Confessions of a GP

The pat dog

My last hospital job before I became a GP was in psychiatry. I already knew that I wanted to be a GP by this stage and, given the large amount of psychiatry in general practice, I thought that it wouldn’t be a bad idea to spend six months learning a bit more about mental health. The job I had was actually in forensic psychiatry. I was on a locked ward with patients who were supposedly ‘criminally insane’. I loved going to parties and telling people I was a forensic psychiatrist. It sounds good, doesn’t it? It gave people the impression that I was akin to the Robbie Coltrane figure in Cracker, solving crimes and bringing insane criminals to their knees with my brilliant questioning and diagnoses. The reality, of course, was very different. I wasn’t really a forensic psychiatrist, I was the junior doctor attached to the forensic psychiatry team. I wandered around the ward doing the odd blood test and checking blood pressures. Occasionally, I would write a letter to the Home Office asking whether a patient would be allowed to go to his sister’s wedding as long as he promised not to drink too much or murder anyone.

The patients themselves were a mixed bunch. They had all committed crimes of some sort while mentally unwell, but many of them didn’t really need to be locked away. One of the lads had set fire to a homeless hostel when he was having scary delusions and hallucinations because of schizophrenia. There was no malice involved in his crime. In his psychotic state he had simply been trying to save the other residents by smoking out the evil spirits. His symptoms were well controlled now by medication and he wouldn’t have hurt a fly; however, arson is taken seriously so he was locked up on our ward. Another patient became quite paranoid when smoking weed. He got into an argument at a party and stabbed someone. I’m not sure if it was the paranoia to blame or simply the stupidity that lots of young blokes have when a bit drunk and stoned. That was ten years earlier, but he remained on our ward because he was still apparently a danger to society.

Our oddest patient was called Tommy. I’m not quite sure what his diagnosis was but he was on the ward because of his sexual disinhibition. He had never raped or sexually assaulted anyone but he used to expose himself a lot and masturbate in public. Tommy was fairly quiet on the ward and the other patients had learnt to tolerate his odd behaviours. They would quite happily sit in the TV room trying to guess the Countdown conundrum while Tommy would be sitting quietly in the corner wanking himself off over Carol Vorderman.

Tommy’s behaviours seemed to be getting better with some help from the psychologist and we thought things were going well until the incident with the pat dog. A pat dog is usually a very docile oldish dog that occasionally gets brought round nursing homes and hospital wards. The idea is that spending some time with a friendly dog can make people feel a little better for a bit, maybe even help bring them out of their depression and anxiety. Everyone loves a big cuddly docile dog that likes being stroked.

Trigger was just this type of dog. He was a ten-year-old Labrador who just adored being given attention. His owner was retired and enjoyed bringing him around to the hospital. While Trigger was being petted by the patients, Ted his owner would have a cup of tea and a chat with the nurses. It was a Wednesday afternoon and I was sitting in the nurses’ office writing up some notes. Trigger was in the lounge with the patients and Ted was in the office with us talking about his impending hernia operation. Suddenly, we heard barking. ‘That’s odd,’ said Ted, ‘Trigger never barks.’ We all rushed into the lounge to see a very upset-looking Trigger being chased around the room by a naked Tommy and his erect member. It shouldn’t have been funny, but it really was. We never saw Trigger or Ted again, speculating that the poor dog had posttraumatic stress disorder and had probably been retired early on health grounds.