“He’s got another ear infection, Doctor.” Mrs Morris bustled into the room with Michael and two full shopping bags. She squeezed into one chair and Michael sat down in the other.
Mrs Morris was grossly overweight and the exertion of walking from the waiting room had made her red-faced and sweaty.
“An ear infection?” Dr Desmond Dennis raised his eyebrows in surprise.
“It’s agony!” Michael rubbed his painful ear.
Dr Dennis sat back in his chair. He took a deep breath and looked first at Michael and then at Mrs Morris as he carefully considered the situation. He drummed his fingers loudly on his desk.
“Have you thought about the tonsil, Mrs Morris, or one of the back teeth, perhaps?”
“It’s his ear that’s hurting, doctor.”
“My ear is killing me!” Michael added. “My teeth are fine.”
“They can all cause an earache, Michael,” Dr Dennis explained, “an ear infection, tonsillititis or a tooth abscess. It’s all to do with the nerve supply.”
Michael fidgeted uncomfortably in his chair and looked at the floor.
“It is his ear, Doctor. He has had it before, lots of times.” The diagnosis seemed obvious to Mrs Morris.
Dr Dennis chuckled. “Goodness me, it would make my job a lot easier, Mrs Morris, if things were as simple as that. Michael Morris has a terrible earache, so Michael Morris has a terrible ear infection. What could be more straightforward? I wouldn’t even have to examine Michael. We could do the whole thing over the ‘phone.”
Michael winced. Dr Dennis’s protracted explanation appeared to be making the pain worse.
“I am afraid the human body is far more complicated than that, Mrs Morris, far more complicated.” Dr Dennis glanced at his watch.
“Well, time is getting on, Michael. We better have a look at you.”
Michael sat up and managed a smile. He was relieved that Dr Dennis was going to look at his ear at last.
“No fever, Mrs Morris?” Mrs Morris’s look of puzzlement seemed enough to establish the answer to Dr Dennis’s first question.
“No cold?” Dr Dennis continued quickly. Mrs Morris shook her head.
“A cold would make an ear infection more likely.” He added. “No headache? No vomiting? No tummy pain? No diarrhoea?” He paused momentarily.
“So we’ve got an earache but no toothache and just a slight sore throat.” Dr Dennis smiled. Mrs Morris spluttered. Michael glared at the doctor.
“My throat’s not sore.” He stated emphatically.
Dr Dennis ignored this comment.
“Right, open wide.” Dr Dennis’s torch shone into Michael’s eyes. The bright light made him blink. He turned his ear towards Dr Dennis.
“No, I want to look at your throat first, Michael.” Michael clenched his jaw tightly.
“Michael, I have to carry out a complete examination,” Dr Dennis explained.
Reluctantly, Michael opened his mouth. Dr Dennis examined his throat, tapped Michael’s back teeth firmly with his wooden tongue depressor and, finally, looked in Michael’s painful left ear.
“Well,” he said as he sat back down. “that’s very interesting. I am afraid we have a bit of a predicament with the diagnosis.”
Mrs Morris nodded. Michael was rubbing his ear again.
“First, I will say, Michael’s teeth are fine. We can be quite sure of that.” Dr Dennis looked rather pleased with himself as he explained this.
“Good news there, then,” Dr Dennis continued. “Now, Michael’s left tonsil is slightly red and swollen. Not a severe tonsillitis, but by no means normal. His ear . . .” Both Michael and Mrs Morris were looking up expectantly as Dr Dennis paused.
“Are you sure you haven’t had a sore throat, Michael?”
“No, I told you, I haven’t.” Michael answered grumpily.
“I am just making sure,” Dr Dennis explained. “Right, your left ear is similar to your throat. The ear drum is slightly red and swollen. Again, it is not a severe infection, but it isn’t normal. So, the diagnosis is not clear.”
Michael and Mrs Morris were disappointed.
“If I had to make a choice,” continued Dr Dennis, “I would suggest it was your throat, Michael. I don’t know why. I suppose it’s years of experience, but I think your left tonsil is the problem.”
Michael looked angrily out of the consulting room window. Mrs Morris sighed.
“But,” Dr Dennis laughed, “don’t worry. The beauty of the situation is that the exact diagnosis doesn’t matter.” He looked very pleased as he explained this. “We can treat both conditions in the same way.” Dr Dennis paused to allow the information to sink in.
The mention of treatment made Mrs Morris smile. Michael turned back towards Dr Dennis.
“In fact,” Dr Dennis continued, “both conditions usually get better on their own. I generally recommend paracetamol and plenty of fluids.”
“What a waste of time!” Michael shrugged and started to get up.
“Doesn’t he need antibiotics, Dr Dennis?” Mrs Morris asked anxiously.
“That’s the alternative, Mrs Morris. I could prescribe an antibiotic that will treat both his throat and his ear.”
“That would be ideal, Doctor,” said Mrs Morris. Michael stood by his chair.
Dr Dennis looked at them both thoughtfully. He raised his hands as he spoke. “Now, let’s not rush into things. Michael is a strong, young man. He will almost certainly get over this, on his own, and in no time. When did you say that the symptoms started?”
“On Sunday, Doctor.”
“Saturday.” Michael stated matter-of-factly.
“I am sorry, Michael. It was Saturday, Doctor.”
“Saturday. Right.” Dr Dennis carried out a quick mental calculation. “So he should be better by Thursday, say Friday at the latest.” He looked sympathetically at Michael. “Just two or three more days. That’s not too bad is it?”
Mrs Morris considered this. Michael did not look happy.
“With antibiotics his symptoms would get better a little bit quicker, that’s all. But, he might get side-effects.”
“It is very painful, Doctor. I am sure antibiotics would help a lot.” Mrs Morris was still very worried. “He’s never had side-effects.”
“That’s fine, Mrs Morris,” Dr Dennis reassured her. “Michael, I will give you a prescription for some antibiotics. I will do my best to help you.”
“Oh, thank you, Doctor. Thank you very much.” Mrs Morris smiled again. “What do you say, Michael?”
Michael said nothing. He looked bored.
Dr Dennis wrote out the prescription then looked at his watch again.
“Ah, look, it’s time for my next patient.” He said, and he ushered them quickly out of the room.