It started off with an all too common telephone call. “I’m nearly 80” he told me. “I was diagnosed last month with Pernicious Anaemia. I’m so tired all of the time and I have dreadful pins and needles in my hands and feet”.
I asked if he was feeling any improvement from the injections.
“I’m not having any” he told me. I asked why on earth not?
“Well the senior partner told the junior partner at the practice that I was nearly 80 so what could I expect?”
This was a first – a patient with all of the neurological symptoms and a firm diagnosis of Pernicious Anaemia and there was no treatment being given because this was to be expected due to his age. And then the telephone made a series of beeping noises which indicate that there is another incoming call – a ‘call waiting’. I decided to ignore the incoming call and advised the elderly gentleman to make an urgent appointment to see his doctor and tell him that he had spoken to us and that we were extremely concerned about his lack of treatment and that if he doesn’t receive loading doses immediately then I will write to the Clinical Director of the NHS Trust concerned. I also told the patient that if he still doesn’t get any treatment then he must ask his doctor to put in writing why treatment was being withheld.
His reaction was the same as if I had given him a million pounds – he thanked me profusely and told me I should be made a saint. I didn’t disagree.
So then I checked on the ‘missed call’ list on the phone and dialled the number. At the other end a voice spoke. “Hi Martyn, it’s J*****” (I’ll withhold her name for confidentiality reasons). This was one of, if not the most senior adviser to the Dept. of Health in the UK. I had met her once before.
I apologised for not taking her call and related the story of the elderly man. “You can make a formal complaint on his behalf” she said. I told her that if I did that to every call I wouldn’t be able to do anything else. She was quite shocked.
Anyway, the fact is that she wants my help in disseminating the new Guidelines from the BCSH to GPs – something I am delighted to be involved in. I don’t want to go any further but I must say the way in which she plans to do this is very clever and will reward GPs who read and digest the new guidelines with Continuous Professional Development (CPD) credits. So whereas I thought I would be having a quiet weekend I will be burying myself in the new guidelines again.
Why did she ask me to be involved? Because we know better than anyone else what problems need to be addressed. And if I start to get frustrated and tired in this next little project I will simply remember the telephone conversation with an 80 year old man who is being left untreated; and we all know what happens when PA is left untreated – it becomes pernicious.