CHAPTER TWELVE: The System at Aberalaw

They went to London and bought some cheap furniture, arranging to pay for this at the rate of a few pounds a month during the next year.

On Thursday morning Andrew began work at the west surgery. His first patient was a man with a bad knee, who wanted a doctor’s note stating that he was not fit for work. Andrew examined his knee and gave him his note. But the next three patients also asked for doctor’s notes.

Andrew got up, opened the door of the waiting room, and called out: ‘How many more men want sick notes? Stand up, please.’

Forty men were waiting and they all stood up.

It was half past ten when Andrew finished his surgery. Then an old man with a red face walked into his room. This was Dr Urquhart.

‘Heavens, man!’ said Urquhart, without a word of introduction. ‘Where have you been during these last two days? I had to do your work for you. Never mind! Never mind! I’ll say no more about it. Come and meet Gadge. He’s a miserable man, but he’s good at his work.’

Andrew followed Urquhart into another room, where Gadge, a thin man with a sad expression, took hardly any notice of him.

‘Well,’ said Urquhart, after introducing them, ‘is there anything that you would like to know?’

‘I’m worried about the number of sick notes that I had to sign this morning.’ Andrew told him. ‘Some of the men seemed quite fit for work. A doctor shouldn’t give sick notes for no reason.’

Urquhart looked at him quickly. ‘Take care! The men will be annoyed if you refuse them their sick notes.’

For the only time that morning, Gadge made a remark: ‘That’s because there’s nothing wrong with most of them!’

All that day, Andrew worried about the sick notes. He decided to give no more unless they were really necessary. He went to his evening surgery with an anxious but determined expression.

The crowd was larger than at the morning surgery. The first patient to enter was a big, fat man who looked as if he had never done an honest day’s work in his life. His name was Ben Chenkin.

‘Sick note!’ he said roughly.

‘What for?’ Andrew asked.

Chenkin held out his hand. ‘Skin disease. Look!’

Andrew could see at once that there was nothing seriously wrong with Chenkin. He rose from his seat. ‘Take off your clothes,’ he ordered him.

Chenkin now asked: ‘What for?’

‘I’m going to examine you.’

Chenkin, who had never been examined by the last doctor, undressed.

Andrew carried out a long examination. Then he said sharply: ‘Dress again, Chenkin.’ He sat down and began to write out a note.

‘I thought that you’d give me one,’ Chenkin said rudely.

He seized the note from Andrew’s hand, and rushed out of the surgery. Five minutes later, he returned.

‘What’s the meaning of this?’ he shouted, pushing the paper into Andrew’s face.

It read: ‘This is to state that Chenkin is suffering from the effects of drinking too much, but is quite fit to work.’

‘I’ve got skin disease!’ shouted Chenkin. ‘I’ve had it for 15 years!’

‘Well, you haven’t got it now,’ Andrew said. A crowd had collected by the open door. He could see Urquhart looking anxious and Gadge with a faint smile on his face.

‘Are you going to give me a sick note?’ Chenkin shouted.

‘No, I’m not,’ Andrew shouted back. ‘And get out of here before I throw you out.’

Chenkin looked as if he might kill Andrew. Then he turned and, shouting threats, left the surgery.

As soon as he had gone, Gadge entered, rubbing his hands with delight. ‘Do you know who he is? His son is an important member of the committee.’

The Chenkin event caused a lot of talk. Some people were pleased that Chenkin had been made to work at last. But most people were on his side.

As he went round the town, calling on his patients, Andrew received many black looks. And there was worse trouble for him. The men had the right to choose their doctor. Each man gave his medical card to the doctor of his choice; if he wished to make a change, he could ask for his card back and hand it to another doctor. Every night that week men came to Andrew’s surgery and demanded, ‘My card, please, Doctor.’

Every card that he returned reduced his salary.

Urquhart warned him: ‘Take care, man! I understand how you feel – you want to improve matters. But take care! Think before you act.’

Andrew soon ran into more trouble. He was called to the home of Thomas Evans, a miner who had burnt his left arm. When Andrew arrived, he found that the Area Nurse, who had since left the house, had put oil on the burn.

Andrew examined the arm and saw that unless he changed the treatment at once, the arm would become infected. So, with great care, he cleaned and treated the burn and put on a new bandage.

‘Will it be all right, Doctor?’ Evans asked anxiously, when he had finished.

‘Yes – quite all right.’ Andrew smiled. ‘Leave this to Nurse and me!’

Before he left the house, he wrote a short note to the nurse, thanking her for what she had done, and asking her to continue his treatment.

Next morning, when he went back to the house, he found that his bandage had been removed, and that the arm had again been treated with oil.

The nurse was waiting for him. ‘What’s the explanation of this?’ she asked angrily.

Andrew felt annoyed, but he managed to smile. ‘Now, Nurse, don’t-‘

‘I’ve worked here for 20 years; and nobody has ever told me before not to use oil on a burn!’

‘Now, listen, Nurse,’ Andrew tried to reason. ‘There’s a danger of infection. That’s why I want you to try my treatment.’

‘I’ve never heard of this treatment! Old Dr Urquhart doesn’t give it. I refuse to take orders from a man who has been here for only a week!’

It was dangerous to quarrel with the nurse. But Andrew could not risk his patient’s health. He said in a low voice: ‘If you won’t give my treatment, Nurse, I shall come in every morning and evening and give it myself.’

‘All right – do!’ the nurse shouted. ‘And I hope that Evans lives through it.’

She then rushed out of the house.

In silence, Andrew attended to the damaged arm. When he left, he promised to return at nine o’clock that night.

But that same evening, Mrs Evans went to his surgery and, in a frightened voice, said: ‘I’m sorry to trouble you, Doctor, but can I have my husband’s card back, please?’

Andrew rose without a word, searched for the card, and handed it to her.

When he returned home after surgery, he was very silent. After supper, he sat down beside Christine and, leaning his head against her, said sadly: ‘Oh, my dear, I’ve begun so badly!’ Tears came to his eyes.