and the great outdoors. Pity about the panic we had trying to get here. Still I apologised for losing it –
Marching up and down like the Gestapo.
“Which one of you kids left on the lights in the van last time we went out.”
Looks of astonished innocence.
“Well the battery”s flat, and the van won’t start, and its someone’s fault.”
Using jumper leads to start a diesel van in the rain is harder than you think.
“What’s that vibration Footie.”
Just the left front tyre disintegrating.
Still changing a tyre is child’s play.
“I can’t seem to loosen these wheel nuts.”
“Be careful Footie, you’ll give yourself a hernia.”
Brute force won the day and I was deposited suddenly onto the gravel with the liberated wheel nut still attached to half its stud.
“Hey Dad, What does reverse thread on left wheels mean?” said Jason reading a plaque hidden on the inside of the door.
Put the tent up in the dark.

Woke to the sound of rain on the tent roof and the discovery that the bottom of my sleeping bag is saturated.
Contingency plans are an essential part of camping.
“Adele what did you do what my carton of books?” I always bring about twenty novels. Nothing beats the printed page.
“You mean the one on your dressing table?”
“Yeah, where did you put it?”
“I didn’t put YOUR carton anywhere Footie.”
Taught the kids how to play Poker instead while we waited for the sun to appear.

Still raining. Things are a little strained with five of us in the same tent and my books still on the dressing table. Read the newspaper three times and had started on “Harry Potter” when Jason kicked up a stink about me flogging his books. Solved the problem by sending them out for a walk in the rain. Took the opportunity to rummage through the girls reading material but I’m not into Georgette Heyer and nothing else looks promising.

Still raining. Stayed in bed until a bursting bladder forced me out into the wind and rain on a long hike to the ablution block. I had forgotten how jandals flick the mud up the back of the legs.
Too late for the morning paper, and the camp shop had never heard of giant jaffas.
Work and Gretchen seem more attractive by the moment. Tried to tempt the kids into another poker school but they were content to read and eat the time away.
The rows of tents and caravans have thinned out as the less intrepid depart for private bathrooms, libraries, and other trappings of civilisation. Considered a quick trip home myself, but Adele wouldn”t have it on.

Perfect weather. Toasted gently in the sun all morning.
“Do you want some sunscreen Footie?”
“No need Adele, you know I tan easily. But don’t forget to put it on the kids.”
Even caught some fish during the afternoon. Happily kneeling in the sand examining various stomach contents with Jason when from behind I heard the stuff of nightmares.
“Dr Foote! You’re sunburnt!”
I’d know that voice anywhere. Gretchen! Looked around guiltily to see Adele and Marie holding a tape recorder and giggling.
Tried to hide the relief.

Very uncomfortable this morning, a bit too much UV yesterday, Minimised my symptoms in case Adele replayed the tape. Opted for a quiet day under a hat, shirt, and sun umbrella.
“Hello Dr Foote. Lovely day isn’t it?”
No tape this time worse luck. Mrs C, a too frequent sojourner in my consulting room.
“Beautiful,” I replied in my best I’m to busy to stop and talk right now voice.”
“You look like you got a bit burnt Doctor.”
“Ran out of sun screen,” I lied trying not to make eye contact.
“Let me loan you some,” she said rummaging in a bag. “I’ve got a spare tube.”
Paralysed for just a moment until the brilliant lateral thinking Foote computer gave me the escape plan.
“Thank you Mrs C that’s very kind. I’ll go and put some on immediately.”

A touch edgy this morning, Thought about wearing a false moustache. After all I go on holiday to escape from the Mrs Cs of my world. Planning an invisible man strategy when there was a bang on the tent pole and the broken glass voice.
“Dr Foote are you in?”
Only because there’s no back door.
“I thought you might like to read this,” she said and passed over the latest Lee Child.
God works in mysterious ways.

All the children of the world

Spent an afternoon at the park with Jason. My first kick was a magnificent spiral punt. Carried a little too far and wedged firmly in an Oak tree. Tried to dislodge it by throwing my shoes at it. Finally hit the target, even managed to catch the rugby ball as it fell.
“Mark! Where’d my shoe go Jason?”
“It’s still in the tree Dad.”
Sure enough. The left half of my new running shoes was caught firmly by it’s lace.
Scrummaged round in a rubbish tin and found an old coke bottle which looked like it would be an effective missile if we filled it with water. Dragged over a picnic table, balanced the rubbish bin on top, and climbed the edifice to get closer to the target. Felt a bit self-conscious, but nobody seemed to notice. Finally got in the perfect shot. The bottle was spiralling directly towards the shoe. Leaned back too far to admire the trajectory. Leg got a bit bruised, but I was able to bend the rubbish bin back into a functioning shape.
“Where did the shoe land Jason?”
“Ah… Sorry Dad,” he gestured skyward. Stuck just beside the shoe was the coke bottle.
Limped home. Hoped that Medical Assurance wouldn’t ask too many questions.

“Dad I’m not feeling well.”
Recognised this opening gambit with resignation. I dislike Mondays as well.
“What’s the trouble Helen?”
“I’ve got a fever, a headache and a sore throat. Mum said to ask you what you think.”
I know she wants another day off school. No pharyngitis, temperature 36.8°, no nodes.
“I think you’re be okay, take some paracetamol and see how you feel in half an hour.”
“Do I have to go to school Dad?”
“Ask your mother.”
“She said you were the doctor.”
“Tell her that I said it was unethical for me to treat my own family.”
Finished the tripartite negotiations with an agreement that I would drop Helen at school on my way to work. Hoped she wasn’t really sick. Made me late. Gretchen suffering from PMT as usual.

Morning surgery disturbed by a tremendous racket. Interrupted the consultation to do a bit of rubbernecking. Found myself as referee.
“She bit my baby.”
Baby looked two years old and was down in one corner throwing a paddy and turning blue. In the other corner also frothing at the mouth and brandishing a forearm tattooed with a perfect set of teeth marks was Gretchen.
“Don’t worry Mrs M, Gretchen was clear of rabies last time we checked.”
“He bit me, so I bit him back,” Gretchen said. “That’s how you teach children how not to bite.”
It was certainly how I taught my own tribe in those less politically correct days.
“What utter nonsense. Thomas was just scared of your nurse.”
I can identify with that. Calmed the mother down with soothing noises. Resisted the temptation to throw a glass of water over her child who was still having a tantrum..
Suggested that Gretchen apologise and retreat.
I bet that’s one toddler who will never fasten his teeth on anyone again.

A million kids with snotty noses. It’ll be a miracle if I don’t come down with something myself. Perhaps I should have had that flu shot after all. My training was light on pediatrics so I looked hard for reasons to give them antibiotics. Pacifies the parents who expect something and reassures me. At least when they come back with diarrhoea it’s something I know how to treat.

Depressed mum and a worried child today. Answered ‘yes’ to every symptom.
“You seem to have a lot of worries?” I suggested. “Tell me does you leg ever get stuck up here?” I asked lifting his leg off the bed.
“Yes Dr Foote. In fact it’s stuck now.”
Talked with a child psychiatrist who suggested I put his mother on an SSRI. Talk about lateral thinking, but then again, my kids drive me crazy too.

Quieter day. Got out the fire-engine with one of my shy young patients. They love the siren and bell and it’s less sticky than lollies. Pushed it round the floor singing “I’m a little fire engine …” when Gretchen came in with the vaccination.
“Second childhood.” I explained sheepishly
“Around here we suspect it’s still his first,” she apologised to an amused mother.
Just about sank my teeth into her ankle when I remembered the last unfortunate who did that.
Retired without comment to my desk.

Raining again. Planned a day in front of the fire reading when Adele said her sister and brother-in-law were leaving their four children with us while they had a weekend to themselves.
“And Jenny asks if you can check all their ears while they’re here?” she added
Maybe I should try an SSRI myself.

Slip slop slap…

Slip on a shirt, Slop on sunscreen, Slap on a hat.
Melanoma check today at the beach.
I spend an hour admiring mostly healthy bodies.
Lots of spots, freckles, warts, a few moles,
Campbell de Morgan spots. One or two solar keratoses, even a BCC, but no sign of anything resembling a melanoma.
The worried well.
I am a secret sun lover. I still believe that brown is beautiful. And that white, pasty, skin looks like a disease. Sometimes at home Adele and I lie hidden on our deck, a glass of wine, a book, covertly enjoying the sun. Makes me feel warm and cuddly. Pity it doesn’t affect Adele the same way.
Later in the afternoon we move discretely along the beach to indulge our vice. A brown whale lying beached in the sun.
“Hey Footie! Don’t you believe in this Melanoma thing.” I see standing between the sun and myself my associate Dr Player. “Slip slop, slap eh!”
Guiltily I ask Adele to pass the sunblock.

Saw Mrs Hampton-Smythe today
“Doctor, My daughter and I seem to have developed a rather nasty skin rash on our legs. Perhaps you would be so kind as to arrange for us to see a dermatologist.”
My notes tell me she was once ordinary neé Smith.
“Certainly Mrs Hampton-Smythe.” I reply in my best BBC voice. “Perhaps I could just have a quick look.”
Little red itchy bites.
“I think they’re just flea bites.” I offer without thinking.
“Oh no Doctor Foote. We could not possibly have fleas in our home Now can I have that referral please.”
No doubt the dermatologist will tell her that she has some erythematous papules caused by contact with an unusual arthropod. And charge her a couple of hundred. I wonder how he will describe the flea bomb she’s obviously going to need.

Staff meeting today. Told Phil Player, about fleas avoiding the upper crust. We laugh again about last year’s outbreak of lice at the local primary school. Queues of mortified and ashamed mothers.
Gretchen is not amused.
“Could it be” I think privately, “that she has had more than a nodding acquaintance with our friend Pediculus capitis.”
I look speculatively at Gretchen raising my eyebrows. Her white skin untouched by the sun, and probably human hands, is flushing a mottled pink.
Score one for Footie.
I diplomatically do not to mention the vast quantities of anti-louse shampoo consumed by the Foote household last year.
Noticed a bit of a mole on my back last night. Scrapped it on the towel and it bled a bit. Awkward spot, can’t really see it myself. But Adele says not to worry, it doesn’t look anything much.
Who’s worried.

Felt rotten today. Really muggy night and couldn’t sleep at all.
Got Phil to look at the mole during the tea break.
He said he thought it should probably come off. Offered to do it at the end of the afternoon’s surgery. Sounds serious.
Under the knife.
Took 20 mg of Valium as a premed so Phil had to drive me home.
Felt quite amorous towards Adele but passed out on the bed before I could convince her that dinner could wait.

Not worried.
Slept 14 hours after the valium. Stopped to get some flowers for Gretchen. Late to work.
“Sorry for being Late Gretch. Thought you might like these..” Roses white and red. Gretchen is so surprised she forgets to tell me off.
Rang for the histology this morning. “It’s not ready yet, Dr Foote”
Not worried.
Super nice to all the patients today. Want them to say good things about me when I’m gone.
At lunchtime I did a meditation. Visualised my funeral and listened to what all my colleagues and family said about me in the eulogy.
I want my kids to say that it had been “fun” to be part of the Foote family. Want Adele to know she was loved.
Resolved to be kind to Gretchen.
Rang for the Histology this afternoon.
“It’s still not ready Dr Foote. Tomorrow at the earliest”
Not worried.
Flowers for Adele. I help with the clean up and then play hockey with the kids. I take Adele for a walk in the moonlight.
“You’re really worried. Aren’t you Footie.”
She loves me.

On time.
Smiled at Gretchen
“Dr Foote’s got Tetanus?” she says as an aside to Phil.
I picture her at my funeral. Weeping over each harsh and unfeeling word she has spoken.
I am nice to all my patients.
“You feeling all right Doc.” They look concerned.
Morning Tea. Ring Histology. Still no word.
Not worried. I am filled with a tranquil acceptance. Goodwill to all men and women, even Gretchen.
The afternoon stretches out. I value each contact with my patients. Savour each minute. Notice the blue, blue sky, the grass, the trees.
I hear one of the patient’s talking to Gretchen.
“Is ‘e all right love?” She gestures in my direction “‘e seems to ‘ave gone a bit daft.”
“Never better!” I think beaming thoughts of warmth and love in all directions.
Afternoon tea. Ring histology. It’s a senile keratosis.
Feel just a little stupid.
Of course I wasn’t worried.
Watched a movie on the telly with Adele.

Lovely sunny day
Off to the beach with Adele and the kids.
Stop to get some sunblock and a hat at the chemist.
Of course I’m not worried.
Slip, slop, slap!

The job of my dreams…

“Footie, wake up.”
I burrowed down further under the blankets.
“You can’t stay in bed all day. It’s nearly lunch-time.”
“I’m feeling sick.”
“You’re not sick Footie. I’ve seen this before. You’re just being a pathetic male. The problem is you’re bored.”
Adele’s right. Fifteen years of medicine, marriage and kids is just too much for a man to bear.
I tried hiding my head under the pillow.
“Like a drink Footie? Water coming in five seconds, open your mouth.”
With a violent upsurge in energy managed to wrestle the glass of water off Adele without getting too wet.
“Well now that you’re up Footie…”
Gave up and went through the motions of being a ground and maintenance man for the rest of the day. Not exactly the stuff that dreams are made of. Wondered if Adele ever feels the same way but felt too vulnerable to ask.
What if she said yes?!

Puncture on the way to work, it was raining, and the spare was flat. Pity there was no one to shout at. Gretchen chewed me out for being late.. Only years of socialization and the remembered words of my father (reinforced by the metronomic beat of the wooden spoon) “Never hit girls, Footie,” restrained my hand. That and the cowardly suspicion that her bite might be as bad as her bark.
Fortunately the weather was so revolting that half the appointments decided that they weren’t sick after all, so was back on schedule by lunch-time. Productive hour working out the goodwill value on the surgery and looking at the situations vacant in the newspaper. If we sold up the practice, I would be mortgage free, and Adele’s interior design work could support us while I looked for another job.
Maybe I could write a Novel. Something with pathos and tragedy. A great man’s character triumphing over adversity. An autobiography perhaps. Decided to be discrete about the idea until my plans were clearer.
“Adele, suppose I was struck of the register; what sort of job do you think I’d enjoy?”
“Does this mean you’re planning on running off with a patient Footie, or has Gretchen been giving you a hard time again?”

Saw what I estimate to be my 20,000th upper respiratory tract infection today. Suspect that on approximately 50 per cent of these occasions I’ve being bullied into prescribing inappropriate antibiotics by my own guilt or my patient’s expectations. Even with generic prescribing, in round figures this works out at maybe half a mill down the drain in the course of my career to date… And that’s just URTIs…
Considered writing a letter indicating how much money they would save if I changed occupations and asking if they would consider a redundancy package. Surprises me that all these financial savants haven’t figured out that the only way to save money is to have fewer doctors. Surprises me that they haven’t offered retraining incentives. I’m sure that with the appropriate package half of us would look carefully at the option.

Afternoon off. Met Adele for a late lunch at a cafe. Have become addicted to cappuccinos over the last few months. A bit more sophisticated than giant jaffas, and the chocolate coffee beans give a great boost for those endless afternoons full of tired patients. Quite enjoy the lifestyle; dining with a beautiful woman and watching the world go past. Can I feel a vocation coming on?
“Adele, have you ever thought about running a coffee bar?”
“Wonderful idea Footie. Of course to really make it work we’d have to open for breakfast. And one of us should stay on in the evenings to close up about midnight.”
Must be boring to have been born with an overdose of reality. Perhaps if I was just a silent partner it might work out. I’m sure some of my more extrovert friends would do a great job.

Made a point of getting an occupational history from all my patients today hoping that inspiration would strike. It didn’t, but I did get two invitations to become a network marketer. Imagined all my friends crossing the street when they saw me coming to avoid being propositioned. Be worse than being a dentist.

Noticed Phil reading the situations vacant.
“Hey Footie,” he asked. “Which do you reckon would be best, locums in Australia, working for a drug company, a summer in the Antarctic, or should I go for something completely different like working on a trawler?”
“But what about your patients?” asked Gretchen before I got over my surprise.
“Oh, Footie and George would take them over.”
“What?! And leave me trapped here with Dr Foote, he can’t even get it together with his own patients?”
Conversation was interrupted by George’s arrival.
“Ah, while you’re all here, I wondered what you’d think about me retiring. All this nonsense about commissioning groups, contracts, and recertification. I’m sick to death of it all. Feels like it’s time to flag it away and grow orchids.
“Looks like it’s just going to be me and you on Monday, Gretchen. And by the way,” I added as an afterthought, “did I warn you not to book anyone in the afternoon? I’m taking a mental health day.”
“I hope they let you out afterwards.”

“Footie, now the kids are a bit more independent, perhaps I should take advantage of the opportunity to do some retraining.”
Why am I surprised?
“What did you have in mind Adele?”
“Well I know it sounds silly, but what would you think about me applying for medical school. Your work always seems so interesting.”
She must have overdosed on those medical romances. Suggested she glance through one or two of my old text books and start Monday.

Family planning…

The kids were all asleep, and I was busy solving the latest JD Robb murder. Promised myself I would complete the PAYE returns just as soon as I finished. Noticed Adele looking distracted.
“I’m listening.” Over the years I’ve learned to hold a conversation and read a book at the same time. Funny how Adele has never fully accepted this.
I sense it’s not the time to try and explain this again to Adele. With a sigh I looked up from my book and gave her my attention
“Yes Adele?”
“I think I’m pregnant.”
“That’s nice Adele.” I gave her a smile and went back to the novel and read for a few more pages.
“Sorry, I missed that Adele. Who’s pregnant?
“I am Footie.”
“Oh… But you were supposed to be taking the pill.”

Breakfast didn’t go well. Kids arguing and Adele still angry after last night. I had only wanted the details, last menstrual period, symptoms, and why she mucked up the pill taking. Just the sort of thing I’d ask any patient. Then she had the audacity to blame it on me. Said I’d been putting off the vasectomy for years.
Tried to read a few pages before going to work. Exciting chapter so didn’t make it on time.
“Dr Foote, You’re late, I suppose you left those tax returns until this morning.”
Couldn’t tell her the real reason, but with a bit of concentration I might finish the novel tonight.
Saw Mrs B today, she’s pregnant again too.
“Three under three. It’s great to have your kids close together. They’ll grow up great friends,” I enthuse.
“Do you think so,” I could see it was a new idea for her. “But what will I tell my husband?
Suggested she try champagne, soft music, and subtlety.
Put a pregnancy test in the briefcase for Adele. And the novel for me.

Adele was in a better mood this morning until I explained that a negative pregnancy test didn’t mean anything this early on. Told me there would be no more sex until I’d been cut. Oh course she didn’t mean it….
I hope.
There’s no sense in hurrying these things, and if she’s already pregnant, a few months won’t matter.
Saw Mr and Mrs T this afternoon. Wanted to discuss sterilization. They sounded really keen on vasectomy. Just drawing the pictures made me feel queasy.
Where do those sperm go if they can’t get out?
Finally finished the novel, too late to start on the tax returns so decided on an early night with Adele.
“Have you had it done already, Footie? Show me the scar.”
A lonely night.

Getting used to the idea of an extra. Perhaps it wouldn’t be so bad. Helen and Marie are old enough to help out, and Adele could continue her interior design business from home. Passed on these thoughts to Adele but she burst into tears and stormed out of the room. Of course she always gets emotional when she’s pregnant.
Another draining day. Saw a young woman wanting an abortion. So difficult to get her past the panic and help her look at all the issues before making her decision. Took nearly an hour with her. Of course Gretchen was furious, but sometimes good medicine takes more than ten minutes.
Didn’t even have time to think about an op until I got the stone wall treatment again from Adele.

Gretchen asked if I could fit in another crisis pregnancy consultation today. Felt pleased that she recognised my skills in this area. Almost like an apology. Told her to make an extended appointment at the end of surgery.
“Adele what are you doing here? I’ve got an obstetric emergency.”
“You’re right Footie, I’m the emergency. I can’t handle the thought of being pregnant again. We have to talk.”
“But you might not even be pregnant. You’re just in a panic.”
“I don’t want to be pregnant. We’ve got three children and that’s enough. I don’t want to lose control of my body and put my life on hold for years.”
Started to listen.

Time to bite the bullet. Rang my tame urologist for a tentative discussion.
“Why don’t you miss lunch and drop around at the end of the day. That way you can have the weekend to recover.”
“Well what about this increased risk of prostatic cancer.”
“Unproven Footie, and small anyway.”
“What happens to all those sperm? It can’t be healthy.”
“Relax Footie, it’s very quick and almost painless. I suppose you’ve discussed this with Adele?”
“Yes, she’s the keen one really.”
“Sounds familiar. Let’s say 5:00 pm at my rooms. See you then.”
Whatever happened to informed consent?

A hero’s welcome. Breakfast in bed, bacon & eggs with a giant jaffa for desert. Adele extremely solicitous.
“And by the way Footie, my period started this morning.”