Doctors at sea

work stop you seeing your GP

dr theodore dalrymple

My family doctor of 65 years ago, Dr S, remains my beau idéal of a GP.

He was like Jim Dale of Mrs Dale’s Diary (rather than Carry On actor Jim Dale, interviewed in this issue of The Oldie). He came to the house whenever he was called, always wore a dark suit and looked at you through gold-rimmed half-moon spectacles.

Nothing could escape his notice: diagnostic X-rays emanated from his wise eyes. You knew that you were safe and that nothing could go wrong. Indeed, nothing did go wrong.

Nowadays an appointment at a GP’s surgery is like the Victoria Cross – rarely conferred but much valued.

One feels almost privileged to be seen by what in Nigerian English would be called a whole doctor. If Heraclitus were alive today, he would not say that you cannot step into the same river twice: he would say you cannot see the same doctor twice.

Practices differ in this, though. When I tell people I have seen the same doctor three times in a year (for the same illness), many are incredulous.

‘How did you manage it?’ they ask.

It helped to present myself in person to the receptionists – always pleasant and helpful. It’s more difficult to obstruct someone standing in front of you. The telephonists, by contrast, are trained at the Lubyanka School of Telephony.

Why should general practice have turned into such a nightmare for so many patients?

Partly it’s because GPs have so much more they can (and must) do. Gone are the halcyon days of placebo and reassurance. Now GPs actually make diagnoses. And elderly patients cannot be fobbed off by being told that whatever they are complaining of is attributable to their age and nothing can be done about it. Doing something takes time.

A majority of GPs now work parttime. An elephant in the room, impermissible to mention in polite society, is the feminisation of the profession (leading to absences for maternity leave and childcare).

Another elephant is doctors’ wages. GPs can earn enough to live on part-time work, which doctors now prefer, given the working conditions.

The aim of medical administration is to prevent doctors from seeing patients. The consultants of one NHS trust were told not to waste their time seeing patients.

What is the poor patient to do when he or she cannot get to see a doctor, let alone his or her doctor? Self-diagnose with help from the internet and from the nearest pharmacy?

I have one rule for dealing with a bureaucracy (which is what medical care, like the police force, has become). Make it implicitly clear to bureaucrats it will be more trouble for them not to do what you want than for them to do it.

We live in an interregnum, at the end of which doctors will be increasingly redundant. Artificial intelligence, which is improving – or at least becoming more sophisticated – all the time, is already as good at giving advice based on questioning of patients as doctors are.

Technicians, acting under the direction of computers, will do the rest of whatever is needed.

We live, however, not in the future or in the past, but in the meantime. Unlike the health service, we must do our best.

The Oldie, 23–31 Great Titchfield Street, London, W1W 7PA letters@theoldie.co.uk

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Pray for a short sermon

SIR: Ysenda Maxtone Graham’s lovely article (January issue) about the merits of short sermons put me in mind of my excellent vicar when I lived in Lancashire. I once said to him that he never preached a boring sermon and asked how he managed to achieve this.

His response was that he worked by the following drill: ‘I stand up, I tell ’em what I’m going to tell ’em, I tell ’em and then I sit down. Five minutes max.’

It is a formula I have often wished his fellow clergy would follow. Yours faithfully, Jane Moth, Stone, Staffordshire

The fall of man

SIR: A conundrum for my fellow pedants. I see that, in the serious part of his amusing column in the January issue, Gyles Brandreth says he has ‘fallen over’ three times in the last three years.

I tell people I ‘had a fall’ in Naxos last May, damaging my shoulder. Gyles is 74. I am 83. At what point does ‘fell’ become the clinical and ominous ‘had a fall’? 75? Later?

Benedict Nightingale, London SW6

Too fat to donate my body

SIR: Re Stephen Halliday’s letter (January issue) about seeking a cheap funeral by donating your body to medical science.

During her medical studies at Oxford, my daughter’s ‘team’ spent many months dissecting a corpse.

During this process, my daughter begged me not to donate my body to science.

Somewhat touched, I asked why.

As my BMI was over 32, her response was ‘because it wouldn’t be fair on the students to have to cut through all that fat’.

Regards, Keith Appleyard, West Wickham, London

Lefties left out

SIR: Good, fun 2023 calendar, but one event missing: Sunday 13th August is national and international Left-Handers Day. You may have known that – but we always get Left out.

Neil Harding, Worth Matravers, Dorset

I’m a Latin lover

SIR: As was the case for many a young state scholarship boy in the 1940s, needing to study Latin in order to go to Oxford to study modern history, the real joy and mystery of the Aeneid were not the words and the translation but the fantastic rhythm of the poetry and the impact it had on the simultaneous discovery of Shakespeare.

Having spent two years in Cyprus on National Service, giving almost no time at all to thinking about Latin, and being faced within months by the need, on return, to prove an ability to translate a chunk of Virgil under exam conditions, I found it was those rhythms clicking into place that did the trick.

They allowed me to leap back into a sense of which part I was faced with, and thereby to translate easily into the memory of what it was about.

Stop studying the classics? Sacrilege! Oliver Trigg, Ferring, West Sussex

My name’s Sir Michael Caine

SIR: How disrespectful of your organ to omit the ‘Sir’ of Sir Michael Caine’s name ‘The usual, sir?’ on the cover of issue 422, while adding a completely spurious one to the scatological antipodean Les Patterson. Yours faithfully, Chris Elliott, Southampton, Hampshire

Wise Sir Les Patterson

SIR: I have just read the article by Sir Les Patterson in the February 2023 issue and I have yet to stop laughing.

The style is so funny and educational in respect of Oz talk. Keep it up, Les –columns like this make The Oldie the best. Terry Knights, Stamford, Lincolnshire

British Marie Antoinette

SIR: In her television review (February issue), Frances Wilson compares the Duchess of Sussex to Marie Antoinette.

I believe she has got the wrong duchess. The Duchess of Cambridge is a closer parallel with the French princess. It is Kate who will, one day, ascend the throne alongside the King, as did Marie Antoinette.

Meanwhile the Duchess of Sussex will live safely in California, while snobbery transmutes into radical republicanism. Yours, Robert Pellegrinetti, London NW5

Death of chivalry

SIR: John Davie writes (Olden Life, February issue), ‘Remember Burke’s

‘I see you’ve been looking at work again on your porn computer’ words to the House of Commons on the death of Marie Antoinette: “I had thought ten thousand swords would have leaped from their scabbards. But the age of chivalry is dead, and that of sophisters, calculators and economists is upon us.” ’

The quotation is essentially correct, but it came not from a postmortem speech in the House of Commons, but from Burke’s book Reflections on the Revolution in France, published in 1790: Marie Antoinette died on 16th October 1793. Burke may have spoken in the House of Commons on the death of the Queen, quoting from his book, but I can find no record of it.

Yours faithfully, J Alan Smith, Epping, Essex

Way forwards is backwards

SIR: ‘Almost nobody uses a landline any more,’ says Matthew Webster (Digital Life, February issue).

More fool those who don’t.

Calls received from a mobile are invariably less clear than those from landlines. I need hearing aids, which may worsen the problem, but if phoned from a mobile I usually ask the caller to ring off and use their landline. Far less frustration and ‘Please could you repeat that?’.

It’s the same problem with digital radio. Although better than it used to be, digital-radio speech is too often indistinct. FM radio is far clearer.

Technical progress is not always for the best.

Yours faithfully, Roger Backhouse, Upper Poppleton, York

Cape Town’s fans

SIR: When two carrier pigeons finally drop your magazine in the post box of my friend Anne, there is ululating from all of us Oldie fans here at the tip of Africa.

We wait impatiently in line to have our turn to read it. First, there is Anne, who was given this very generous subscription by her husband. She sends photos of some of the cartoons and puts sticky notes on certain pages lest a reader fail to notice. The anticipation is heightened!

Next the Benefactor, who sometimes has to go to the back of the queue, lest he be too slow. I am third in line, and spend the next few days reading aloud to the Dyslexic One at my side – and anyone else who will listen. Then Alex, Anne’s best friend.

Thereafter, I, as the Hoofmeisie, decide who is worthy of the privilege of borrowing it. There has to be a pledge to transport it always in a plastic sleeve. Recently someone left it in a guesthouse! The drama, the texts to the owner, the recrimination…

All to say thank you so very much for a generous feast of reading. I read – and often re-read – every article always, just for the joy of such fine writing and entertainment.

Sincerely, Noeleen Sparks, Cape Town, South Africa

Beethoven’s deafness

SIR: Regarding Beethoven’s hearing (Old Un’s Notes, February issue), many oldies will know there is a difference between hearing impairment and deafness. Beethoven was 27 when he began to suffer from severe tinnitus and loss of high frequencies.

It wasn’t until 20 years later that he became profoundly deaf and had to resort to hearing trumpets and notebooks to communicate with others. Yours truly,

John Hornsby, Prémilhat, France

Sweet Caroline

SIR: Reading the article by Caroline Flint in your December issue brought back memories of being pregnant 40 years ago this year. I was very lucky to be invited on to a scheme called ‘Know your midwife’, which was headed by the lovely Caroline at St George’s Hospital in Tooting.

Throughout my pregnancy, I was cared for by a small team of wonderful midwives, each hospital appointment was half an hour long, a team member was always available on the phone and labour held no fear as I knew I would be familiar with my midwife.

How grateful I was to be part of Caroline’s group of mums-to-be and how very different obstetrics in the NHS is now!

Jacki McGlinchey, Woking, Surrey