Hard Labour

4

4Vince pulled into the car park at the rear of the surgery and fumbled for his stethoscope from amongst the mess on the passenger seat. Benny was dark blue, twenty-five years old and was a fine example of that large and square Volvo-style of the late eighties—safe but definitely not stylish. It was all Vince could afford when he arrived last year, and he could fit his surfboard in Benny’s capacious interior. He grabbed his bag and pushed open the back door.

The Timor Street Medical Centre had once been a stately sandstone house circa 1895 and sat grandly on the corner a block down from the hospital. Vince’s predecessors had adapted the building over the years. The dining room at the front was now a reception area and the grand sitting room a waiting room. Vince had to admit the joint was classy enough, but the vagaries of GP clinic architecture were not his bag. As far as he was concerned it was always just another day at the salt mines. He was there under sufferance—a conscript. The Medical Board had deemed that he work in one of the town’s general practices as well as be a faux-Obstetrician, so he had no choice in the matter. For now.

As soon as he opened the door, Vince was greeted by the usual barrage of familiar sounds: the continuous ringing of the phones, the babble of conversation from the waiting room, the voices of the staff making appointments and processing accounts, babies crying and consulting room doors opening and closing. He was met by a guard of honour—a phalanx of receptionists, each wielding a piece of paper and jockeying for position to gain his attention first.

‘Mr Norton is waiting to pick up his referral for the dermatologist—’

‘Sister O’Shea wants you to visit Mrs Nervo at lunchtime—’

‘There’s a man from the meat works with a cut hand and Rita thinks it will need a stitch—’

‘Okay, okay, just give me a bloody chance, girls,’ Vince barked as he resolutely headed past the throng of waiting punters to his room. He flopped down at his desk and tossed the messages onto yesterday’s pile.

He’d learnt that this constant state of chaos was part and parcel of being a ‘Geep’, a term coined by his old uncle—a GP in a one-doctor town in the Mallee. Just like a Jeep was a ‘general purpose vehicle for rough terrain’, Uncle Phonse reckoned this was a good working definition for a GP. He also referred to patients as ‘punters’ on the basis that consulting a Geep was akin to backing a racehorse. Variable odds.

Before kicking off, Vince had a couple of important calls to make. The first was to the Coroner. He had absolutely no idea of the cause of Polly Cotter’s death, so he couldn’t fill in the death certificate, which automatically made it a Coroner’s case—there would have to be a post mortem. He then rang the Victorian Medical Defence Association to speak with Bridget Ryan, a medical litigation lawyer and a contemporary of Vince’s from uni days, who was the VMDA Claims Manager.

‘Good to hear from you, Vince. You just can’t seem to keep out of trouble, can you? I thought you’d be okay down there in the country. So was this girl a private patient?’

‘No, Bridget, she was public.’

‘Where was the antenatal care conducted? ’

‘At my rooms.’ He was wondering where this was all going.

‘Okay, unless something can be sheeted home to her antenatal course clinically, then it’s a job for VMIA.’

More bloody acronyms. ‘Come again?’

‘Don’t you guys keep up with the changing world of medical indemnity?’

Vince was in no mood for a medical insurance current affairs quiz. ‘Bridget, with all due respect, I was hoping never to speak to you again.’

She sighed deeply. ‘I never cease to be amazed how allegedly intelligent specialists seem unable to keep up to speed. Vince, listen and learn. Since 1998 the Victorian Managed Insurance Authority has covered all Victorian public hospitals. VMDA only apply to a doctor’s activities in their rooms or involving private patients in hospital. This is definitely a job for the VMIA.’ Bridget paused. ‘You’re not anticipating any litigation at this stage?’

‘I certainly bloody hope not,’ Vince answered, aware of a sudden burst of gastric tightening. ‘I’m just being a good boy and reporting an adverse outcome, like I’ve been told.’

‘About time too. I’ll open a file on the matter and ring the VMIA and get them to contact you. Keep in touch. Regards to Lydia and the girls. Cheers.’

Regards to Lydia! Who’s the one not keeping up? Vince took a deep breath, booted up his computer and called in his first patient, Mrs Aureline Dove. He had one important call yet to make, but it would just have to wait.

Mrs Dove was an absolute heart sinker—a GP’s nightmare. She had some legitimate medical concerns but they were buried beneath a veritable avalanche of the psychosomatic and the neurotic.

After unloading her after only twenty-three minutes, probably a record, Vince was still confident that if he could rip the next one through he could get back on track, but he came up against another shocker—a middle-aged woman who casually tossed an unopened seven-page insurance medical form on his desk.

He picked up the phone and let the young receptionist have it with both barrels. ‘Listen Suzie or Tracey or whoever you are, these bloody medicals need a double appointment and you’ve got to get the punters to fill in their part of the form first! Got it?’

He raced the alarmed patient rapidly through the process and herded her out the door—nineteen minutes flat, definitely a record. By this stage he was almost an hour behind, fast losing confidence and praying for a quickie like a pill script or blood pressure check.

His next patient was new; a pleasant looking man is his mid-sixties.

‘What can I do for you, Mr Perkins?’

The bloke unravelled a long list from his pocket and said in a jocular voice, ‘Doc, how long have you got?’

Bugger, thought Vince, the game’s up—the medical gods have turned against me!

‘Just excuse me, mate. I’ll be back in a minute.’ He marched out the door, through the busy waiting room, past the office staff and out into the tearoom, where he collapsed into an easy chair. ‘s**t, s**t, s**t!’

Vince’s boss, Dr Shirley Tiang, a tiny bird-like figure with an elfin face and dressed entirely in black, was sitting at the tearoom table with a coffee, doing some paperwork.

‘Having a bloody bad day, eh Vince? You’re buzzing around like a fart in a bottle, cobber.’

Shirley, a Malaysian Chinese, was in her late fifties and married to Gareth Jones, the local psychiatrist. She’d started the clinic from scratch several years back and built it up into a thriving concern, and Vince was grateful she’d taken him on. He knew he was a risk.

‘Geez you’re astute, Shirl,’ he replied. ‘I thought I was hiding it really well.’

‘You’re always Mr Grumpy anyways, champ,’ she commented, head c****d and dangly earrings jangling. ‘Makes it hard to tell.’ Shirley reminded Vince of Puck from A Midsummer Night’s Dream, but with more attitude.

On day one last year, Vince had sauntered in fifteen minutes late for his first meeting with his new employer. ‘Hey sunshine,’ he’d said to the receptionist, ‘white with one sugar, and tell the boss I’m here.’

Shirley had come out of her room fuming, shrewd eyes flashing. ‘Don’t you dare keep me bloody well waiting, mate. Just cos you’re a big shot fanny mechanic doesn’t mean jackshit here.’

Jesus, he’d thought, she’s a bloody mad woman! ‘Settle, Dr Tiang. I’ll soon get the hang of the joint. It’s only general practice, how hard can it be?’

‘I’ll tell you nothing for something, buddy. You’ve got a lot to learn and if you don’t pull your leg round here, I will drop you right back in the shits with the board!’

Hell, this is going to be a bloody long sentence.

Vince soon discovered Shirley had boundless energy, a good head for business and mostly female clientele—‘tears and smears, mate’. And that she looked after her own.

He suppressed a yawn. ‘Just running miles behind, Shirl, the usual thing.’ He sighed. ‘Oh yeah,’ he went on, after staring at the wall for thirty seconds, ‘there’s also the small issue of a maternal death.’

Vince knew Shirley would’ve learnt of last night’s events on her rounds that morning. Not much got past her and the sombre mood on the mid-floor had been palpable.

‘I did hear something from a tiny bird on the grape line.’

Shirley loved to use Aussie sayings and slang but often butchered them, despite constant correcting by Vince and the other doctors. Her father had learnt his English while working in a factory in western Sydney and it was this rough mix of Sino-strine, swearing and colloquialisms that she had grown up with. She also added frequent malapropisms to this bizarre linguistic cocktail.

‘What a bastard, eh? So what happened, bud? Give me the drums?’

After his talk with Bridget Ryan, Vince had tried to push last night’s events from his mind, but they were still there—right at the front.

‘It was Polly Cotter, Shirl. She had a long first stage with a posterior position, but then it all came good and she did the business but collapsed and arrested after the third stage. Danny and his troops just couldn’t get her going, then it was thank you linesmen, thank you ballboys.’

Vince sat back in his chair pensively.

‘How old was Polly, Vince? Only about bloody twenty?’

He nodded. ‘Twenty-three.’

Shirley shook her head with disbelief, earrings chattering. ‘Can’t remember the last maternal death round here, bud. Be way back before my times. Bad s**t for you.’

Vince shrugged. Nothing to say.

‘She didn’t have any relevant past histories, did she? Or antenatal problems?’

He shook his head.

‘Maternal death, mate, rarer than chicken’s teeth these days. It’s a Coroner’s case then?’

‘Well I can hardly write the death certificate, can I, Doctor?’ Vince responded impatiently. ‘Unless you want me to make something up!’

He pushed back his chair and stood. ‘Listen Shirley, I know the routine. I’ve rung the Coroner and reported the death to the medical defence people and now I’m just waiting for Sarah Bell to do the PM. Must’ve been a concealed bleed or a cardiac thing or a pulmonary embolus or some other such bloody bolt from the blue.’ Vince pointed at his chest and shook his head. ‘Nothing to do with me.’

The tearoom phone suddenly burst into sound. Shirley picked it up and listened for a few seconds.

‘Vicki has resigned because you yelled at her and Mr Perkins is at the reception desk saying he can’t wait any longer and is about to blow his heap.’

‘Too bad,’ Vince muttered, sitting back in his chair and looking at the new man’s card, which was still in his hand. ‘It says here he’s retired, so what else does he have to do?’

Shirley put her ear to the phone for another minute. ‘Apparently he works at the Red Cross shop and runs the Meals on Wheels and needs to get back home to check on his disabled wife. s**t, Rooned, the man’s a good doer!’

One of Vince’s old patients had dubbed him ‘Rooned’ after a character sharing his surname in a poem penned by Father John O’Brien—an Aussie bush poet from early last century. That particular Hanrahan was an eternal pessimist who constantly predicted ruination for the locals—‘We’ll all be rooned, said Hanrahan, before the season’s out.’ Shirley thought this was hilarious and habitually called Vince ‘Rooned’, especially when she thought he was being a wet blanket—like most of the time.

She turned her attention back to the phone. ‘Tell him Dr Hanrahan is on his way, Lynne.’

‘Shirl, you are better than any anti-depressant pills,’ Vince responded, laughing for the first time that day, as he reluctantly headed back to his room. ‘A good doer is someone who likes his tucker; you know, good on the tooth. This bloke’s a do gooder!