As soon as I had rung the doorbell my heart sank. High-pitched yapping of a small dog was followed by the scraping of paws against the front door – always a foreboding start to a home visit.
‘Sinbad, shuddup! Stop that noise!’ I heard, as my patient Mrs Briggs shuffled slowly up to the door and grappled clumsily with the handle.
When the front door finally opened, Sinbad didn’t allow his advancing years or excessive weight to prevent him from jumping up at my legs and excitedly sniffing around my groin. Sinbad was a fat Jack Russell with a tuft of white hair on his chin that uncannily matched the sprouting white hairs on the chin of his owner.
Mrs Briggs was a kindly lady in her 70s. She was large all over, but most notable was the size of her legs. Years of fluid retention meant that her legs had steadily expanded to the size of small tree trunks. The circumference of her thighs looked barely different from that of her ankles, with only a few creases of her tightly stretched skin to suggest where her feet joined her lower legs. Her bloated feet were completely solid, and poking out were 10 spherical toes with brittle yellow toenails nestled on top. The soles of her feet were made up of a white crust of rock-hard skin with a flaky surface and some cracked scaly patches around the heel. The only footwear that she could now fit into were some old frayed slippers that had had the back cut away.
‘Do you want me to lock Sinbad in the backroom, Doctor? I know not everyone’s a dog lover.’
Every part of my being wanted to say ‘Yes, please’, but for some reason I politely agreed to allow Sinbad to accompany us. After Mrs Briggs had sat down on the sofa, Sinbad curled up contentedly at her feet and for just a short moment I felt something close to affection towards them both.
‘Thank you so much for coming out and visiting me, Dr Daniels. I’ve got some biscuits out specially.’ With that Mrs Briggs reached over and passed me a cracked china saucer holding a number of shortcake fingers. ‘Do take one,’ she said.
Over the years I have had all sorts of refreshments offered to me by patients during home visits – cups of milky tea and custard creams are the norm, although I have been offered more than one gin and tonic, and on one occasion an old Rastafarian gent tried very hard to persuade me to share with him the enormous spliff he was smoking. As a general rule, I always decline the food or drink (or marijuana) offered by patients, but I’m rather partial to shortbread and I hadn’t yet had a chance to grab my lunch.
I took a seat in the armchair and politely nibbled on my biscuit while Mrs Briggs began to explain why she had asked me to visit. I was making my best effort to listen intently, but I couldn’t help but be distracted by Sinbad. The dog had started sniffing intently around his owner’s lower legs. This in itself was only slightly disturbing, but he then started enthusiastically licking the hard crust of skin on the soles of her feet. He systematically licked the entirety of each foot in turn, even endeavouring to squeeze his tongue between each of her swollen toes. After completing this, Sinbad focused his attention on a particularly hard callus on her left heel. After softening it up with a particularly vigorous lick, he began gnawing at it as if it was a tasty bone. I couldn’t quite believe what I was seeing and initially wondered if Mrs Briggs was even aware of what was happening, but as Sinbad struggled to get a good vantage point on which to clamp his teeth, she purposely manoeuvred her foot to a more accommodating angle.
Mrs Briggs was talking away, but I had very little recollection of her words. All I could focus on was the relish with which her elderly Jack Russell was feasting on her dead skin. Surely this couldn’t be healthy for either dog or human? Yet, I got the impression from their mutual sense of ease that it was in fact something that they had both been enjoying for some years. After around 10 minutes, Sinbad appeared to have had his fill of foot, but, clearly on the lookout for some dessert, he jumped up on the sofa and began sniffing around the saucer of shortbread biscuits that was perched on an adjacent side table. With the same sort of concentrated deliberation he had shown his owner’s feet, he licked each shortbread finger on the plate from top to bottom and then chose one that he liked the look of and began chomping away messily.
Finally taking some notice of her dog’s inappropriate dining habits, Mrs Briggs shooed Sinbad away from the saucer of biscuits and then, without the merest hint of shame, held the saucer out in my direction and offered me another. It was at this point that the harsh reality hit home. I had no way of knowing if Sinbad had already given the shortbread fingers a good going over before my arrival. Even as a glass-half-full kind of guy, I still couldn’t get away from the fact that it was quite likely I had just eaten a biscuit laced with dog saliva and foot scale. My gag reflex began triggering uncontrollably and God knows how, but I kept myself together and managed to leave the premises before vomiting.