Thursday, March 23, 2006

In Pursuit of the Recently Departed

‘Funny things accidents - you never quite know when they are going to happen.’
Winnie the Pooh
A. A. Milne

Monday afternoon, 3.50 p.m. to be precise, and I have a sixty mile round trip to make, all because a dead body went walkabouts.

She didn’t really go walkabouts and it wasn’t truly her fault. It couldn’t be as she was dead, in which case I don’t suppose she had much say in the matter. However, at times like this, it always seems that the recently deceased are having their final revenge on the physician who latterly attended them in life. It is as if they are saying, in the style of Laurel and Hardy, ‘well, this is a fine mess you have got me into, so now I am going to make life just that little bit harder for you.’

I can tell that you are probably having difficulty following this, so I will endeavour to explain.

I have the privilege of practising medicine within a rural environment. That has the advantage of enabling one to have an attractive lifestyle whilst avoiding the socio-economic problems that my inner city colleagues have. However, one of the disadvantages is that it is a long way to the major towns and cities. Most of the time, that is of no importance. The local market town provides for most everyday needs.

Like funeral directors, for example.

This usually makes providing the dead with the various documentation required for the next part of their voyage of discovery, a simple process. The patient dies (as they sometimes ungratefully do), the doctor takes five minutes (between treating Bessie Smith’s varicose veins and collecting his dry cleaning) to pop up the road to Messers Ivor Grave & Sons to sign on a few dotted lines, leaves a message for one of the partners in a neighbouring practice (who will nip in, make sure that the aforementioned patient is not playing sham and really has decided to check out, and sign the second part of the cremation form) and still has enough time to collect a brace of pheasants (which the butcher has kindly plucked and disembowelled) before arriving back in the surgery for the afternoon sore throat and aching back parade.

However, just every so often, one finds an awkward patient who, having been born in the market town, attended the local school, married in the parish church, worked all her life in the local library, shopped at the Corner Shop, shunned holidays and finally ended her days, at the age of 96 years, in the departure lounge of the local residential home, suddenly decides that Messers Ivor Grave & Sons is not the tour operator of choice for the next leg of her journey. No, she wants excitement, the smell of sea air and the thrill of a weekend’s break in the seaside resort thirty miles away.

The first one knows of this late burst of wanderlust is a message during the second surgery of Monday morning. A little pop-up appears on the computer screen, announcing “you have mail.” Unprepared for the message contained therein, one eagerly opens it as it provides a welcomed distraction from Mr Heartsink’s meaningless waffle about the state of his bowels. After all, he cannot see the screen and will just think that one is diligently recording every detail of his recalcitrant plumbing.

Mrs Stayfast died on Friday afternoon. They need the death certificate today and she is for cremation.’

Not a problem, you think. She had a stroke one week ago and developed bronchopneumonia four days later. Simple and tidy; coroner doesn’t need informing, paperwork straightforward and a spot of “ash cash” into the bargain.

Another pop-up and another e-mail:

She is at Diggit & Furnace Funeral Parlour in Great Grimesthorpe By-the-Sea.

All hopes of a quick resolution to that task immediately disappear. Grimesthorpe is thirty miles away and I have no idea where to find Diggit & Furnace. There should be a rule against poaching bodies away from their home towns, even if it is at the family’s request. It is most inconvenient.

Thus it was, at 3.50pm, that I found myself in the surgery car park entering the address of Diggit & Furnace into the Land Rover’s satellite navigation system. ‘Fast Route…’ Yes, that will do nicely. Usually, I would take a leisurely drive across country. However, a quick flit down the dual carriageways will suffice for this trip; longer in miles but much quicker.

Five miles later, I am sat at the back of a very long traffic jam, which is going nowhere. The only slip road on this stretch is behind me and my green, magnetic emergency beacon, which has in the past enabled me to worm my way through all sorts of jams in true ‘let me though I am a doctor’ style, is sitting in my garage back at home. The announcer on Classic FM rather too gleefully gives out the motoring report and I learn that three lorries and a car have become snugly acquainted with each other at the intersection ahead. I eye the embankment, for a brief moment wondering whether the 4x4 would get up it and whose field it was on the other side. However, I decide against such a bid for freedom, well knowing that dozens of fuming drivers would be willing me to fail. There is nothing for it but to sit it out and rue the fact that I didn’t take my accustomed meandering route across country. It is another fifty minutes of quiet reflection time before I resume my journey down the “Fast Route” to Great Grimesthorpe By-the-Sea. Winnie the Pooh was absolutely right about accidents.

Mrs Stayfast’s revenge didn’t end there. Diggit & Furnace are in the middle of a council estate, whose roads are subdivided by pedestrian walkways and bollards, presumably to deter joy riders. With difficulty, I navigate my way through the maze and finally arrive to find, much to my relief, that a young employee has stayed behind to study for his NVQ in shroud-folding. He directs me to the refrigerators and then abandons me.

The refrigerator is a double-fronted, three-tiered one. Labels on the door announce the identities of the occupants, rather like the communal front door to an apartment block; only here you don’t expect the occupants to answer the doorbell – if there was one. True to form, Mrs Stayfast has seized the top bunk, which is conveniently situated about four feet above my head. The trainee shroud-folder is nowhere in sight. In one corner there is a mechanical lifting trolley, which looks far too complicated for my liking and prompts nightmarish images of spending the night on the floor with Mrs Stayfast for company. I decide to abandon any thoughts of getting her down to my level and opt for the mountain-goat approach. Really, it is just like climbing the parallel bars in my old school’s gymnasium, only a little colder; one step, two steps, pull-up with the biceps and there I am, squatting next to Mrs Stayfast. A one-handed uncovering (the other is firmly holding on to the freezer unit) and I have positive identification. Pupils fixed and dilated, no pulse, no heart sounds; job done.

Back at ground level, I ensure the refrigerator is fastened (just in case she gets wanderlust again), and go off in search of the junior pickler. I find him in the office, chewing his fingernails (always an unsavoury habit in an undertaker). Death certificate signed and Part One of the Cremation Form completed and I am on the road again. Only this time, I take the cross-country route home.

Mrs Stayfast’s revenge does not even end there, however. The following day, I have the task of trying to find a willing doctor to complete Part Two of the cremation forms. That used to be an easy affair. A simple task for a reasonable fee; everyone was happy to oblige. Then Shipman came along and overnight it got a whole lot more complex. So much so that, outside the market town (where the practices oblige each other as there is nowhere else to go) nobody wants to know. Five telephone calls later and I had been turned down by three practices for a variety of thinly veiled reasons. Not that they suspected me in anyway (honestly). It just wasn’t worth their effort and they were unlikely to need a favour returning. Finally, I managed to speak to someone who knew me from when we both sat on the Faculty Board for the Royal College of General Practitioners. Uttering comments like ‘for old times sake’ and ‘oh, ok, just this once,’ he acquiesced and I was finally free of Mrs Stayfast.

Looking at her thin set of notes, Mrs Stayfast probably took up more of my time after she checked out, than she had of any doctor throughout her entire ninety-six years whilst happily respiring.

So, if you are anticipating emigrating to the next world within the near future, please spare a thought for your poor GP and opt to support the local Funeral Director. If, by chance, you still decide to have one final holiday and go off elsewhere, then please use your new-found advantageous position in life (or should that be death?) and forewarn your doctor of any impending accidents on his route to find you.

That is, unless you also think that fifty minutes in a traffic jam is a fair punishment for him only allocating you the odd ten minutes here and there for the past decade or so. Sorry, if that is the way you felt, Mrs Stayfast. May you now rest in peace.

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