Last Tuesday morning Mrs Roberts was admitted to one of the local nursing homes. This slightly surprising news was conveyed by the nurse manager, asking if I could continue her care. Mrs Roberts was one of my regular home visits, a lifelong battler, loving mother and grandmother.
Her hypertension had eventually been too much for the cerebral arteries and she suffered a severe stroke with permanent hemiplegia. Her retired husband had taken on the role of permanent nurse, but unfortunately he succumbed to a heart attack; we were left with one devoted daughter to take on the burden of carer. With much weeping, the caring daughter, who just could not cope, had sacked herself as permanent carer.
Sacking was very much in my mind as I thought over a year of dismissals. In the field of government, the Queensland electorate had just sacked the long-reigning National Party. Doctors can also be sacked by their patients.
It occurred to me while driving that I had not seen Mrs Thomas for some time. A regular patient, Mrs Thomas had suffered from multiple complaints, including osteoporotic fractures and a very high ESR, the cause of which several colleagues and I had failed to track down. She was one of my ‘specials’ with numerous problems that I never quite managed to cure or relieve fully. She did, in fact, become one of my ‘first-division heartsink’ patients. However, we had become used to one another, which is one of the developments in the care of the ‘heartsink’, and regular consultation and counselling seemed to be meeting with good reception and some success, or so I thought. With the thought, ‘Where are you, Mrs Thomas?’ in my head, one of my spies (yes, GPs do develop their very own networks) informed me that Mr and Mrs Thomas had been seen quietly slipping off in the direction of another practice in the district. What had I done wrong?
That same week, I had been taken aback early on the Monday morning by one of my long-standing famous doubles: ancient women from the parish. ‘Your services are terminated, Doctor,’ said Myrtle with her eyes staring straight ahead. ‘Thank you for your help in the past.’ End of conversation. This couple I had considered my very own forever. Was I losing my touch?
Only a month previously I had received a little note from another practice asking if I would, please, send some details about Mrs Jackson. ‘Mrs Jackson?’ thought I. ‘I only saw her last week. I have looked after her for 11 years. We had a good relationship.’ Obviously not good enough.
Nothing daunted, I picked up the phone. ‘Mrs Jackson, we have known one another ...