Mortimer visits the doctor
Mortimer Percival Grenfell was what in an earlier age might have been termed, portly. His family doctor clicked her tongue at him at every checkup. "BMI, Mister Grenfell, is not a sort of dish", she would scold in her slightly sing-song Pakistani accent, and she would wag a stern finger from side to side. Mortimer's unenthusiastic response would usually be something along the lines of "I am just big boned", and he would steel himself for what was inevitably to follow. "Your tummy isn't a bone, you know," Doctor Patel would say emphatically, looking over her bifocals at the now fidgeting patient. "Neither," she would say with emphasis, her slender index finger raised, "is your buttock, Mister Grenfell. Adipose, not bone, is what's driving your BMI beyond optimal limits." Dr. Patel would pointedly gesture towards the slightly dog-eared BMI chart on the wall behind him. The chart was tacked above a collection of vintage medical books and instruments laid out almost ceremonially on a sturdy but aging wooden bookcase. The finger would then point directly at his midriff, "You have an overabundance of adipose!"
A screaming and hotly swollen ankle was what had brought Mortimer to the doctor, that grey and drizzly morning, years before. It had been uncomfortable all the previous evening, but was a big red pulsing lump of agony when he stepped out of bed in the morning. His left foot was a scorching beetroot of anger that throbbed and sparked with sharp edges of pain that shrieked up his leg at every movement. All the way to the consulting rooms of Dr.Giannis Giannopolis, Mortimer was in agony. Dr. Giannopolis had been in the Grenfell family, so to speak, for decades. Giannopolis was an elderly but exuberant man, who drank, smoked, and womanized. On this particularly leaden and miserable day, when the streets were slippery and even the pigeons on the square were huddled miserably together, Dr. Giannoplois was unavailable. In fact, as would come to light in the weeks to follow, Dr. Giannopolis had left the country with his nurse, leaving behind several angry creditors, and the nurse's bemused and abandoned husband.
Emily, the ancient and gleefully cantankerous receptionist and general office manager, had stared at Mortimer through spectacles that were scratched and wobbly. "Not here," she said flatly, folding her arms over a thin blue jumper, "you can't see him". She went back to filling in an order for cotton swabs. She had planned her order meticulously to be as inconvenient to the supplier as humanly possible. Emily had been a logistician for the military until retirement, and used this expert knowledge to make life a misery for the suppliers. She had a similar if slightly more humane approach to patients. She generally had it in for anyone who interrupted her ordering process, arrived without an appointment, or hovered around her desk. Mortimer was winning the jackpot by doing all three.
"Well, how about later?", he queried. Emily laboriously opened the dusty and cracked appointment book, and leafed to the current day. She consulted the page, muttered a bit, and then peered up at Mortimer.
"This afternoon?"
"Yes, yes, fine," said Mortimer in exasperated tones.
"No," she answered, shutting the book firmly, "Nothing available this afternoon."
"Tomorrow then?", Mortimer asked, biting back an oath. Emily peered at him coldly, and slowly reopened the book.
"Morning?", she asked, after finding the page and consulting it for several seconds. "Morning will be fine," Mortimer heaved a sigh of relief.
"No," she said, shutting it again, "he's not here in the morning."
Exasperated, Mortimer took a deep breath and asked in his most polite tone, "and when are you expecting him to be available again?"
Emily stared straight at Mortimer, and delivered her sucker-punch.
"Not for several months, I shouldn't think."
Mortimer's mouth dropped open and he looked somewhat like a mud fish. A somewhat surprised and unhappy one.
"... if ever," Emily continued before he could break out of his fishy trance.
"You could try Dr. Patel though," she looked satisfied. "Shall I look?"
Mortimer was too stunned, too frustrated, and in too much pain to even answer. He nodded weakly.
Emily opened the book laboriously, oozing satisfaction.
"Tomorrow morning?", she queried.
Mortimer took a deep breath, "Yes, please, tomorrow morning would be very nice, thank you."
"No, nothing tomorrow morning", and before Mortimer could let out the scream he felt welling up in his chest, Emily cut him short.
"Dr. Patel could see you now though," Emily announced with a grim but satisfied smile, "If you like, that is. Third door on the right, opposite the cloak room."
Emily closed the book sharply, and returned to her ordering with a finality that made it clear that no further discussion would be possible.
Mortimer had shuffled off as rapidly as he could, and having found the washroom, turned sharply to his right, only to see a storage closet in front of him.
"The NEXT door, “came Emily's voice from down the passage. "Go in and sit down."
Mortimer found the room, and his impression was that this room was more an annex to the broom closet than what a doctor's consulting room should look like. There was a waist-high bookcase with Leopardwood doors and a dark Neem wood top and frame. Neem trees have many medicinal and culinary purposes, but it was the instruments and books that rooted Mortimer to the ground when he first entered the consulting room. A sense of panic gripped his mind, and he surveyed the medical books with their cracked and tattered leather covers. Most seemed to be from the late 1800's, and at least one would have looked at home on a British warship of the 1600s. This specific volume was laid open at a section describing the procurement and use of medicinal leeches. A pewter box shaped somewhat like a large hip-flask with a flat perforated lid for transporting leeches was illustrated. "God help me" muttered Mortimer to himself, "he's a quack!"
He stood looking at the illustrations in the ancient medical book, and felt a sense of panic.
He gingerly picked up a large bone saw from the display, and looked aghast at its bent and missing teeth. He burst out, "He is a bloody quack, this Patel guy is a quack!"
"She" came a woman's voice from behind him, "and while certainly nonconformist at times, I disagree strongly with any accusation of quackery, Mr. Grenfell."
Dr. Patel was a tall slim woman in her mid-fifties, he judged, dressed in a colorful green and gold sari, topped with a white lab coat. She looked at him sternly, holding out her right hand, palm down, “Sit!" Mortimer sat down heavily, adding acute embarrassment to his growing list of conflicting emotions.
Other than a few answers to her sequence of ever-more specific questions as she examined him, Mortimer was relieved to have to say very little.
"I will need to collect some fluids," Dr. Patel explained, fetching a slightly battered steel box from a wooden cabinet behind her desk. She laid it on the green leather surface of the desk, and flipped open the slightly creaking lid, and elicited a sharp gasp from Mortimer. In front of him was a fat glass-barreled syringe with an impressively thick fixed needle. The three nickel-plated brass loops attached to the barrel and wide thumb loop on the plunger suggested physical force, and the sturdy needle looked like it belonged more in a bovine laboratory than a general practitioner’s surgery. Mortimer winced noticeably and unconsciously grasped the sturdy armrests. He had started to rise out of his seat, when Dr. Patel lifted the top tray with the syringe clear, revealing a layer of modern and sterile evacuated collection tubes, and modern color-coded needles in sterile packs.
"God, I thought you were going to ...," Mortimer burst out. Dr. Patel clicked her tongue at him and selected a needle. "No, Mr. Grenfell, have no fear in that regard. I am going to draw some of the synovial fluid from your ankle." She explained. "We must rule out various forms of arthritis including rheumatoid and septic arthritis, cellulitis, and nephrolithiasis."
"We will be looking for a very irritating compound by the name of monosodium urate in the lubricating fluid in your joint."
After expertly drawing fluid from inside his ankle joint, some blood from his arm, and coaxing him to produce a urine sample, Dr. Patel sat on a chair next to him and began in an unhurried and kindly tone.
"I must run some tests, Mr. Grenfell, but I am very confident already that it is gout that is chewing your foot right now."
Mortimer opened his mouth to object, but she held up her hand.
"Yes, I understand, you think this is an ailment of dotage, of fat old men in their country clubs."
"This is a misapprehension" she continued, "It can strike at many ages, and in your case, right this very day."
"We are going to solve this misery in three steps"
"I will do most of the first step - stabilizing the acute attack"
"We will together address the prevention of further medium-term attacks. I will work out a prophylaxis, and you" she looked him in the eye "will comply with it"
"The third step is mostly yours," she put a hand on his shoulder, "and requires exercise, increased water intake, and some dietary restrictions."
"If you shall fail" she said getting up and walking to a large wooden cupboard behind him, "your future will be this" Dr. Patel held out a skeletal hand and forearm, the joints and finger bones twisted and bulging. "It will not be pretty, it will not be enjoyable, it will not be quick"
"But, it will be certain".
She walked around to her chair on the other side of the desk and picked up her prescription pad. "Shall we do this thing?" she asked him.
That had been his first session with Dr. Patel, one which saved him from untold misery, set his course for the rest of his life, and started what was to become a close friendship over many years. It also started them on an adventure that would put both of their lives in peril.
A screaming and hotly swollen ankle was what had brought Mortimer to the doctor, that grey and drizzly morning, years before. It had been uncomfortable all the previous evening, but was a big red pulsing lump of agony when he stepped out of bed in the morning. His left foot was a scorching beetroot of anger that throbbed and sparked with sharp edges of pain that shrieked up his leg at every movement. All the way to the consulting rooms of Dr.Giannis Giannopolis, Mortimer was in agony. Dr. Giannopolis had been in the Grenfell family, so to speak, for decades. Giannopolis was an elderly but exuberant man, who drank, smoked, and womanized. On this particularly leaden and miserable day, when the streets were slippery and even the pigeons on the square were huddled miserably together, Dr. Giannoplois was unavailable. In fact, as would come to light in the weeks to follow, Dr. Giannopolis had left the country with his nurse, leaving behind several angry creditors, and the nurse's bemused and abandoned husband.
Emily, the ancient and gleefully cantankerous receptionist and general office manager, had stared at Mortimer through spectacles that were scratched and wobbly. "Not here," she said flatly, folding her arms over a thin blue jumper, "you can't see him". She went back to filling in an order for cotton swabs. She had planned her order meticulously to be as inconvenient to the supplier as humanly possible. Emily had been a logistician for the military until retirement, and used this expert knowledge to make life a misery for the suppliers. She had a similar if slightly more humane approach to patients. She generally had it in for anyone who interrupted her ordering process, arrived without an appointment, or hovered around her desk. Mortimer was winning the jackpot by doing all three.
"Well, how about later?", he queried. Emily laboriously opened the dusty and cracked appointment book, and leafed to the current day. She consulted the page, muttered a bit, and then peered up at Mortimer.
"This afternoon?"
"Yes, yes, fine," said Mortimer in exasperated tones.
"No," she answered, shutting the book firmly, "Nothing available this afternoon."
"Tomorrow then?", Mortimer asked, biting back an oath. Emily peered at him coldly, and slowly reopened the book.
"Morning?", she asked, after finding the page and consulting it for several seconds. "Morning will be fine," Mortimer heaved a sigh of relief.
"No," she said, shutting it again, "he's not here in the morning."
Exasperated, Mortimer took a deep breath and asked in his most polite tone, "and when are you expecting him to be available again?"
Emily stared straight at Mortimer, and delivered her sucker-punch.
"Not for several months, I shouldn't think."
Mortimer's mouth dropped open and he looked somewhat like a mud fish. A somewhat surprised and unhappy one.
"... if ever," Emily continued before he could break out of his fishy trance.
"You could try Dr. Patel though," she looked satisfied. "Shall I look?"
Mortimer was too stunned, too frustrated, and in too much pain to even answer. He nodded weakly.
Emily opened the book laboriously, oozing satisfaction.
"Tomorrow morning?", she queried.
Mortimer took a deep breath, "Yes, please, tomorrow morning would be very nice, thank you."
"No, nothing tomorrow morning", and before Mortimer could let out the scream he felt welling up in his chest, Emily cut him short.
"Dr. Patel could see you now though," Emily announced with a grim but satisfied smile, "If you like, that is. Third door on the right, opposite the cloak room."
Emily closed the book sharply, and returned to her ordering with a finality that made it clear that no further discussion would be possible.
Mortimer had shuffled off as rapidly as he could, and having found the washroom, turned sharply to his right, only to see a storage closet in front of him.
"The NEXT door, “came Emily's voice from down the passage. "Go in and sit down."
Mortimer found the room, and his impression was that this room was more an annex to the broom closet than what a doctor's consulting room should look like. There was a waist-high bookcase with Leopardwood doors and a dark Neem wood top and frame. Neem trees have many medicinal and culinary purposes, but it was the instruments and books that rooted Mortimer to the ground when he first entered the consulting room. A sense of panic gripped his mind, and he surveyed the medical books with their cracked and tattered leather covers. Most seemed to be from the late 1800's, and at least one would have looked at home on a British warship of the 1600s. This specific volume was laid open at a section describing the procurement and use of medicinal leeches. A pewter box shaped somewhat like a large hip-flask with a flat perforated lid for transporting leeches was illustrated. "God help me" muttered Mortimer to himself, "he's a quack!"
He stood looking at the illustrations in the ancient medical book, and felt a sense of panic.
He gingerly picked up a large bone saw from the display, and looked aghast at its bent and missing teeth. He burst out, "He is a bloody quack, this Patel guy is a quack!"
"She" came a woman's voice from behind him, "and while certainly nonconformist at times, I disagree strongly with any accusation of quackery, Mr. Grenfell."
Dr. Patel was a tall slim woman in her mid-fifties, he judged, dressed in a colorful green and gold sari, topped with a white lab coat. She looked at him sternly, holding out her right hand, palm down, “Sit!" Mortimer sat down heavily, adding acute embarrassment to his growing list of conflicting emotions.
Other than a few answers to her sequence of ever-more specific questions as she examined him, Mortimer was relieved to have to say very little.
"I will need to collect some fluids," Dr. Patel explained, fetching a slightly battered steel box from a wooden cabinet behind her desk. She laid it on the green leather surface of the desk, and flipped open the slightly creaking lid, and elicited a sharp gasp from Mortimer. In front of him was a fat glass-barreled syringe with an impressively thick fixed needle. The three nickel-plated brass loops attached to the barrel and wide thumb loop on the plunger suggested physical force, and the sturdy needle looked like it belonged more in a bovine laboratory than a general practitioner’s surgery. Mortimer winced noticeably and unconsciously grasped the sturdy armrests. He had started to rise out of his seat, when Dr. Patel lifted the top tray with the syringe clear, revealing a layer of modern and sterile evacuated collection tubes, and modern color-coded needles in sterile packs.
"God, I thought you were going to ...," Mortimer burst out. Dr. Patel clicked her tongue at him and selected a needle. "No, Mr. Grenfell, have no fear in that regard. I am going to draw some of the synovial fluid from your ankle." She explained. "We must rule out various forms of arthritis including rheumatoid and septic arthritis, cellulitis, and nephrolithiasis."
"We will be looking for a very irritating compound by the name of monosodium urate in the lubricating fluid in your joint."
After expertly drawing fluid from inside his ankle joint, some blood from his arm, and coaxing him to produce a urine sample, Dr. Patel sat on a chair next to him and began in an unhurried and kindly tone.
"I must run some tests, Mr. Grenfell, but I am very confident already that it is gout that is chewing your foot right now."
Mortimer opened his mouth to object, but she held up her hand.
"Yes, I understand, you think this is an ailment of dotage, of fat old men in their country clubs."
"This is a misapprehension" she continued, "It can strike at many ages, and in your case, right this very day."
"We are going to solve this misery in three steps"
"I will do most of the first step - stabilizing the acute attack"
"We will together address the prevention of further medium-term attacks. I will work out a prophylaxis, and you" she looked him in the eye "will comply with it"
"The third step is mostly yours," she put a hand on his shoulder, "and requires exercise, increased water intake, and some dietary restrictions."
"If you shall fail" she said getting up and walking to a large wooden cupboard behind him, "your future will be this" Dr. Patel held out a skeletal hand and forearm, the joints and finger bones twisted and bulging. "It will not be pretty, it will not be enjoyable, it will not be quick"
"But, it will be certain".
She walked around to her chair on the other side of the desk and picked up her prescription pad. "Shall we do this thing?" she asked him.
That had been his first session with Dr. Patel, one which saved him from untold misery, set his course for the rest of his life, and started what was to become a close friendship over many years. It also started them on an adventure that would put both of their lives in peril.
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