The Boy in Blue

The Boy in Blue

In general practice, anything can happen: the big, difficult, and tragic; or the little, funny, and rewarding. Both can be equally memorable.

          Paediatric experience, when I started as a doctor, was not necessary to work as a GP. We did the usual undergraduate training, then had to work six months in medicine and six months in surgery to gain registration. Other specialties were optional. This may have changed. I was lucky. I managed to do three months of paediatrics in my second year as a house surgeon. Then I did further work in hospital paediatrics as a junior doctor in England and during the Family Medicine Training Programme. I also studied child development and learning as part of my arts degree through Massey.

          Perhaps more annoyingly, to parents, is that having children of your own is not considered necessary to care for other people's children. The dismissive attitude I encountered from some parents, after what I regarded as my extensive training and experience of looking after sick children, used to irritate me. There is no training for parenting either. But I now need to admit, after the experience of being a parent myself, of many sleepless nights, and opportunities to make mistakes of my own, my empathy has improved. Parents gain valuable experience that cannot be understood by "outsiders". Sometimes though, it's hard for parents to be objective.

          One little boy I looked after as a GP in rural practice, let's call him Charlie, was diabolical. He was three or four. His mother was totally unable to control his behaviour. His misbehaviour always followed a pattern: he would do something naughty; his mother would tell him, "If you do that again you will be in trouble"; he would do it again; but no "trouble" ever seemed to eventuate. His mother usually came in with health problems of her own, bringing Charlie with her. I guess there was no-one else who would take him on.

          I will describe one incident I especially remember, for a number of reasons. The previous day, there had been a tragedy. Charlie and his parents lived in a farming community up a remote valley. I had been there less than 24 hours before, when one of the local farmers, one of their neighbours no doubt, had rolled his tractor on a silage pit. This is dangerous work. When I got there, he was already dead. There was little in a physical sense that anyone could do. I confirmed his death, talked to his family, and left it to the police to sort out.

          The incident stayed in my mind. I needed to push it out. If I allowed myself to think of it, it would have been overwhelming. But I had twenty or thirty patients booked that day. As was my usual practice, partly to protect my own feelings and partly to allow me to engage fully and equitably with each person's concerns, I attended to each patient's problems for fifteen minutes than put them aside while I brought in the next one.

          Charlie's mother as usual came with an unrelated problem, and with Charlie in tow. While we talked, he ran around the room, removing equipment from the shelves. His mother kept excusing herself from our conversation to run after him and put it back. He sat down behind me, opened one of the drawers of the examination couch, and began removing things one at a time.

          At that stage, my telephone rang. This was unusual: normally it meant some urgent call, or maybe another doctor phoning. I hoped I wouldn't have to leave my busy practice again. This time it was the receptionist phoning about the incident from the day before. Peter, one of the two policemen (they were both called Peter), had come with a form for me to sign. An idea came to me. "Is he in uniform?" I asked. He was. "Ask him," I requested, "to come and stand outside the door".

          While we were talking, Charlie continued emptying the drawer.

"If you take one more thing out of that drawer," I warned him, "I will get the police to come." Charlie looked at me with his usual casual disbelief, paused briefly, and continued emptying the drawer. I leapt to my feet, flung open the door, and there was Peter standing in his uniform, holding his piece of paper.

          Charlie's jaw dropped. Constable Peter, quite rightly, when he found out what was going on, was critical of me for misusing his powers. But it worked. No doubt Charlie was naughty again in other situations, but his behaviour when he came to the doctor, as I remember it, greatly improved.