Travel expenses reimbursed

That's what I call a house visit

Every morning after surgery we meet for coffee and dole out the house visits. Despite people saying "doctors don't come out to your house for love nor money these days" we do about half a dozen visits a day. Usually the GP who knows the patient best will go out, but if it's someone who is only known vaguely it will just be random. Often if it's far away there will be a subtle umming, erring and mumurings about having a lot of paperwork in an attempt to avoid having to drive out a distance.

So the furthest visit away, practically in a different town, was apportioned to poor old Dr Genesis, the registrar. Remember, an old colleague in hospital once said, sh*t travels downstream.

But I'm glad I went.

A poor man had innocently remarked to his doctor that he felt a bit more tired than usual. Hardly surprising for a 79 year old. But something must have ringed the bells of the partner because he was sent for blood tests. The tests showed an obstructive liver picture and an ultrasound confirmed...metastatic cancer. Within three weeks the culprit had been found: a tumour in the lower bowel. I say tumour, but really ought to say cancer. It just sounds more manageable when you say tumour.

Although he had seen the surgeon, the oncologist and countless junior doctors he was none the wiser as to the extent of the disease, where the primary was (a lot of people do not understand what is meant by "bowel") or what the future held.

Dr Genesis explained it all, in language he and his wife could understand, and took his time doing it. "Thank you, Dr Genesis", he said. "You've told us more in the last ten mintues than we've been given the whole two weeks in hospital".

I love this stuff. I think talking to patients and explaining things, particularly palliative care, is more rewarding than most other areas of medicine.

I wonder how much longer he'll be around with a liver packed full of metastases.