Three Doctors, A Dentist And A Nurse

By William Boyd

Back in 1971, during my first year at university (in Glasgow), aged 19, I began to suffer from debilitating headaches. They would come and go at random, while I was eating lunch, sitting in a lecture theatre, walking back to my hall of residence.  They were mainly on the right-hand side of my head and they were so severe that I had to close my eyes, clench my fists, stop whatever I was doing and wait for them to pass.

Of course, I thought I had a brain tumour.

I went to the university’s medical officer and he suspected I was suffering from chronic sinusitis. He arranged for me to have an appointment with an ear, nose and throat consultant at the nearby Royal Infirmary, a huge, sprawling Victorian hospital. It was my first experience of the NHS, having been born and raised in Africa and educated at a boarding school. I was a healthy young fellow but these headaches had rocked my sanguine insouciance about my well-being.

The ENT consultant was a bit baffled but he conceded that it may have something to do with an inflamed or congested sinus and he said it would be a good idea, anyway, to have an antral lavage – in other words to have my sinuses hosed-out. Anything to get rid of these headaches, I thought. And an appointment was swiftly booked.

The headaches continued and I counted down the days to my appointment. I learned that a cannula would be inserted into the maxillary sinus, attached to a hose and a saline solution would wash the sinus out. I would need a local anaesthetic, it transpired, and here’s where things went wrong.

The anaesthetic that was being wiped around my nasal cavity with a swab had a powerful unforeseen effect on me, for some reason. The room went red, then yellow, then blue. It was as if I was tripping on LSD. I went deathly pale and the room began to sway. The nurse who was applying the anaesthetic stopped at once and she went to fetch me a cup of tea. I came round very quickly and apologised. I said I was ready to give it another go. But she said: you know what? I think we should postpone this procedure. I agreed, with some reluctance – I desperately wanted rid of these headaches — but she was insistent.

When I returned to my hall of residence there was, coincidentally, a letter from my father. My father was a doctor, also. He was a specialist in tropical medicine and spent his working life in West Africa. I had written to him listing my headache symptoms and now in his letter he — strangely, I thought — suggested I go and see a dentist and have my teeth x-rayed.

I went to a nearby NHS dentist who duly x-rayed me. It turned out I had a huge abscess under my rear right molar. It wasn’t giving me toothache, yet – that would have arrived in due course — but the purulence was infecting the nerves that ran up the side of my neck, causing these intense headaches. The dentist removed my tooth and drained the abscess and the headaches went away forever.

I was, of course, beyond grateful to the NHS doctors who had seen me, and to my father for his diagnosis at distance and to the NHS dentist who had finally solved the problem. But, curiously, it’s the nurse who didn’t perform the antral lavage who earns my lasting gratitude.  She saw the state I was in and unilaterally decided to postpone the procedure. It was an act of caring that involved withholding care. I didn’t need an antral lavage as it turned out, not that she would have known, but that understanding of my distress – that empathy — contributed crucially to the curing of my headaches and allowed the dental intervention. It is a nice paradox, but that nurse’s instinct not to do what she was there to do explains my undying devotion to the wonderful institution that is the National Health service.