Out-of-hours work had been busy the night before and I was flagging by mid-afternoon. Outside, it was one of the first truly summery days of the year. My usual enthusiasm was proving hard to muster; there were just so many patients still to see before I’d be able to get home and rest.
I had mixed feelings when I saw that Alan was my next appointment. I’m very fond of him, so I should have been pleased. But what had happened since we last met made me trepidatious about the consultation to come.
Alan and his wife moved here three years ago, after he retired as head of geography at a public school. He was clearly one of those teachers who command pupils’ respect. Plain-speaking and sure of his own mind, he exuded confidence but there was no hint of arrogance or intolerance. He had an unremittingly positive outlook and a great appetite for life.
By the time we’d had a few consultations, I knew all about his new house and the rockery he was planning to create in its garden. He loved fly-fishing and was delighted by the new butterfly species he was encountering while walking the dog. After a while, he joined a community group and had a mischievous glint in his eye when recounting the latest triumph over bloody-minded bureaucracy. Alan was the sort of man who believed in starting each day with a hearty cooked breakfast.
His health was as robust as his temperament, excepting the operation that he’d had to have to remove a cancerous kidney. His remaining kidney was functioning fine but we had to do a fair amount of tinkering with blood-pressure medications to get around a tendency to salt imbalance.
Then, nine months ago, I received a letter from the hospital saying that Alan had presented with frank blood in his urine. A scan had found a new cancer in the second kidney. The only treatment was to remove the diseased organ, condemning him to spend the rest of his life on renal dialysis.
Dialysis entails three long mornings each week up at the hospital. Because of this, as well as the complexity of their altered physiology, patients are often looked after exclusively by the renal physicians. I hadn’t seen Alan since.
While dialysis keeps people alive, they commonly experience marked fatigue and symptoms such as muscle cramps and altered appetite, which take a toll on their quality of life. The thought of meeting Alan again and witnessing his inevitable decline – the loss of all those outdoor activities that had given his life meaning – made me sad.
I went to click his name on the screen and noticed the receptionist’s message: “Sitting on wall outside with dog.” I walked through the waiting room, out of the front door, and found Alan basking in the sunshine with Jess, his black Labrador, at his feet. We quickly decided that it was too nice to be cooped up indoors, so I sat myself next to him and we conducted the consultation al fresco.
We dealt with his problem swiftly, then proceeded to catch up. He said that the first months of dialysis had been hard but he delighted in telling me how well he was now doing. The rockery was finished, he had resumed dog walks and he was on the brink of returning to the river with his rods.
And he did look well. Today was his 70th birthday. He had been for dialysis that morning and had taken cakes for the staff and other patients, many of whom had become good friends.
As we talked, we provoked broad smiles from patients coming in and out of the surgery. The sun was gloriously warm. I reached down and stroked Jess’s head. I could see my receptionist watching us through the glass doors, clearly tickled.
By the time Alan and I were done, my enthusiasm and energy had returned in spades. Sometimes our patients give us something unexpected and precious, and there’s no better example than Alan.
This article appears in the 25 May 2016 issue of the New Statesman, The Brexit odd squad