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FEATURE: Dancing with Dokker D -- Patience & Patient Power | MINI-SERIES: Portraits
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DISEASE, DEGRADATION & D'ATH . . . . . . . . .THE DOKKER'S ONE-STOP GUIDE
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DANCING WITH DOKKER D

Still managing to keep out of the way of the authorities,
our own Dokker D'Ath, phsyician to the really needy
(and we mean that,) has finally remembered the combination
of the hospital safe and has helped himself to the right
medication. He is, he says, ready to make his contribution
to the forward thrust of medical science. That hip movement
he does when he says it, however, is not exactly reassuring.
Haircut, anyone?

. .
. PATIENCE AND PATIENT POWER
. .
. As I sit in my Liz Hurley Street consulting rooms at my intimidatingly large dokker’s desk -- specially designed to keep sick people as far away as possible -- I think back over my medical career. With only a shudder or two at the most embarrassing bits, I recall my early days as a houseman. In those days I was not as you see me now -- raddled and made cynical by the whines of hypochondriacs, pricked by little conscience but many hypodermics, tortured by mysterious pains that I seem to get from my patients but manage . .
A urine sample or a G and T? Only the
dokker knows. And as you can see, he's
not sure.
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incisive comments on the body parts of some of the more ghastly patients in their totally confidential medical

. to ward off by taking those nice little pink pills. Once upon a time, when medicine was young, I was full of enthusiasm for my chosen profession. I had great expectations. Indeed, every aspect of my training in the dokkerly skills (as Ned Flanders would say) was designed to develop a sense of superiority, arrogance and overbearing self-righteousness that would maintain my position at the top of the social heap for the rest of my life. I loved being a dokker. Just thinking about healing people,

ordering nurses around and how I would organise my accounting system kept me constantly enthused. I was a qualified dokker, a master of the healing arts, a fearless combatant of all illness and I thumbed my nose at germs. As I strode the wards in my white coat, tastefully spotted with just a little blood, clipboard in hand, illness quailed before my presence and nurses and patients alike fell to their knees before me imploring me to lay my healing hands upon them.
...Ah, those were the days. In those days dokkers were almost as much feared (I mean, respected) as bank managers. Patients waited with bated breath while they were probed and poked and pulled around as the diagnosis was arrived at. And if, as sometimes happens to every dokker, one had no idea what was wrong it was simple to make up a condition with a Latiny sounding name. If you could make it a nice long one, that always went down well. An illness with a long name, particularly one in Latin, is always so much more desirable. More mystique, you know. Thus it is that emphysema has replaced the phrase ‘a bit of a bad chest.’ More impressive, you see. There would be no intrusive questions about the illness or its treatment; questions were not allowed under the National Health Service and cost extra in private practice. The patient would listen to the diagnosis, nod a couple of times and take the offered prescription. His or her health remained, as it had always been, in the hands of God.
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...They were innocent days. Clear and understandable days. Days in which everyone knew their place in the hierarchy of health. Dokkers at the top; patients at the bottom. Yes, in those days there were the dokkers and there were the patients. And both knew how to behave. The dokkers were the all-knowing, handsome, dashing professionals that had carved a place in the heart of the nation in such movies as ‘Dokkers’ Bikini Beach Party,’ ‘The Dokker from the Black Lagoon’ and ‘Carry On Up the Nurses.’ And there were the patients who were . . . . well . . . . just a crowd of sick people.
...Of course, that has all changed. Now no one knows their place. Everyone has become a barrack room dokker. Health has become an ‘issue.’ Whereas in the good old days, patients were happy to live their mean little lives, get ill and die, now no one is. Everyone has the health bug, everyone is interested in health, information that should be solely in the hands of the medical profession is now available to all and questions are allowed. Questions, of course, lead to discussions and even suggestions. And before you know it the patient is participating in the treatment.
...If it wasn’t for the fact that I have a hungry accounting team to support I would be reminding patients which one of us is the dokker at least ten times a day. Patients seem to think that they have some kind of provenance over their bodies and their health. But, as we all know, health is a matter for God and dokkers alone. And not necessarily in that order, either.

...It did not, of course, discourage patients from assuming they could be involved in their own treatment when they were allowed access to their medical records. There was a time, at the end of a hard day usually, when us dokkers could rid ourselves of the obsessive fear and hatred of illness, disease and our patients that we naturally develop over time. The opportunity to vent one’s spleen (medical term) with a few

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. . records was both enjoyable and therapeutic. But no more. These days patients can demand to see their own medical records and tend to take umbrage if the comments they find therein are too personal. But us dokkers do not take our responsibilit-
ies lightly and we do everything we can to protect our patients from too much knowledge of their body’s fallibility. However, once they have invoked the Freedom of Information Act and have acquired the services of a good lawyer, there is little we can do to protect them.
...As well as making the records much less fun to write, all this free access stuff has made them much more difficult to write. The truth, particul-
arly the truth as handled by dokkers, can be a powerfully disturbing thing. And a truth like: ‘This patient will be dead in two weeks,’ only shakes down a few ways. This is a crucial piece of information for us dokkers as it is often hard to distinguish the essentially healthy from the dying and sometimes, even, the already dead. It is info that has to be expressed in some way or other in the patients medical records. However . . . . A patient reading this bald statement about his or her demise is actually

unlikely to make it through the whole two weeks. Even as veiled statement -- in this case a long black veil -- is going to produce the same effect. Code? Forget it. They ask. “What does DTW mean, dokker,” they enquire in their innocence. Although the Hippocratic oath, which every dokker takes, is, as its name suggests, a licence to lie, it is hard for us dokkers to spare the patient the painful truth. Usually this results in their fairly immediate death. But that’s life, as we dokkers say.
...It is, of course, possible that allowing patients access to their own medical records is a ruse designed to cause their early demise thus freeing up more time to waste on those who aren’t dying. If so it must be pretty successful. It is my contention that all medical records should carry a Government Health Warning. It is a good thing there is more space available on a folder containing

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PORTRAITS FROM
THE ATTIC
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Generation after generation, from father to son, the baton of health care has been passed on down the line of the D'Aths like it is a birthright or something a bit too hot to handle. From medicine's earliest days, the D'Ath's were there. Whether it was brewing a potion, making a posy, collecting leeches or a short back and sides, there was sure to have been a member of the D'Ath family somewhere in the vicinity. When William Harvey discovered the circulatory system, it is said that a D'Ath was heard to murmur: "Bloody hell." As William Hunter single-handedly (in fact, single-fingerly) established the field of obstetrics, you can be sure that there was a D'Ath drooling over his shoulder. And, at the birth of anesthetics, a D'Ath was among those lying on the floor giggling. From quacks to consultants, from the famous to the infamous, from the Delphic D'Aths of ancient Greece to D'Ath Vadar, they have been at the heart of the struggle between life and death (usually but not always on the right side) since history began. Join us now as we ascend the wide staircase here at D'Ath Towers and head towards the gallery (as they call the attic) where we can take a look at some of the good dokker's ancestors.
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The Coffeehouse Culture medicine show rolls into town. High-stepping minstrels and banjo strumming troubadours lead the brightly painted wagons down main street. The entertainment starved residents read the exhortations to experience the wonders of the ancient east, to enjoy a long and vital life, to fortify and even fiftyfy the physical frame and they are hooked. “Come one. Come all. Roll up. Roll up,” proclaims the Barker. "Hear the wisdom of the Ancients, the secrets of the Magi and the tales from mysterious Atlantis. Come one. Come all. Try the Pro-Fess-Or’s nostrums, potions and lotions to cure all your ills, to strengthen and bring vitality. Energy, vigor and good health can be yours. Come one. Come all.” And already the stage is erected and the nigger minstrels are tuning up as Mr Interlocutor dances the cakewalk along the edge of the platform. The population gather round -- women in crinolines and bonnets with parasols resting on their slim shoulders, men in work dungerees or leather chaps, children in flowered dresses or short pants, the girls with ribbons in their plaited hair and the boys with Bowery boy caps pulled rakishly over one eye. Young and old, healthy and infirm, the bad and the beautiful, they gaze at the stage with their eyes sparkling as Mr Interlocutor and the Barker trade insults and go through a long stand-up/sit-down/stand-up routine while the two rows of ministrels mug along. There is music, a chorus line of four scantily clad black girls who dance a mild version of the hooychy koo (some of the women in the audience turn their backs to show that they are church-goin' and 'cain't abide no lowdown women leading their men astray,') there is a stand-up comedian dressed in a striped blazer and wearing a straw boater, a magician who astounds and mystifies and then it is the Barker's turn. Like a siren he sings his songs of allure and mystery and the audience is right with him. He describes the far away pyramids and the secrets of longev-ity, vital-ity and, dare he say it -- he winks conspiratorially -- fertil-ity" discovered therein by our own Magus of Med-i-cine, our own Master of the Healing Arts, Physician to Kings and Maharajas, Midwife to the Mighty . . . . . " He measures the pauses between each word. The band strikes up. The tension is palpable. Standing in the wings is a tall, grey skinned and dark-eyed figure in a black frockcoat. His lined face and rheumy eyes reveal little of his exotic past. Could it be ‘Professor’ D’Ath, great grandfather of our own good Dokker? He strides onto the stage, looks out balefully over the audience and says in a slight but sonorous voice: "Is there anyone called Mary Clarke here?"
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. . medical records than on a cigarette packet because they are going to need it for this warning. ‘These medical records may damage your physical or mental health, disturb your sense of well-being and cause distress. The reading of medical records has been associated with deaths caused through cancer, heart illness, strokes, depression and suicide. Read with care.’ That should keep them away.
...But the problem is really this terrible obsession people have with their own health. If people are worried about ill health they should seek the help of a dokker. He will put names on the many illnesses the patient possesses -- and some that he or she does not possess -- and give all the right medications to push the shares he owns in the pharmaceutical companies a few points higher on the markets.
...That is the way health care should be run. There should be none of this getting involved rubbish. That they
sit quietly, stick out their tongues when asked, say “Aahh’ at appropriate moments and cough occasionally is all we ask of patients. If only they would do that instead of asking for tiresome explanations of their malaise, its treatment and the medications and/or procedures that will be applied, I would not be writing this column.
...There is, however, more and worse. For now alternative health therapies are starting to become more widely available through us dokkers. What is the world coming to? When I think of how much energy and enthusiasm the medical profession contributed to burning all those witches, I am aghast at the fact that I am required now to assume the role myself. I didn’t train for years -- okay so what if it was a correspondence course -- to become a successful dokker so that I could dispense newts eyes to my patients. Nor did I become an expert in portfolio management and investment analysis so I could be poor.
...So now, along with all my other skills and areas of expertise, I am required to be an expert on everything from acupuncture to xylophony. Don’t they realise that I am a dokker and not a little old lady with a wart on her nose and an unhealthy relationship with a cat. Like those great dokkers who preceded me -- Dr Kildare, Dr Inlove, Dr Nick and that nice Dirk Bogarde -- I was trained in Western Allopathic Medicine by someone who resembled Sir Launcelot Spratt not someone who resembled a witch dokker. I don’t know any more about these crackpot remedies than do my patients.
...I really shouldn’t rattle on like this. It does me no good. I had only to mention the subject of my article for this issue to the drug-crazed editor of this publication for him to decide to publish an A to Z of alternative therapies. The only consolation I have is that it will take him 15 years or more to get it together.
...Gosh, is that the time. I must go or I’ll be late for my Probation Officer. Although I am a dokker, let me offer you some free advice -- stay healthy, keep taking the pills (I do) and try not annoy your GP.

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