A Christmas visitation

A doctor never forgets their ‘long case’

“You had better go before the roads get too bad. It’s a dirty night for Christmas Eve”.

“I will so. I have a few last things to get in town. Don’t stay too late.”

“Just a bit of paperwork.”

“Ah, leave it for once. I’ll see you in a few days. Don’t let them work you too hard in the co-op. And happy Christmas.”

“Happy Christmas to you too.”

The doctor saw the look of concern in his secretary’s face. It had become a familiar expression. As he closed the door behind her, he noticed a dog at the gate. Even in the rain he could see the unmistakable shape of a Boxer. He loved the breed and still had a picture on his desk of Susie, the Boxer who had sat in the passenger seat beside him for many years as he did his rounds. General practice had changed since then; you could not bring a dog to work anymore and rounds in the car were in the past.

He was about to investigate when he saw a woman standing in the hall. He had learned long ago not to argue with late comers, so he merely said:

“Come on in. You’re welcome. Happy Christmas.”

“Happy Christmas, doctor.”

Her accent was not from the area. She was neat and elderly, with a good-humoured expression. He knew he had met her before, but he could not think of her name.

“Could you give me your date of birth please?”

It was his way to find out who she was on the computer without admitting that he had forgotten. He never forgot a case, but he often forgot a name.

“I’m not on your system. But you do know me.” Her voice was affectionate, so she was not there to complain anyway.

“I’m sorry,” he admitted. “I just can’t place you.”

“That’s alright, it’s been a while. I bet you know what I had wrong with me, though.”

The diagnoses leapt effortlessly into his mind.

“Replacement mitral valve. Controlled hypertension. Arthritis of the knees and a cataract of the… left eye.”

“Well done! You’re the best.” She clapped her hands together, her eyes shining. He had heard her say that before. It was all so familiar, but he just could not place her.

“I’ll help you out,” she said. “What used Prof O’Dwyer say? About the ‘long case’?”

“You never forget your long case in the final med exams.”

“He said that to us too. The patients. We were all volunteers and we were praying inside that you would pass. I was so happy when you got it all right for that nasty extern.”

“You told me that beta blockers gave you cold feet. And about the cataract operation. I hadn’t a clue of that. But how did you find me. It must have been… ”

“Over 40 years ago.”

He sat back in the chair. She must have been in her 70s, then. He knew he was giving her that long look he used when he was gathering his thoughts.

“I see that you have worked it out, doctor,” she said.

“And I am so happy to have helped you get that name. Now, follow me.”

She led him to the window. He knew that he had been lucky to practice with a view of the countryside from his office. The fields were now full of people: Thousands and thousands of them, of all ages, from babies to old people in wheelchairs, stretching away into the far distance. There was no sign of rain. It was as fine and crisp a night as a Christmas Eve could be. Stars were twinkling over the vast crowd.

“How many?” he asked.

Problems or people? “In your 40 years as a GP, you tackled 600,000 problems. You had quarter of a million consultations. There are enough out there to fill Croke Park twice and more. That’s how many you have touched in your work.

“But I was the first. Your long case.”

He followed her out through the front door. There was no need to open it. He took a last look back at his roll-top desk, the paintings, the leather chair. His body did look very wise sitting in the chair and he finally realised why those in trouble would come to him.

Susie ran up to him, wriggling with excitement. Her bullet head fitted his palm snugly as always. The town was adorned in snow, the stars were sparkling overhead. He could hear a choir singing in the distance. He had never seen the place look so beautiful. That niggling pain in his chest had gone for the first time in weeks. Susie ran ahead and then turned back. He knew she wanted him to follow.

“It’s perfect,” he said, taking in a breath.

“It is. Everything will be like this from now on,” said his long case.

“Congratulations. You’ve passed.”

Thanks to Dr William Behan for the figures. Happy Christmas.