When Beer is an Aid to Diagnosis

With the FA Cup semi-final, pubs attract their fair share of crowds. Today I spotted a Spurs supporter with deposits of cholesterol around his eyes, along with a physique one can only get from eating all the pies.

This spot diagnosis took me back decades to my days as a medical student at the Middlesex Hospital, when we’d try to convince ourselves that time spent in a local hostelry was equivalent to the same amount of time spent poring over textbooks.  

Three essential texts

I say ‘we’ but the pub pathology sessions were a guy thing. There were just four women in my year. Swots that we were, however, we often tagged along to make sure we didn’t miss out on anything educational.

We didn’t just think of the pub as a causal factor in disease, though it must have been in some cases. One of doctors would regularly claim that the King & Queen had given him spider naevi (small blood vessel swellings typical of liver disease).

In the interests of presenting both sides of the story, I’d like to add that Steve from my year was convinced that impurities in the beer were to blame for all the complications of excess alcohol.

“Pints of Beer” by Simon Cocks is licensed under CC BY 2.0

Anyway, someone would go, “That’s a basal cell cancer over there.”

“Where?”

“Guy at the bar. Left cheek. Don’t stare.”

“So it is.”

“Also known as rodent ulcer,” another student might offer.

“Doesn’t spread to distant organs,” said someone else at the table. “Not ever.”

“Unlike squamous cell carcinoma,” added a show-off.

“You’d never know I had PSORIASIS – SIROIL 1959” by Nesster is licensed under CC BY 2.0

A pint or two later, one of us claimed to have spotted psoriasis. All nodded sagely, even though at that stage we barely knew the difference between psoriasis, cirrhosis, and sclerosis.

It was like winning the jackpot when a man with a stomping gait entered the pub one winter evening. This type of gait occurs in late syphilis, when foot position sense is lost, so the person bangs the foot down hard at each step. Although it’s possible that the man was just been getting the snow off his boots.

I like to think that the fictional GP Geoff from my novels will have once given pub pathology a whirl. On the whole, however, education has moved on. Sitting in the pub is not a learning method I’d recommend to my current medical students. For one thing, misdiagnosis is common. For another, it’s rude to stare.

Though sometimes it’s impossible not to. In one saloon bar, there was a man with a massive swelling down there.  So ginormous did it grow that he needed a wheeled trolley to help him (and it) get around. He finally did seek expert advice, but, it was said, only when one of the wheels fell off the trolley and needed to be replaced.

One keen student was desperate for the chance to shout, “Let me through – I’m a medical student,” but we never witnessed a medical emergency. Lucky, really, as our life support skills at the time would have done nobody any favours.

We never saw anything as dramatic as the stripper and the snake, though we all heard about it, naturally. This particular lady had a snake as part of her act, until the night her sidekick decided to hug her neck a tad too tightly. She was rushed to A & E wearing little more than a sizeable reptile, where an anaesthetist injected the snake with muscle relaxant and saved her life.

Photo FreeImages.com/Marcel Herber

As I say, we all heard about it. But we missed it. We were in the pub instead.

***

GP Geoff and other characters can be found in my novel Hampstead Fever.

You may also enjoy these posts:

What They Don’t Teach at Medical School

What Happens When You Become a Doctor

Hampstead Fever

How to Tell if You’re Old

Every time I go away, it takes me longer to recover. If you too find that jet lag lasts longer than the holiday, or that hangovers are more vicious these days, there may be a simple explanation: no matter how young you look, you could be deep in the clutches of anno domini.

Here are six more signs of age.

1 You enjoy sex. But a cup of tea and a nice sit-down are far more appealing, especially with a slice of Battenberg cake.

Royal Doulton teacup

2 Your kitchen cupboards are full of empty jars, take-away containers, and margarine tubs. Then you graduate to saving bits of aluminium foil, smoothing the creases out carefully to make it easier to reuse.

storing empty jars

3 You have to sit down to put your socks on. And you can’t put underpants on without holding onto something for balance.

pair of men's socks

4 You understand the meaning of “How are you?”, and know perfectly well that people don’t want to hear all about your gall stones or your hip replacement. But you tell them anyway.

5 Your mobile phone is powered up only when you’re expecting a call. After which you may turn it off. Or else forget all about it, until it plays Sgt. Pepper in the middle of a funeral.

Nokia mobile phone

6 It’s a mystery why people offer you a seat on the bus. After all, you still feel as young as ever. You even look it, as your mirror will tell you.

That’ll be the cataracts, then.

Apologies for not posting last week. I had some jottings for this post, somewhere. Spent days looking for the piece of paper, only to discover it right where I had left it. It was so unfair that I then had the worst gall bladder attack ever. A shocker, it was, I don’t mind telling you.

Ooh, before it slips my mind, you can now get my novel Hampstead Fever in many WH Smith travel bookstores, where it’s on a buy-one, get-one-half-price offer. Which is handy if you’re heading for a dose of jet lag.

Hampstead Fever, as seen in WH Smith