Category Archives: consultants (hospital)

The spinster consultant

This colleague of Dalrymple’s was in her mid-fifties and her patients

were her family, her recreation, her life. Her devotion to them was absolute.

On her ward rounds

she examined each with minute care, read their notes from start to finish, and ordered long batteries of tests in case she had missed something, even when the diagnosis had been made weeks before.

Although she was a woman of the greatest kindness, her rounds

were an ordeal for all concerned — patients, nurses, doctors – lasting eight to ten hours. By the end one wished to scream, to kick the walls, to smash plates. And the worst of these ordeals was that they benefited no-one. I do not recall a single patient whose life was saved, whose diagnosis was made, whose prognosis was improved, by this minute sifting of details.

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Black comedy in the ward

Like something from Hancock's Half Hour, only blacker

Like something from Hancock’s Half Hour, only darker

Once as a medical student, writes Dalrymple,

I was deputed by a hospital consultant to tell a family that their loved one was dying of lung cancer.

The imparting of such information was not regarded by the consultant as very important,

indeed he thought it almost a distraction from the serious business of curative medicine.

Without any guidance as to how to do it, Dalrymple told the family

in a very straightforward way, not because of any commitment to honesty but because I could think of no other.

To Dalrymple’s horror,

one of the relatives was very hard of hearing, so I had to raise my voice to so high a volume that my voice echoed round the ward. It would have been comical if it had not been so appalling.

In any case, the dying patient might have guessed that he was in a bad way because,

when the medical notes were put out at the end of the bed before the consultant’s ward round, those that contained a diagnosis of cancer were left out. In other words, if you were lying in bed and the notes failed to appear at the end of your bed, you knew the diagnosis was bad, despite the doctor’s assurance that it was ‘just a little ulcer’ in your lung or your bowel.