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Thursday, 3 June 2010

Back to the start

Bangkok 1988

Where does an illness start? In your genes? In your own lifetime? In your experiences? In your environment? It’s hard to know sometimes.

It’s 2010, Nottingham. I’m 53, white middle class, and mediocre.

I’m getting out of my car, making sure I have my pad of paper and a pen . . . glasses as well – yes I’ve got them - that’s good. I’m at my doctor’s. I’ve come to read my medical notes.

I am met by a wise looking woman who is very polite and professional. She is the practice manager. She asks me to sign in, and reminds me that my squiggle on the paper binds me to discretion; that I will not reveal names, places, and details of anything I may see or hear. So in what follows I haven’t.

I Squiggle; I accept.

She shows me to a computer and runs swiftly through the MS-DOS style screen that contains my notes. It seems that the electronic notes only go back to 2000. I’m looking for something way back in 1988.

With remarkable speed she presents me with a tattered and browning wedge of notes that go right back into my childhood. Medical records in thick brown manila, fading fountain pen script, letters written on manual typewriters, actual documents that go back as far as the 1960’s.

There’s a typewritten letter from a child psychologist that documents my meeting with her, the paper old like a leaf, but the typewriter impression still fresh. This hasn’t seen much light since 1965; The red letterhead at the top still sharp.

I shouldn’t really dwell too much on this letter, as it’s not what I’ve come to find out about. However it describes me as a fair-haired child, reasonable verbal intelligence, problems with writing, and as a consequence having “behavioural problems” due my frustrations at school. Dyslexic.

Aha! What’s this? I find a card that records a visit to my doctor. At the time I am 36. Many years ago, before I had guts ache.

I’m back in 1988, a small town in the East of England. A sunny spring morning. The Stranglers “All Day And All Of The Night” can be heard leaking from a tinny radio. Across the wooded park I can see the doctor’s. Never been there before. Bit nervous.

I always felt guilty visiting doctors. Never wanted to waste their time on my irrelevant problems. I’ve been brought up not to waste a doctor’s time unless it’s a last resort because there are many people with real problems.

It’s a Victorian red brick house, with a bit of a fake Doric column around the door. Inside a waiting room with a lino floor that had that smell and the usual selection of out of date magazines; dog-eared by a thousand fearful fingers and thumbs.

A cordoned off play area contained a garishly coloured collection of plastic toys. (Nowadays it would be some kind of infection risk I’m sure)

It was my turn and I entered the unknown; the doctor’s room. I had not been to a doctor for donkey’s years. He sat behind his desk and blinked at me from behind his glasses. White hair, a slightly red face. When he spoke he had a charming southern Irish accent.

“So what seems to be the Trouble?”

I started to explain, rather hesitantly, something that I could not really describe very well.

“I’ve got this feeling . . . it’s like a very mild stitch almost, but not even that bad. . . It’s just an odd feeling . . . doesn’t hurt at all. I just haven’t had it before.”

“And where are you feeling that?”

“Here” I pointed to the left of my navel, on the side. The soft bit.

“And you’ve not had this before?”


“Eating alright? Not doing anything new and strenuous? No reason you can think of?”


“And are you going to the toilet often?”

“No . . . not really just the usual you know”

Why do doctors always want to ask you about your backside or your genitals – never about your fingers or your feet or your face?


“Yes, I work in an Arts Centre, film and video stuff . . . some teaching . . .”

“And do you get worried much - stressed?”

“No – not really”

He pushed the glasses up his forehead, rubbed his eyes. Then took his hands away so the glasses dropped back into position. He blinked at me again.

“You know what I think?”

“No – I don’t know what you think.”

“I think you might be stressed, this might be stress related: psychosomatic.”

“Oh – right. . . It’s just that I haven’t had this sensation before. . .”

“Now. . . What I’m going to do is suggest that if it doesn’t go away in a couple of weeks that you come back and see me. But like I say – I’m pretty certain it’s psychosomatic.”

“OK – I will”

And I left feeling a better.

But it didn’t go away, so I went back a couple of weeks later. This time he said he would refer me to a gut specialist. I pointed out that I was going on a long trip in a few weeks time and he took the dates I would be away.

“And where will you be going?”

“Thailand, Hong Kong, China, Coming back through Russia; Trans-Siberian”

“Well that sounds great. You enjoy it – Now you’ll get a letter inviting you for an appointment. I’ll tell them when you are away. OK?”


“And in the meantime if you feel it deteriorating or anything go to your chemist and get some “Fybogel”. It’s going to pad out your gut a bit and it may have a small laxative effect.”

“OK . . .”

And I left feeling a bit better.

We went on the trip. The first time Clare or I had ever been in a aeroplane, went on a trek in Thailand, got married in Hong Kong, went by train to Beijing, crossed Mongolia, hooked up with the Trans-Siberian, flew home from Moscow.

We had a great wedding party when we got home. It was great to have done the journey, and it was great to be back.

There were two letters waiting for me. One inviting for an appointment, and one expressing disappointment that I hadn’t turned up. Another date was offered but I was unable to go to that as I had work in Newcastle. The record shows that I phoned to say so. Soon I received a letter telling me I would not be offered any more appointments as I had wasted the consultants time and that it wasn’t fair to other patients.

Today, 22 years later I read the letter that the consultant wrote to my doctor. He was apoplectic with rage, and it really comes across in his writing. Really angry that I had not turned up.

I am sorry to read the letter.

“This man” He wrote “ seems to think the service is designed for his convenience . . .”

I am feeling so bad reading this letter.

“I think if I was to meet this man I would not be able to view the case objectively” he wrote.

How annoying to realise that even at this very early date I was in conflict with a consultant. It was the last thing I wanted. I thought I was trying to keep them informed, trying to communicate.

I am very presently aware of his anger – I have wasted his time, and deprived other patients of his attention. I’m really sorry and shockingly surprised.

Dear Doctor Goodman (fake name), if you ever read this I apologise. I certainly never meant to anger you or waste your time.

However perhaps you too had some fault. Maybe a little arrogant; in reading your letter the words you use assume that I will do as you say. That I am an underling. You consider yourself above me, and you were not, nor I above you.

Back to 1988: the odd feeling? It had gone away. Nothing to worry about at all. It was Psychosomatic after all.

On the TV “500 Miles” by The Proclaimers, looking like two psychotic Joe 90’s. I bought the CD.

I don’t know if this was the first whisper of U.C. but many years later when it was clear and present it was in the exact same spot.


  1. Arkayeff, you weren't in conflict with a consultant, it was vice versa - you told them when you'd be away, you phoned to say you had to work in Newcastle. Ha! As if such after-the-event rationality is much good to you, these neural pathways (er, I think) are etched early in our lives, and they are not easy to change. I too worry about wasting the doctor's time, even when I am ill.

    A fascinating post. Two further thoughts: I'm impressed they had all your notes; I can't understand why there are so often cock-ups with NHS notes. It should be simple enough to store docs accurately and logically, and transfer them carefully.

    Secondly - you're too kind to Doctor "Goodman." He is/was a twat. His comment about his potential lack of objectivity is a damning judgement on his own lack of professionalism. Doctors of my acquaintance would be ashamed to write such a thing. So please don't feel bad about it.

    Goodman and his colleagues should be mortified to know that they refused to treat you for two no-shows which you strove to avoid, and troubled to hear of all you have been through since.

  2. Dear G

    Glory of the world to you. Thanks for reading.


  3. AnonymousJune 06, 2010

    When I was first being treated for the HKPP, which is genetic and present in more than one family member here, I mentioned to my doctor that my sister (who was diagnosed clinically first) had been reading about it on the internet as it is unusual and there wasn't much printed/whatever stuff about. Doctor Whatsit actually closed his eyes briefly, then picked his pen up, then scribbled something in my file and informed me that he got plenty of patients in there who'd diagnosed themselves off the net, and people misled themselves all the time etc etc etc. That moment coloured everything for him, despite the clinical diagnosis, my notes of syptoms held in common with other relatives, genetic component, the rest of the file in front of him.

    I was not at all pleased about the apparent 'medical person/underling' idea either. He really pissed me off and I changed doctors. Sometimes it's as if one incident can cloud the whole thing for some medical professionals (not exclusively 'some medicals' of course, a human rather than vocational thing) and their conclusion is that everything they know about you is reframed by that. Just had a similar though milder incident again, and had to write to the clinicals as I'm no longer patient (no pun, oh ho ho) enough for it.

    As the prev commentator says, sometimes they are twats with a lack of objectivity, but luckily, many aren't. If you don't know what you've got, and you've kept them informed about when and why youcan't attend, it's a communication issue for them and their systems, and hardly your fault if the Imperial Consultant gets his knickers in a twist over it.

    /Rant (this is fairly high on my rant topic league table!)
    Catherine (C9)

  4. Catherine, hello again,

    I'm not for a minute suggesting all medics are twats, but that incident has stayed with me. Actually I don't think it would happen now, in my more recent experiences they have tried really hard to accommodate me and my fears.

  5. AnonymousJune 08, 2010

    Hello..I'm really glad it's now improving (and didn't think you were suggesting that about medics, btw). Have to agree - doctors since I met that one have seemed much more open, and after genuinely listening to patients(even ranty ones like me).

  6. Dear Arkayeff and Catherine,
    Well, a twat's a twat - whether s/he is representative or not is a different matter. So far, I've been luckier than you, perhaps, and certainly wouldn't generalise negatively about medics. The two most selfless and saintly people I know are both doctors.

    I recently came across a blog, "The Examining Room of Doctor Charles":
    which you might find interesting. To use a modern cliche, I'd say the man was a healer as well as a doctor.
    Peace, as we used to say, to you both.
    Gloria M

  7. G

    A very interesting blog - the examining room.

  8. jeez, hi, hope iv found you. had to actually create a blog myself and allow google access n i neva allow any applications access, just to speak to you! hope this actually posts. thats all im tryin to do, is post a message to you... thats all im sayin. just wanna say hello. thats all. if it comes up wiv some crazy name, blame yourself. i was on a mission to find you. much love xxxxxxx

  9. dr goodman was definitely more concerned with himself and his time than you. i know you know that. it doesnt make it ok. it makes it an "unfortunate" encounter. that you would be takin time n thought to try and make allowances for him in his utterly unprofessional and inhuman attitude to his role in your life at that point is just head shaking and i despise him for it, tho i know u should neva despise anyone. doctors are just human, doctors are just inhuman. some, some... love x

  10. Hello Nettle - have we met?

    Thanks for reading - and creating a blog. All you've got to do is write something there now!

    The Good man was probably up to his eyeballs in work and all that. . .

    I don't despise him, I was just confused and surprised by that incident.

  11. hi again. yes we have met. but dont worry, im not stalking you or anything. im just one of a number of people who have encountered you over the years and been following your blog and happen to think you're a top bloke. doubt you think so, who does? its what other people including me think that allows me to say that. to you, to us, to them. x

  12. Nettle,

    You are very kind.

    I welcome and encourage all comment, and I'm, of course, flattered by your words.

    I'm busy filming and editing at the moment, but I will posting again shortly.

    May we all live to be 100


I'm always interested to hear any thoughts or stories of your own. Please do comment.