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A recent short story -- Patient X

Patient X

‘Silly bugger! You shouldn’t have phoned her!’ Graham lifted his pint as the others guiltily smiled and nodded agreement.

Ronnie knew fine well most of them would have phoned home before the meeting. With Sheila’s anger still dinging he had locked the surgery at 6.40. A flash across the rearview mirror as he turned out of the tiny car park told him that he’d left the light on in his room again. Another row from the practice manager tomorrow.

Once a month! What’s wrong with that? I have to collect enough education points to prove I’m up to date, she knows that! Yes, yes, it’s December, and Emily has parties and sleepovers, and she’s had all day teaching Tillydrone’s teenagers, but it’s still only once a month!

As he had pulled in to the Atholl carpark another thought struck home. Oh shit! I’ll have to tell her I need to top up Mrs Dinnie’s morphine on the way to work tomorrow, if she’s still alive. Sheila’s going to have to take Ross to nursery again.

‘You’re always late anyway, Ronnie, that’s why we wait before we start. Come and get a drink, we’re going through now.’ Graham Barrett picked up his glass.

‘How d’you always manage to get away early, Gullet?’ Ronnie asked Graham at the bar.

‘Better class of patient, Ronnie. I joined the right practice.’ He smiled widely and not unkindly as he turned away to follow the chattering gaggle of doctors heading to the small function room. Ronnie followed with his cola, reflecting on how his medical school classmate had always landed butter side up.

‘Right,’ announced Malcolm, standing at the head of the shiny table as his seven colleagues found seats. ‘It’s the Christmas men-only event, and my turn to chair the proceedings. As tradition demands, the subject is chosen for fun and frivolity while retaining the necessary educational elements to satisfy the stringent requirements of the postgraduate education allowance.’

‘Shut up, you prick,’ called Gullet, ‘get on with it, the drug rep’s put on a free bar.’

‘Christ, he’s brought slides! You wanker, Malcolm! It’s xmas. This is meant to be fun.’ Alistair Sinclair, also a GP, was a stalwart of the group. Only a year or two older than Ronnie and Gullet, Ally had nonetheless become a wise and reliable source of support for his friends and peers, even after his senior partner died leaving him to run their small practice.

‘Aye, but they’re fun slides. MRI scans I found from way back, and—.’

‘Aw fuck off, Malcolm. That’s work!’ Gullet was smiling broadly as he spoke, and backed up by the laughing, gulping, jeering group.

‘No, really, it’ll be good. I’m going to go round the table testing you on what each slide shows—.’

‘That’s a tutorial, Malcolm!’

‘Ah, but the funniest answer wins this.’ Malcolm lifted into view a bottle of Glenlivet. He had the meeting’s attention.

Malcolm switched on the projector and lit the screen Kenny had rolled down.

‘As I was saying, the slides tonight are a collection of old scans done in 1987 on the first MRI scanner in the world, here in Aberdeen. Subjects were selected carefully and included those who wanted the free lunch and — err — those who wanted the free lunch.’

‘I remember that! I went along for food. They scanned anybody in sight. Nurses and porters. Doctors, students. You were there, Ronnie.’

‘Quiet, please, Dr Sinclair. Thank you.’

‘I’d forgotten that,’ whispered Ronnie to Ally.

Malcolm McRorie showed the slides he had selected for their curiosity. Guesses were offered up as blurry images clicked their way into view from the slide cassette.

‘A panda’s head?’ The cross-section of the upper thorax illustrated what Malcolm assured the group was a pharyngeal pouch containing partially-digested food. Alok Talwar, a psychiatrist, persisted. ‘I still think it’s a panda.’

The banter continued, and a highlight was a slide introduced by Malcolm as ‘One to make you think next time you rush a scrotal examination.’

‘Oh no, don’t bring that up again!’ Ally groaned but smiled as his friends laughed. As a medical student Alistair Sinclair had been asked to demonstrate to his teaching group how to examine the male genitalia. The keen and willing volunteer patient had shown his consent by meeting Ally’s shaking hands with a huge and rapid tumescence, which quickly became folklore in the medical community.

As the room quietened Alok commented, ‘It is good we have safer teaching methods now.’

No one could spot the abnormality Malcolm was bursting to reveal. He paced back and forth behind the projector, dismissing clumsy guesses and teasing them. ‘Think what you have two of but the poor subject doesn’t.’

‘But we’re all men here tonight, and he’s obviously got two goolies!’ Gullet was frustrated, and keen to know what the obscure anomaly was.

‘OK.’ Malcolm squeezed round the table to approach the screen and with his pen pointed out two gaps which quickly became obvious to his rapt audience.

‘Congenital absence of the vas deferens, bilateral. He’s infertile.’ The tube draining spermatozoa from each testis was missing.

‘Christ! How did they fix that?’ asked Gullet, ‘Call the plumber?’

When the laughter receded, Malcolm continued, ‘That’s just it. These scans were never reported, and only done to test the machine’s settings. They were filed away without being looked at, once the technicians had checked the exposure and contrast. That guy probably doesn’t know why he’s never had kids.’

As they filed out to the bar for a break, Tim Pinder said, ’Thank god it’s the yearly men-only meeting. We’d have had endless debate about ethics and consent if the girls had been here.’

‘You’re a typical surgeon, Tim, “never mind the sensitivities, look at the size of my knife”.’

The chat was lively and Malcolm had to chase them back to their seats for the second set of slides. More curios were displayed, one of them a tumour of the A-V node, a lump growing within the heart which Malcolm explained might at any time induce sudden cardiac arrest and death.

‘That young man’s a ticking time bomb and he doesn’t know it. If he’s still alive, that is,’ said Malcolm with a flourish as he clicked on to the next slide.

The meeting over, the business of food could begin. After his breaded chicken, Ronnie excused himself. Entering the Gents he heard loud retching, and saw Ally Sinclair vomiting in a sink.

‘Bad pint?’

‘I know who it is. With the A-V node lump.’ He was red-eyed and shaking.

‘But the scans are anonymised. Just a code in the corner.’

‘You know I remember numbers. I can’t help it, I just memorise numbers when I see them. Not everything, but things like dates of birth or unit numbers.’

‘Aye, you were always a great one for phone numbers, better than directory—’

‘Listen! When we were on that trial back in ’87 I spent the waiting time memorising everyone’s code. I know who they all were.’ He wiped a string of sticky sick from his chin.

‘Aye, that guy’s probably dead by now.’

‘That’s just it. He’s not. Malcolm’s fucking “ticking time bomb” was in the meeting tonight.’

‘In there? No. Who?’ A lump seemed to swell in Ronnie’s throat as he began to understand. The door crashed open and they were joined by Gullet.

‘You two getting cosy in here? People will talk, you know!’

Ally marched out and headed for the car park.

Back at his seat Ronnie heard little of the table talk as his friends and colleagues shared stories, concerns and gossip. He looked at them all in turn. Who was it? He tried to tell himself it was one of them, rather than him.

Blue flashes passed the window. Then more. A siren screamed.

‘That’ll be two kidneys for me!’ smirked Tim, always on the lookout for transplant donors.

Kenny entered the room and cleared his throat. Ronnie thought he looked odd in his silly waiter’s apron. He was speaking but no one at the table listened. His voice rose.

‘I’m sorry, gents, I have to interrupt. The police have closed King’s Gate. You’re not going to get out of the car park. There’s been an accident just down the hill.’

Sheila held his hand as they exited the crematorium. They could see their freezing breath.

‘Hi, Doc. Terrible business, eh?’

Ronnie took a moment to recognise Kenny from the Atholl.

‘He was a great doctor to me and my family. I knew him from my time in Foresterhill when he was a student. I saw him leaving that night. I never thought —.’ There were tears in Kenny’s eyes.

His heart raced, its thumping loud enough to scare birds. It was lasting longer this time. Tears clouded his eyes as fear closed in. His children shrieked, their delight a fleeting relief. Chocolate smiles and rolling eggs. His chest pounded faster, harder, in his neck now, faster!…….STOP! He heard a blackbird chirrup. Then a gurgle. Silence. Nothing. Blackness.

Ronnie spent a miserable six months. Work was hellish, and his nightmares continued. He couldn’t have faced the others if the monthly meetings had continued. He wrestled with his guilt of hoping Ally’s heart had been the time-bomb. The official cause of the accident was the stolen car broadsiding him at the end of Fountainhall Road. But a tumour of the A-V node could easily have been overlooked at a post-mortem.

He looked at Sheila dozing on the couch. She’d have kittens if he told her he might drop dead at any minute. She stirred when the phone rang.

‘What? — Oh — no! It’ll wake the kids!’

Wishing he had a cordless receiver, Ronnie went to the hall. ‘Hello?’

‘Ronnie, it’s Graham.’


‘Aye. Listen, the group fell apart after Ally’s RTA, and I’ve been trying to set up another meeting.’

‘I’m not sure I could, Gullet, sorry.’

Ronnie wished he hadn’t been persuaded to come. He looked around the table, trying to stifle his need to replay the cruel Russian roulette. Out of the nine doctors around the table six had attended at Christmas. Three had definitely taken part in the trial, perhaps more. He looked at each. Alok? Gullet? Dave Hayton? He tried not to include himself but knew he was as likely to die as any. But he had borne the burden of knowing, surely he should be spared?

The waitress handed drinks out.

‘Where’s Kenny, tonight?’ asked Gullet, his smile showing approval of Kenny’s attractive stand-in. His face fell when she spoke.

‘Oh! My! Mr Grieve!’

The meeting hushed and the girl blushed before stammering, ‘Kenny died at Easter. His kids were rolling their eggs. Just dropped dead. His heart. ’

* * *

N J Edmunds

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