The Official Website  for Carol Margaret Tetlow

November 1st

Dear Doc Britton,

Trouble chez Wottle, I'm afraid. Mrs W has been watching too many of those home makeover programmes (she says she has to , to pass the time while I'm out with my camera) and has decided she wants to re-decorate the lounge and get new furniture.

She wagged her finger at me and said, 'I feel like those curtains, worn out and in need of a change.'

Quick as a flash I replied, 'pull yourself together then!'

Sadly on this occasion it was only me who laughed and she refused to make my tea.

Please could you do me a brief note on headed notepaper to confirm that I have a bad shoulder, bad elbow and get dizzy when looking up, then she might believe me and I'll be excused from all the work.

Yours patiently

W Wottle Esq

November 3rd

Following last week's blog about a wayward piece of fruit, there seems to have been a flurry of activity about everyday objects in unusual orifices.

At one point in my career, I was starting a small museum of 'objects I have retrieved'. I had a marble from a little girl's bottom, a piece of lego from a nostril, someone had generously donated their gallstones after I had removed their gall bladder. It's a good job they wanted the plum back as it would be a very small prune by now.

The largest object I encountered was when I was doing a surgical job (location omitted, just in case). Nowadays stag dos involve elaborate trips abroad that last a whole weekend or more. Gone are the days of having a really good laugh and handcuffing the stag to a lamp-post or shaving his eyebrows off or.............inserting a ten inch phallic object up his rectum, whereupon, rather than protruding, it disappeared from view.

Once the alcohol had worn off, he was taken to theatre and guess who was the lucky surgeon on call? Indeed, me.

Normally in the middle of the night, there would be one surgeon, one sleepy anaesthetist and a couple of scrub nurses. On this occasion (it's amazing how word spreads round a hospital) there must have been twenty or more spectators, agog, waiting to see what emerged.

The operation was a complete success and no damage had been done, luckily, for this is a jolly jape I would not recommend.

I went to see the patient a few hours later to check on him.

What a surprise! He had taken his own discharge, but left us a memento - no prizes for guessing what.

November 6th

The town where I worked for many years was a big tourist attraction and famous names would also come to perform. My brushes with celebrity were few and far between. I did get to see a singer, whose name meant nothing to me, with laryngitis wanting an instant cure so he could perform that night (no chance) but then........they were filming just outside town and the cast was star-studded.

The then senior female partner had to see one of them. Oh, the excitement, the glamour, the kudos! How envious was I? I never had such luck as she had. Once she had visited a well known sports presenter and received flowers afterwards! Oh my! She was full of her consultation with this famous actor, how charming she had been, how generous she had been with thank you gifts (without breaching confidentiality, of course) and I sat listening, mouth open, wishing that I could see someone really famous.

Then, as if by magic, the very next day..................the receptionists told me that they had booked one of the stars in to see me. I brushed my hair (not really but it makes a better story) and got ready to welcome them.

In they came. Well, I thought, I don't recognise you.

'Do sit down. How can I help you?' I said in my most welcoming, sympathetic, empathic, friendly, knowledgeable voice ( it is good to strike up an immediate rapport if possible).

'Hi Doc, I'm one of the cameramen with the film. I think I've got gonorrhoea.'

Always the bridesmaid.......never the bride........until that day that member of the very famous boy band came to see me.…

November 8th

Dear Doc,

Hate to say it but I think I must have caught a bit of a chill at the Lambdale firework display and bonfire last night. Saw you in the distance with Mrs B but thought you'd not appreciate me discussing the subject then. I should have listened to Mrs W's advice (which of course I usually do) and put on a vest but the day had been so mild, I thought three jumpers, a shirt and a cardi (the one with leather elbow patches) would do. Oh, and trousers of course!

Also my tummy's a little disgruntled and maybe the four hot dogs and slab of parkin on top of the tea I'd had before I went out, might not have helped. We can talk about this on Tuesday when I see you (same time, same place) if the liquid paraffin I took this morning hasn't given me a good flush through.

I was back a bit late and Mrs Wottle gave me a bit of a rocket! I pointed this out to her and replied, quick as a flash, that nobody can hold a Roman candle to her. How we laughed!

Hope you like the pics. Mr Wosnian was there but I expect his photos aren't as good.......

Yours patiently

W Wottle Esq

November 11th

0200h, not just blowing a gale but snowing too. The roads covered with snow, driving conditions treacherous.

I am woken from my slumbers by the telephone. It is a request for a visit to a child who is coughing. I am assured it is urgent and that I must go.

I take the address. It's out of town in the army residences, a small plot of identical buildings, perched on a bleak site, with a completely random system of numbering the houses.

I set off, probably at approx 5 mph as I hate driving in snow and the whirling flakes made visibility very poor. On reaching the army residences after what seems like hours, I cannot see the numbers on the doors.The houses are in darkness. I have to go up the paths and literally wipe snow from the doors, one after the other until I finally find the house I'm looking for.

I knock loudly, several times and eventually a light goes on and someone appears at the door.

I introduce myself, after all by this time, I resemble a yeti.

'Oh,' says man of the house, ' he's fast asleep now. We never thought you'd come out in this terrible weather. We'd better not wake him. Thanks and goodbye.'

The door is closed in my face.

I cannot write the truth about how I felt at that point.…

November 13th

The weather here might be awful but this should make you smile and hopefully get your weekend off to a good start.

The phone rang. It was 0500 on a summer's morning, so at least it was light and not snowing (see last entry).

'Come quickly, my husband has chest pain.'

Remember now that in those days, the GP went out to chest pain. Nowadays these patients all bypass the humble GP and go straight to A&E.

'On my way,' I replied, scribbling down the address and dressing at the same time (female - multi tasking.......).

It was not far away and at that time of the day there was little if any traffic. I screeched my way down a road, either side of which was full of terraced houses, trying to catch glimpses of numbers on doors, so that I knew when I was close by.

Ah! Nearly there and oh! fabulous, they've opened the front door for me.

I deftly leapt out of the car, grabbed my bag and rushed in, rushed up the stairs and met a mature lady with her hair in curlers and the rest of her in a quilted dressing gown. She gasped!

I looked at her and she looked at me.

I introduced myself. She continued to look at me, horrified.

Yes! Wrong house!! I put my bag down. It fell open and everything fell out, just to add to the agony.

Two doors down, my patient was waiting patiently, not particularly unwell and no worse for my slight detour. I believe the lady in the dressing gown got over the shock quite quickly...... On the other hand it took me ages to put everything neatly back in my bag.…

November 17th

Dear Doc,

Struck down by what must be influenza this week so very disappointed to have to ring, cancel my appointment to see you as I was too ill to go to the doctors. Clearly my flu jab didn't work.

Got a soaking at the weekend, when Mrs W and I went for a walk and foolishly forgot our matching waterproof capes (with hoods). Also had the wrong footwear on and slipped and fell. I hurt my arm and mentioned to Mrs Wottle that I suspected that I had fractured my humerus.

Quick as a flash she replied, 'I don't see what's funny about that!'

How we laughed.

Any old how, I think that's where I must have picked up this horrible illness. Mrs W had the audacity to suggest it was just a cold and that I should 'man up'. Not sure where she's got that terrible expression from - her knitting group, I would imagine.

Here are some photos Mrs Wottle took. I had to give her the camera after my fall. It wasn't a good walk. All that rushing water played havoc with my prostate problem.

Sorry again doc, see you next week.

Yours patiently

WWottle Esq

November 20th

There are two types of people you are asked as a GP to visit in hotels. The guests and the staff. Go to see a guest and you are greeted with a smile by the smart, uniformed receptionist, accompanied up to the room, introduced to your patient and assured that your every need is at the touch of a button, or rather the end of a telephone. The consultation takes place in a pleasant room and the edge of the bed is comfy to sit on.

Be summoned to see a member of staff who is resident at the hotel and prepare yourself for a shock. The same uniformed receptionist greets you though not quite so cheerfully. You are taken up to the top floor but led down a beautifully carpetted corridor. A door that looks like any of the others is opened for you and immediately you are transported into another world, where cockroaches scuttle at the sound of your footsteps, old pipes groan and drip and the rooms are cramped and unwelcoming.

The staff you may well already know as they are registered with you but the guests are completely unknown quantites.

'He's feeling a bit dizzy,' was the reason for the house call request, which came from the receptionist, one evening when I was on call. 'He's from Italy and speaks no english. I don't know anything else apart from that he's 64.'

Ever tried conducting a consultation when the interpreter is a dictionary and nearly every word has to be looked up? It's not easy. In fact it's quite scary with the potential for huge mistakes. And there are dozens of reasons why someone might feel 'a bit dizzy.'

Off I went and was shown to the room. I knocked and went in. Where was the patient? Oh there he was, lying between the white sheets and exactly the same colour as them. On the floor was blood he had vomited up and in the bathroom, everywhere, including the walls, was covered with black tarry faeces. Incontrovertible signs that he was bleeding internally and needed emergency care.

It is remarkable that, when called for, a bond can be forged by waving ones' arms about, speaking very slowly (and loudly of course, as this makes all the difference) and sign language which you make up as you go along.

By the time the ambulance arrived - mercifully speedily - the patient and I were at the holding hands stage and good friends.

For those interested, he had a bleeding stomach ulcer and made a good recovery.

November 22nd

Once upon a time, I was working in A&E. It was one of those winters when we had proper snow, loads of it and it stayed for days. The roads and pavements were treacherous and one night it was so bad that the doctor coming to take over from me couldn't get in, so I did a double shift.

A patient came in by ambulance with a bad cold.

'I couldn't get my car out because of the snow.....' the patient said.

A few days later and the thaw was well on its way. In totters a dear little old man, clutching his wrist, which is clearly broken.

'It happened a few days ago, but I couldn't get here and anyway I knew you'd be busy and I didn't like to bother you.'

Suggestions on how to educate patients on a postcard please.…

November 25th

Today I was the guest speaker at the local NSPCC lunch.Eighty ladies congregated at the Bedale Golf Club and enjoyed salmon with a delicate sauce, a selection of vegetables and dauphinoise potatoes, followed by either Bakewell tart and custard or lemon and lime cheesecake (I had the cheesecake -it was delish!). Then there was coffee and mints (no need for any supper tonight), a comfort break and then my talk.

Thank you to those who organised the lunch, made me so welcome and for the beautiful plant.

I sold sixteen copies of my books and gave half the proceeds back to the charity.

Why standing and speaking for fortyfive minutes can be so completely exhausting baffles me but I think everyone enjoyed themselves. I know I did.

November 27th

There is a lot of advice and guidance about consultation skills. How to build rapport, make the patient feel comfortable, recognise the clues (eg clothes in disarray, patient looking pale, or yellow, or even red or blue). And just when you think you've finished, it's advisable to ask, 'is there anything else I can do for you?'

you'd be surprised how many patients test you out with lesser worries to see if they like the way you behave before getting down to the real reason for them being there.

This question can yield nothing but occasionally it can be the most useful thing you ask.

Sometimes though, you get answers that you are not expecting. These more often happen when you are visiting patients at home.

Here is today's discussion. What do you do when the reply to that question is.....

1) please post these letters when you pass the postbox

2) make me an apricot jam sandwich before you go

3) put the rubbish out

4) help me find the cat

5) take me to the toilet

6) help me get dressed

7) go and visit my friend two doors down who also has a nasty chest

8) go and get my tablets from he chemist

Answers on a postcard please....

Happy weekend everyone!

November 29th

Here is some advice about how to pass an examination.

Paediatrics as a student. The end of placement assessment. I was asked to see a small boy, about four, with his mother, find out the diagnosis, the abnormal findings on examination and then present all this to the scary examiner.

The little boy is a dear. The mother is tight-lipped. She's not done this before and is taking is all very seriously.

I start asking questions. Apart from telling me he is four, she is not giving anything away. Not his name, nor his symptoms. Nothing!

Her answer is the same to everything. 'I can't tell you because it's an exam and it's up to you to find out.'

I try different tactics to no avail. I'm not only exasperated but beginning to panic.

What am I going to report to the scary examiner who is loitering close by.

'I've been told not to tell you anything,' she repeats.

'Yes, but I need to know some things from you,' I plead.

I look pleadingly at the examiner who senses all is not well. He comes over and has a word with the mother.

'You can answer the questions,' he assures her. 'That's fine.'

He walks away.

I take a big breath in and start again. I ask my first question.

'Oh,' she replies, 'never mind all that, he's got a ventricular septal defect, he was born with it, he has a systolic murmur when you listen to his heart, gets breathless when he runs about and is awaiting surgery.'

And suddenly my world improved considerably......