The Official Website  for Carol Margaret Tetlow

July 3rd

· Private email from Dr Ellie Bonnington to her partners, Dr John Britton, Dr Ed Diamond and Dr Clare Jennings.

Have you all noticed how, when the sun comes out, it gets hot and it's Wimbledon fortnight that we see a sudden surge in cases of sunburn, dehdyration, shoulder problems, tennis elbow, low back pain and athlete's foot?

I'm getting fed up of advising people to take up sport gradually to avoid injury, to warm up, cool down, put on sun block, use the right equipment (ie not their best friend's trainers which don't fit properly). Please- my male colleagues, do remember to advise women about the importance of sports bras. Any questions - ask me.

How annoying is it when they tell you what the scores are when you were hoping to avoid hearing so you can watch the highlights in the evening with no prior knowledge of what happened? And how can we let them know that sudden consumption of a kilo of strawberries may well lead to some intestinal hurry?

Ok, rant over. I must call in my next patient who I can see is waiting in her tennis skirt.....

Oh by the way, Ian has managed to get two tickets for the mens' quarter finals next Thursday, so is it ok if I take that day as holiday. It is my half day, so it'd only mean I was missing in the morning....please?


July 5th

Dear Dr Jennings,

You sent me into hospital last week because I was very short of breath and my ankles were swollen and you said I was full of fluid. I was initially on Gerbil ward, in the new wing, which I feel is a very strange name for a ward and was distressed to hear the nurses talk of the Violence ward down the corridor.

This is the 21st century. Surely they don't have a need for wards like this.

Apart from this, my stay was satisfactory, the food quite good and overall, I had nearly as good a time as I had twenty years ago when I was in another ward with a tropical pregnancy.

Yours sincerely

A Patient (name changed to avoid embarrassment.)

Dear Mrs Patient,

Thank you for your letter. It took me a little while to work out just exactly what you were referring to. You were indeed in the new wing, where the wards are named after local Abbeys. The ward you were on is actually Jervaulx, not Gerbil and the ward you heard speak of is Byland, not violence. The others are Fountains and Bolton.

Also, for future reference, twenty years ago, you had what is called an ectopic pregnancy.

I hope that clears up your concern. I am glad to hear that you are home and feeling better.

Yours sincerely

Dr C Jennings

PS the audiology clinic has open access to advise about hearing aids on Wednesdays from 1200-1500h


July 6th

John Britton, senior partner, is sitting in the common room, looking a little green around the gills, holding a letter in his hand. Ellie, on entering notices that all is not well and asks what the problem is.

'Last week, Mrs Pipsqueak gave me a bag of brazil nuts as a present. She left them at the reception desk. They were really nice,' he explains.

'So?' asks Ellie, 'what's wrong with that?'

'Nothing at all,' John agrees. 'I dropped her a line to say thank you and didn't think anything more about it until I got this just now.'

'What does it say?'

John clears his throat.

' 'Dear Dr Britton, thanks for your note -much appreciated. Glad you enjoyed the nuts - I really enjoyed the chocolate that was round the outside of them. Yrs G Pipsqueak(mrs)' .'


July 9th

Yet another big thank you to Mr Wottle, who has been down by the river and then popped into the surgery with these stunning photos for us. We are so lucky to be living and working in such a stunning part of the countryside as these and our new cover photo confirm.


(Click here to go to see the photos)


July 11th

Dear Mr Wottle,

Thank you for yet more photos. We're all extremely grateful, as always. You did send in over a hundred this time. Dr Britton suggests you make an appointment as it might be that your medication needs adjusting a little.

Yours

E Douglas (practice manager


(Click here to go to see the photos)


July 13th

Miss Sparrow was the sweetest little old lady you could hope to meet. Embracing her eighties with a fortitude few have, she lived in a huge bed sitting room in a warden controlled block of similar residences. The size of a sparrow, she was all bones and looked as though she could fall over and snap at any minute but she was a lot tougher than she looked. She and her adorable whiskery terrier (who bore more than a passing resemblance to her) made the most of life.

She was fortunate in that she had little in the way of medical problems and it was unusual to be asked to go and visit her one day.

How things had changed!

Her flat, usually spick and span looked as if she had held a wild party for some crazed buffalo in it. She looked unkempt, her clothes dirty and mis-matching, her hair a stranger to her hairbrush or comb. From the first word she spoke it was clear that she was completely confused.

She offered me an apple pie - there were three of them, little ones, lined up on a radiator. She told me they had been there a couple of weeks now and should be nice and hot. I declined, politely and went to sit down but was immediately steered towards another chair as apparently The Prince was sitting in my first choice. We chatted. The Prince was asked for his opinion at all times. At one point, she turned to the standard lamp, referring to it as her father, and spoke to 'him' as well.

The dog sat on her knee, devoted as always.

One long chat later, I had to ask a psychiatrist to come and visit her with me and she ended up being sectioned under the Mental Health Act. For someone so tiny, she put up quite a fight when the ambulance came. She tried to take the standard lamp with her.................and the dog. It was all very sad. Probably yet another of those situations where I would drive away, stop round the next corner and cry.

She was in hospital a long time. When she was discharged, she was never quite the same, somewhat blunted on her medication, her joie de vivre subdued by tablets. Shame.

Oh the dog? He went into kennels, refused to eat, pined away and died. And now I'm going to cry again..…


July 14th

The wisdom that comes with hindsight is a wonderful thing.

For some reason, today, I would like to pass on the advice to think twice before you gaily offer to look after someone's pets because they are going on holiday or into hospital.

Three incidents come to mind, one of which I shall draw a veil over completely.

In a friendly fashion, I offered (as you do) to look after a patient's hen and parrot while they went on holiday. The parrot was in a cage, which did not stop it from biting ferociously and the hen lived outside in a hutch. On day one, the hen, of whom they talked with great love and emotion, escaped and was later seen on the stable roof before disappearing from sight altogether. There then followed an agonising ten days wondering how best to explain the situation. All the dangers out there kept whirring round in my mind. The hen was surely doomed. Meanwhile the parrot kept on biting.

But, if you have ever questioned whether miracles do happen then read on for.....one the very day they were coming to pick the birds up, lo and behold, one hen reappeared on the stable roof and leapt down and into the hutch. After ten days of no sleep and not being able to eat, my relief was indescribable. But, never again!

Mrs X had to go into hospital. There was no two ways about it. But, she cried, what shall I do with the cat? Living alone in a first floor flat she had, she claimed nobody who could help. Cue the nice, friendly GP who promptly offered to have the cat for as long as it took. So, let's call him Tom - he was a huge ginger cat who stank of cigarette smoke - was wrestled into a box and came to y house where he rushed into the airing cupboard and hid. Needless to say, he too disappeared. (Perhaps I'm not a very good hostess???). The countryside was scoured, the roads were searched, no sign. In desperation I went back to her flat, about 2 miles away. There he was in the flat below where he lived, looking triumphant. 'Oh,' said the neighbour, when I explained, 'I'd have looked after him. I've got a key to her flat.'

And as I say - never again and I mean it, I really do.


July 16th

Rambling again....

Up until the mid 1990s, all GPs were responsible for the care of their patients 24 hours a day. At 1800h the phones would be transferred to the house of the doctor who was to be on call until 0800h the next morning. The spouse of the on call doctor was expected to stay in and take all the messages if the doc was out. Quite a commitment for both parties. Some spouses hated it. Of course there were no mobile phones then and not only did we know how to navigate round the town in the most efficient manner, we also knew precisely where all the public phone boxes were so that we could answer our pagers promptly.

When I first started ten years earlier, about three calls were the average during the evening and often you would sleep undisturbed but the next decade saw a huge changes, a big increase in patient demands and it was not uncommon to be up either all night or four or five times, which in many ways was worse as you were repeatedly disturbed as you tried to relax. Add into the mix being on call for the police and patients going into labour and out of hours work was hard going at times, especially as you were expected to work the following day, all day.

The partners once had a discussion about rituals that were involved with being on call. Though nobody actually admitted to having a pair of 'lucky pants' certainly a lot of us agreed that we didn't take our coats off as that would always make the phone ring. We had favourite chairs we sat in and we never ever started to do anything (eg make a cake, read a book, have a bath. Perish the thought of having friends round - it would be guaranteed you would never see them).We also discussed what we wore to go out on calls in the night ( ie once you had already got into bed). I admitted that I went out in my pyjamas with a coat on top (could be chilly but definitely easy when you got back), others confessed that they threw on jeans and a jumper but left a bit of pyjama trouser on show, the benefit of both these approaches being that patients realised we had actually got up from our beds to go and see them. But one partner revealed that he dressed fully, from underwear, to shirt, tie and suit! Amazing! I hope his patients noticed and appreciated it.

Doing our own on call was a curate's egg. You saw patients you knew, who knew you. You learned an enormous amount. You could drive round empty roads and get to your destinations rapidly. But it's an ideal and as patients increasingly wanted 24 hour availability - well, they can shop 24 hours a day, so why not see a doctor? - the system became unsustainable. I'm glad that I've experienced it with hindsight. But now it seems a lifetime away and I doubt it will ever return. Yet another nail ....…


July 2nd

It's just over a year since Out of Practice was published by the fabulous, tireless @Guy Boulianne and @Editions Dedicaces

If you thought writing the novel was the hard part, think again. Self promotion does not come easily to some of us. But, in this day and age it's vital.

Thanks to wonderful people -

I've done two interviews on US radio stations and been on the @Kama Burton show. I've had my novel advertised on the back of a pedicab in New York for two weeks and in the back of a taxi. It is currently being advertised on a US TV station.

I've been interviewed on Radio Tees by John Foster and I've had the most fabulous booksigning at Waterstones.

I've had articles in three magazines, including Retirement Today and GP magazine.

In September I start giving talks to the WI, womens' forums etc.

I've created this page and it's sister page @Hector and Rufus and keep my website www.carolmtetlow.co.uk up to date.

I blog twice a week on @AuthorsDen.com.

All good, positive stuff. BUT - I've emailed three other radio stations and simply had no reply and I've emailed over a dozen other magazines and again not even had an acknowledgement, apart from one.

What do I have to do?

And then I had this brilliant idea - ask on this page. So.....

Anyone got any ideas or contacts?


July 25th

Funny how memories come back. I was baking (yes I like to try) this afternoon and I remembered dear little Mrs X, skeletal, tiny but able to talk the hind legs off a field crammed full of donkeys. She would prattle on and on and then depart, leaving me feeling that I had done very little for her.

Her visits to the surgery were approximately monthly and she would stagger in carrying a plethora of shopping bags, one of which inevitably contained a cake that she had made for me.

I was assured that this was a healthy cake as it had little fat in it but twice as much sugar and some juice. Shaped like a brick and resembling a brick in quite a lot of other ways, it was always wrapped in several sheets of newspaper.

How very kind of her to go to so much trouble.

One day, she wasn't so well and asked for a home visit.

My suspicions were that she had a urinary tract infection.

I asked her if she could manage to provide me with a sample of urine.

No problem, she said, wobbling to the kitchen and producing a large bowl to catch her sample in. 'This will do. It's the one I use for baking your cakes.'

..............enough said


July 28th

Catastrophe at the Teviotdale Medical centre yesterday when the computer system crashed!

Receptionists were unable to book appointments or order repeat prescriptions, other than by hand and doctors had no access to patients' notes for more than half a day.

Dr Britton, who years ago was somewhat sceptical about the use of computers in the surgery, believing that they might add an additional and unwanted dimension to the consultation, commented that he was horrified to find how dependent he was on them now. His language by coffee time was a little colourful as the knock on effects of this catastrophe became increasingly obvious - nobody to could access the hospital pathology service for results and nobody could write referral letters. It was impossible to view the most recent consultations and all prescriptions had to be written by hand, which proved beyond onerous, especially for the patients who have more than ten items on their repeat prescription list ( and some have more than twenty).

Engineers worked tirelessly, creating havoc in the waiting area as the queues built up to rival Disney world but by mid afternoon, normal service was resumed, though everyone was exhausted and had to go to the pub at close of play for a small, refreshing tipple (three in some cases).

The doctors would like to apologise for any inconvenience caused and reassure patients that all is well now and they trust that there will be no further issues.


July 30th

It was a fairly quiet day on Labour ward, well it was 0730h so the day had really not had a chance to get going. Four ladies dutifully arrived, looking a mix of apprehensive and excited as they were due to be induced, being a couple of weeks beyond their due date. Mr and Mrs X were shown into their room for the day, Mrs X settled in and Mr X took up his place in a corner of the room.

They had a very precise birth plan, in writing (possibly in triplicate) which they were adamant they wanted to adhere to, come what may.

In my experience, the more insistent you are with your birth plan, the more likely things will go wrong.

They requested no pain relief, no epidural, no gas and air. Everything was to be natural. Mr X to be present throughout, Mrs X to be allowed to adopt whatever position she felt best, soft music to be playing in the back ground, subdued lighting, then after delivery, Mr X would cut the cord and take the placenta home to eat.

Induction was not part of their plan but they had no choice, so her waters were duly broken and she was left comfy to await the start of contractions. Mr X opened up his bag and took out a small pack of sandwiches and a flask of cocoa and tucked in.

Some hours later, she was starting to contract more strongly. The songs they had sung to help her through the early contractions no longer were helping alleviate the pain. Beads of sweat were starting to appear on her forehead, wiped tenderly away by her husband with a yellow flannel.

She was asked if she would like to reconsider pain relief. It was going to be a long day. No, was the answer, supplied by Mr X.

The contractions became more frequent and longer. Her face became increasingly worried and distraught. Mr X opened a Tupperware box and had some cake and some more cocoa.

Again she was asked if she wanted pain relief.

No, no, no, answered Mr X between mouthfuls.

Her labour was proceeding very slowly; she was exhausted. Hair all over the place, nightdress round her neck, bed sheets awry as she was totally unable to get any rest.

Mr X applauded her and produced another piece of cake and offered her a bite.

That was the final straw, she sat up, turned round to him and bellowed.

'get out of here. now! and don't come back! And someone get me some f****** pethidine (pain relieving injection).'

She went on to have pethidine, then an epidural and then a Caesarian section for failure to progress.

The baby was fine.... I'm not sure about them...

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