If symptoms persist . . .
We doctors have wonderful self- control. Our careers span four decades, yet never once in all that time do we tell our patients how disgusting they are. Is there another profession that equals ours in forbearance? The strain of keeping our disgust to ourselves is terrible: no wonder our suicide rate is so high.
The other day it fell to my lot, for reasons it is unnecessary to relate, to examine a lady's toes. The stench was awful, overpowering. It quite knocked me back against the white-tiled wall of the clinic.
'They'll have to come off!' I exclaimed, referring to her feet.
`But why?' asked the lady, thoroughly alarmed.
`The smell, the smell!'
Actually, this exchange took place only in my head. What I really said was: 'Thank you, Mrs Jones, you can put your slippers back on now.'
Why don't people wash before they consult a doctor? Why don't they wash full stop? After all, they never know when they might need to call a doctor in an emergency. The fat unwashed are particularly gruesome, the folds in their skin harbouring . . . no, I won't, I can't, describe it.
It's not that I'm particularly squeam- ish: I can wade in oceans of blood without turning a hair, or at least I could until the Aids epidemic. Nevertheless, there are products of the human body, especially in ill-health, which still repel me, though I've seen a lot of them. For example, I have never been able to look sputum full in the pot. Chronic chest cases tend to treasure their output — Great Expectora- tions — and bring it to me in jars marked `apricot jam' or 'English marmalade'. I don't much care for vomitus either, even when the patient considers it an indis- pensible aid to diagnosis. I wish I could report that medical ethics always overcame aesthetic sensibilities, but in my case, even in matters of life and death, this has not been so. Mouth to mouth resuscitation I have never found attractive, and usually whenever it has been necessary I have managed as person in charge to delegate it to others. Once a highly agitated lady arrived at my clinic and I gave her an injection to calm her down. She calmed down all right: in fact, she stopped breathing. There was no one else around, so I braced myself for mouth to mouth. Then I saw the colour of her lipstick — mauve — and I simply couldn't bring myself to start. Luckily for me — I can't speak for her, she didn't seem to be enjoying life much before my injection she began to breathe again.
On the other hand, I don't mind pumping someone's chest to stimulate their heart to beat again, even though I once caught scabies from a lady covered in the fulminating variety known for some reason as Norwegian. She died, but the scabies mite, Sarcoptes scabei, lived on.
Naturally, no reader of The Spectator will have cause to blush at my strictures. I refer only to non-readers.
Theodore Dalrymple
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