Four inches with a manicure

To the Hon. Surgical SHO

Thank you for seeing this patient.

He is 83 years old,a widower who lives alone,and who reports that he has no medical problems of any sort and that he doesn't take any medication of any sort on a regular basis.He has no allergies and is a non smoker.

He told me that he had a surgical procedure in your hospital 5 days ago-he doesn't know what the operation was called;why he needed it;who did it;or what the outcome was.

The only paperwork he has relating to the procedure is a letter asking him to attend Surgical OPD in 3 weeks time.

After some long and frankly torturous discussion during which he kept on repeating the words "bum" and "big pipe" to me, it sounds like he may have had either a sigmoidoscopy or a colonscopy.

He presented today concerned that he may have a foreign body in his rectum-specifically,he has been constipated since the surgery and feels that someone may have inadvertently left a metal spring in his rectum,when it "fell out of the machine".

He told me that he had performed a rectal examination on himself this morning and that he can feel the spring which he describes as being about 2 inches long.

I too have performed a rectal examination (with my freakishly long middle finger)(which was handy given the crop of external haemorrhoids I had to fight my way through) and whilst I cannot feel a metal spring,I can,-alas-, feel a mass.

Unfortunately he is unhappy with my inability to find the spring,and has asked for a referral to a doctor,which is his right under the Patients Charter.

The Out-of-Hours GP service has declined to see him on the grounds that they had not performed the surgery;I have spoken to the A&E registrar who has also declined to see him on the grounds that they too had not performed the surgery;which is why I have to refer him to you.

Apologies.

Kind regards

Lucien