It was six o’clock and I wanted to go home when the nurse came in and announced I had one more patient to see. I thought I’d seen the last one, I complained, my heart sinking. I’m sorry she said, but this one’s a bit special.
In truth, he didn’t look well. He shuffled in, an elderly man dressed in a fur coat, red in the face, wheezing and grossly overweight He deposited an enormous bag on the floor, sat down, leaned on the desk and stared at me with watery eyes.
‘It’s all too much. I just can’t cope any more’. I asked him to explain.
It turned out he was in the logistics business and there was always a rush before Christmas. Not only did he have to prepare all his packages to individual specifications, but they all needed to be delivered on Christmas eve. ‘I do have my own air transport business, but all those houses, all those expectant children, how can I manage it? And I’m not getting any younger, you know. And now the National Elf Service were threatening to go on strike. I am so tired and my bowels are all over the place.’
I settled down for a long appointment. I asked about his diet. It was clear he liked his food; fruit pudding, mince pies, poultry, gravy, sprouts, parsnips – the lot. I explained about the effects of fat and FODMAPs, but I might as well have been speaking double Dutch. We discussed his life style. ‘Shift work always tends to be associated with IBS, I told him, ‘and flying at altitude in an unpressurised vehicle causes expansion of the gas in his colon and symptoms of bloating.’
He was trying to do too much. At his age, he shouldn’t be trying to climb down chimneys, most of which were blocked off anyway. And then there was the stress of deadlines, the fear of letting people down. It was little wonder that his guts were all twisted up in knots.
‘Why do you do it?’ I asked him. ‘You must know you are too old and unfit to carry on like this any more. All that food coupled with your stressful life style are playing havoc with your guts and,’ I took in his red cheeks and nose, ‘I bet you like a drink or two.’
He nodded. ‘I just can’t let them down. You see, I never had anything when I was young’.
‘But that was then’, I added. ‘You can’t spend your life making up for what happened in the dark ages. It’s all changed now. The children that you give all those wooden toys to; they don’t want them any more. They want iPads they can play their games on and mobile phones to Facebook their friends. Besides, they don’t really believe in you anymore.’
He stared at me and sighed.
‘You need to change’, I told him. ‘Get into the 21st century. Set up a website for mail order. Get the elves onto it; they understand IT. Don’t whizz around the sky all night. Get them to make some videos. Market the make believe. That’s all the kids want these days and you can do all of that in Lapland sitting in your favourite arm chair in front of your wood burning stove. If David Attenborough can do it, so can you.’
Dr Nick Read is a gastroenterologist, nutritionist and psychotherapist, and chair and medical adviser to The IBS Network, an independent charity that supports, informs and advises people with Irritable Bowel Syndrome (IBS) and facilitates the concept of self care of IBS in the community. For more posts, check out his blog on www.thesensitivegut.com.