As a very young doctor, a very long time ago, I had to support myself by making house calls as a locum or for an agency. The calls often came at night, often from a worried-well patient. Finding the right house was frequently challenging, especially in the suburbs, where people used fancy, elegant names instead of numbers. I once went into such a house, examined a patient, wrote out a prescription, and left before realizing that I had been in the wrong house and seen the wrong patient.

Wrong patient or not, history taking was like group therapy, with everybody in the room and everybody talking at the same time. To examine a patient lying in the middle of a king-size sagging bed required contortions and acrobatics, and one often ended up being in the same bed as the patient. When one was finished, the wife would sometimes suggest that while I was here, I might as well look at the baby.

For moderately severe pain, it was expedient to take a 10 mg methadone tablet and have the patient take one-quarter of a tablet every six hours. In those halcyon days before HIV and hepatitis, it sufficed to use for everybody a single needle and syringe immersed in alcohol in a metal container and flushed out with hot water prepared in advance by the patient’s wife.

Many general practitioners gave their patients regular injections of iron, vitamin B12, and mercurial diuretics. As a locum tenens, I had to visit a monastery where the mother superior was to receive a weekly injection of a mercurial diuretic. Young nuns would pull her vestments one way, then another, and then expose a small square of pink flesh available to plunge in my needle.

On one occasion, towards midnight, while the patient was explaining his symptoms, a large, dirty dog suddenly jumped on the bed, shook the dust out of his mane, licked the man’s face and hands, and snuggled down under the blankets. Later, while driving home and reflecting how unhygienic all this had been, I called the patient’s wife and suggested she should keep the dog in the yard. “Oh, we thought it was your dog”, she replied.