PERIPHERALIA

The page number in the footer is not for bibliographic referencingwww.tandfonline.com/ojfp 56

I have always enjoyed doing house calls and in some cases 
consider it part of the general practice care of patients.  I get 
to see the context that the patient lives in as well as often 
meet significant others whom I would not normally meet. It 
also gets me out of the rooms for a change of scenery.  

House calls often use up valuable time and it is estimated that 
one could do three or four consultations in the rooms for one 
house call, if you take into consideration the travelling time 
and general entrance and exit problems, including parking.  

In the medieval ages when I started practice, I would usually 
do one house call at lunch time and a couple on my way 
home in the evening but now with the increased availability 
of transport, usually from  family members and other 
agencies, we all do fewer domiciliary visits.

House calls are not without their dangers.  I was called out 
one dark rainy night by a distraught woman who said she 
was having a severe panic attack.  When I got to the double-
storey house in the street, I could see through the upstairs 
window of the house that she was having a damn good fight 
with her husband.  It was about midnight and I rang and 
rang the bell by the garden gate but they were making such 
a din that they did not hear the bell. I then gave up,  stepped 
backwards in the dark and promptly fell down a drain.

I have twice been bitten by dogs on house calls, both times 
on the ankles by small black dogs, and I have had a couple 
of near misses with larger dogs, so I always carry my doctor’s 
bag in front of my testicles until I get inside the house.

The most difficult house calls are always at night. This is 
partly because there are very few names left for the smaller 
streets in Pietermaritzburg and several of them have had 
name changes.   So even though I know the town well I have 
first to plan my journey on the map (I am not part of the GPS 
generation).  Once in the street there are usually only a few 
houses that have visible numbers so I slowly search with a 
torch till I find the correct number in case I find myself in the 
wrong house.  I have done this once.  It was at a house at a 
crossroads that I knew well.  The gate was open and so was 
the kitchen door.  I went in and called out “It’s the Doctor, 

where are you?’’, which was answered by a female voice from 
one of the bedrooms. I marched in to find a young woman 
sitting at a dressing table in a skimpy negligée only to find I 
was in the wrong house.  It is part of the measure of respect 
that people have for doctors that she was not alarmed and 
informed me that it was probably the lady in the opposite 
house whom I needed to see.  A similar incident happened to 
my partner who was called out at night to a row of terraced 
houses attached to the Anglican church.  It was dark; he 
entered the house,  went into one of the rooms and woke up 
an old woman. He made her sit up and started to listen to the 
back of her chest with his stethoscope.  It was then, while he 
was making her breathe deeply in and out, that the son came 
in to tell him it was his mother, not his grandmother, who was 
the patient.

Some calls can be quite dramatic. As a young GP, I was called 
out on a Sunday afternoon in the summer to a “domestic 
problem”. On arrival at the house the husband and wife of the 
house explained that they had invited their new neighbours 
over for a drink at lunch time but after a couple of drinks the 
new neighbour’s wife had taken off all her clothes (she had 
apparently done this before and it is a rare form of Alcohol 
Disinhibition Syndrome). In the kitchen was the naked 
inebriated neighbour’s wife.  

There followed a series of subtle negotiations after which 
her rather embarrassed husband and I decided to wrap her 
in a blanket and try and walk her back over the road to their 
new house.  We got out of the front door with the patient 
wrapped between us but then she started to fall over and all 
three of us fell into the front flowerbed.  I remember thinking, 
as I lay amongst the petunias with a naked woman beside 
me, that my intensive medical school training may not have 
completely equipped me to work in general practice – and 
why, oh why, had this never happened to me when I was 
dating as a medical student.

Chris Ellis is a family physician from Pietermaritzburg, 
KwaZulu-Natal

Email: cristobalellis@gmail.com

House Calls