Second opinion

ANYONE planning to break his leg in such a way as to require a wheelchair afterwards had better — at least if he lives in my hospital's catchment area — give plenty of notice of his intended accident, for there is a three-week waiting-list for wheelchairs. This, of course, is but the twinkling of an eye by comparison with the wait for a hernia repair, so I don't want to hear any grumbling. Remember, in today's NHS there is always someone worse off than yourself.

Of course, the very worst-off people are those who ruin their own lives: that is to say, the great bulk of mankind. For example, last week my first patient had tried to do away with himself because he said he had ruined his career.

'How's that?' I asked.

`Because I've just been convicted of GBH,' he replied.

He was awaiting sentence.

'I never thought it would get this far,' he said, with real bitterness at the injustice of it all. I asked him to explain.

`Me and my best mate, we had a hit of a fall-to. I thought he was going to have a fight on me.'

'And what happened?'

'He came for me. I had a knife and it went in.' `Was he injured?'

`They had to pump up his lungs and take the blood away from the bag round his heart.'

`So he very nearly died?'

'Yes, but he knows I didn't mean nothing by it. He wanted to drop the charges; he knows I get these mood swings.'

`Yes, but. . .

`I never thought it would get this far, doctor. I mean, it's crazy. I'll never get the kind of job I wanted.'

'What kind of job did you want?' 'Looking after people.'

The patient in the next bed had also nearly died. He told me that, in fact, he wished he were dead.

`Why do you want to die?' I asked. "Cause I don't want to be here no more.'

It is amazing how many people think that a redescription is an explanation. 'There's nothing for me no more.' Actually, that wasn't strictly true. He hadn't paid his drug-dealers for a few weeks, and they were threatening to beat him up. Therefore, there was most definitely something for him when he left hospital.

'I owe them £500 each and I haven't paid them for six weeks. They said, "You're taking the piss, so you owe £1,000 now."' Evidently the low interest rates haven't filtered down to the drug-dealers' world.

`So I asked this geezer to inject me with heroin to kill me,' he said.

'Then he's guilty of a very serious crime,' I said. `You might easily have died.'

'But he didn't do nothing wrong. I told him I wanted to die, and I asked him to do it, so he did it.'

My next patient had tried to hang himself, prophylactically as it were. He said he thought he had better kill himself before someone else did it for him.

'Who?' I asked.

'This Indian bloke.'

'And why does he want to kill you?' `Because I sold him a car and it broke down. He wants his money back.'

'Can't you give it him back?'

'No, I've spent it, so he's going to get me. You know how Indians all have these long knives.'

Theodore Dalrymple