I sit on a man’s back choking him and making him carry me, and yet assure myself and others that I am sorry for him and wish to lighten his load by all means possible – except by getting off his back – Leo Tolstoy

The figure – hideously contorted, his pink face just recognisably human – lurched into the surgery waiting room.  A small woman seated opposite let out a cry at the shock of this huge, lumbering mess as he tried to sit himself down, spreading his lopsided frame over 3 plastic chairs.

Her cry was overtaken by a bout of vociferous coughing from the man, his body convulsing with the contradictory effort of venting pain while trying to suppress it.

Several minutes passed, with intermittent announcements from the speaker for patients to go to room number such-and-such.  The only other sound came from the twisted man wheezing so noisily that the name-calls were welcome interruptions to his terrible exhalations.

Though praying for her name to come up instantly, the small woman took advantage of her wait to inspect the dreadful creature who faced her.  He held a filthy scarf over his face to stifle his coughs; only a bulbous, purple-veined nose and two red, piggy eyes could be seen.  His body was wrapped in a dirty greatcoat, frayed at every edge – collar, sleeves and hem.

She surveyed his left hand: his fingernails were black and long, almost like talons, at the end of yellowing fingers, skin cracked with bloody scars which ran in reddened lines up to his swollen wrist.

He gave another violent cough, so fierce he almost fell off his seat.  His body writhed wildly and his arms flailed for support.

And that was when the woman noticed something so peculiar, she could hardly believe her eyes. As his left arm shot out, his right hand became visible, up to his sleeve. 

There sat the most beautiful wristwatch imaginable.  Behind its countless hands, dials and intricate workings, she could just make out the words: Patek Philippe.  The band was of a leather so opulent it seemed to caress his wrist.

Her startled gaze spread to the rest of his right hand.  What she saw was even more bizarre.  The nails were beautifully manicured, polished and trimmed to a perfect shape.  The fingers, free from blemish, were scrupulously clean and healthy-looking.  The skin on the back of the hand was soft and supple, without a trace of hairs, as if each one had been lovingly tweezered out.

On the smallest finger, not one but two rings.  The lower gold ring held an emerald of startling lustre – it must be worth a fortune.  But not as much as the thin band of platinum just above it.  Proud of the precious metal sat a glittering diamond, the size of a molar, polished, gleaming, flawless. The lights from the polystyrene-tiled ceiling glinted off its facets.

How could there be such a staggering disparity between the man’s two hands? And the rest of him? 

Any chance of further clues into this mystery was abruptly stopped.  The man whipped his arm back inside the folds of his rancid coat.

Suddenly a name was called that made the man rise clumsily from his chairs.  He careened towards the door, gripped its frame for support, swung his weight down the corridor and into one of the small surgery rooms.

As soon as she remembered who it was – she’d registered his name earlier that day from a quick scan of her patient list – the GP gave a sigh.  The effect of seeing – and smelling – him again in the flesh, swathed in his putrid clothes, filled her with a familiar dread.  How many times had she seen him in the past five years? 

He’d been a patient at the practice for even longer than that.  He kept attending, kept seeming to want treatment, but nothing ever changed.  In fact, his condition – despite all the drugs prescribed, advice proffered and correctives urged upon him – just got worse. 

The man ignored all instructions; he just didn’t seem interested in getting better.  She made the opening effort, because that was the protocol. 

So, how are you this time?  A pause and then his deep, faltering voice followed several rasping coughs:

No better, no worse.

She took the bull by the horns. 

But that’s just not true is it?  You’re certainly not getting better and so you’re getting worse.  You have to face up to it.  I’ve got the results of the tests the nurse did last week.  Your blood levels show cholesterol higher than ever, and given that you’ve got diabetes, your glucose result gave a blood sugar level that’s way too high.

Nothing to be done, he grunted in reply.

His indifference goaded the GP into going further, struggling to keep a calm tone.

Look, Mr Bass, things can’t go on like this.  Surely you can see how sick you are?  You whole body is twisted; your spine is hopelessly bent after both slipped discs that you refused further treatment for.  Look how your shoulders are misaligned.  And you’re limping worse than ever!

Silence.  She felt obliged to push on.

You do nothing to improve your diet – what you consume is ruining your system.  Yet, far from cutting down you appear to gorge more on all the fatty, sugary and salty foods we’ve told you a thousand times to avoid.  You never seem to do the slightest exercise.  You’re overweight.  Your heart simply won’t last the course if you carry on like this.

A cough, another grunt, but nothing spoken.  Now she went for the previously unmentioned. 

This is ridiculous!  My colleagues and I can’t fail to notice the care you take of your right hand, seemingly at the expense of the rest of your body.  None of us can understand it.  My god, if you can afford that watch and those rings, you could afford to have the most lavish health care in the world!  How on earth can you justify looking after one small part of your body so carefully, while you wilfully neglect everything else?

At this last salvo, the man become really agitated.  He shot to his feet, unevenly, and seemed to be shaking with rage that she had dared to refer to the disparity.

Piss off, you stupid cow! he spat.  He smashed his body at the door before reeling back and wrenching it open.  Mind your own fucking business!

And with that he thrust himself down the corridor, past the reception, still cursing loudly, and out of the main entrance.

by Paul BassettGlasgow, September 2019.

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