Confessions of the real Doc Martin: Men who grow moobs after accidentally taking their wife's HRT, and how to fix a brain haemorrhage with a drill
00:34 GMT, 9 April 2012
They say that truth is stranger than fiction — an adage never more accurate than when describing the day-to-day life of a GP.
My experiences as a family doctor have often seemed as if they might have come from a particularly dramatic film. There was, for example, the patient who dropped dead during a check-up and, in one of the more bizarre moments of my career, the man who grew breasts.
So colourful have been my years as a London GP that scriptwriters have used them as inspiration for storylines in the popular Sunday night TV series Doc Martin.
Alert: Martin Clunes (centre) as Doc Martin
I have been a medical adviser on the series since work first began on it in 2003, ensuring everything that happens in the drama is factually correct and, on occasion, providing ideas for stories based on my real-life experiences.
One of them was a male patient who visited me many years ago, complaining that he was growing breasts. After establishing that the problem was not some strange quirk of his metabolism, we eventually pinpointed the cause as his wife’s hormone replacement therapy cream.
Apparently, it had rubbed off on him when they were in bed: his body had absorbed some of the female hormone in the HRT cream, as a result of which he had started to develop a feminine shape.
This incident inspired the first-ever episode of Doc Martin in 2004 when, for comedy purposes, the story was adapted. Celia Imrie played a woman using HRT cream. As well as sleeping with her husband, however, she was also having an affair with a surfer.
When both men started to grow breasts, the village began to fear something in the local water was causing the problem. Of course, Doc Martin managed to solve the case.
It may seem unusual for a family doctor to be involved in TV, but for this I can thank my ex-wife, who is a film producer.
Stranger than fiction: Martin Clunes as the lead in ITV's hit series
Through her, many years ago, I met Dominic Minghella, who had been commissioned to write a script for a new TV series.
Dominic had seen the 2000 comedy film Saving Grace, in which Martin Clunes plays a family physician, and wanted to create a TV series based on the character — which is where I came in.
Dominic wanted to pick my brains because he knew nothing about being a GP, so we sat down together and sketched out some stories about a brilliant surgeon who takes up a job in the sleepy Cornish village of Portwenn.
Doc Martin is a brilliant doctor who’s obnoxious, contrary and inept when it comes to human relationships. I regard him as the opposite of me. I spend my days as a general practitioner being as welcoming as possible to my patients, even if they are late for their appointments.
When it comes to the medical aspect of the Doc Martin storylines, I work with the writers to make them as realistic as we can.
Bearing in mind that he can only ever have his doctor’s bag with him — limiting the equipment we can use — we have to invent challenges that are dramatic but plausible, as well as clinically accurate.
Fortunately, true life has provided enough events to keep the series going and inspiration flowing.
In one episode, a man falls off a cliff and is found unconscious at the foot of it.
Doc Martin arrives on the scene and realises that the man has suffered a subdural haemorrhage — bleeding on the brain — which could kill him by creating a build-up of pressure in the skull.
It is the same condition which, tragically, claimed the life of actress Natasha Richardson — late wife of Hollywood star Liam Neeson — after she hit her head in a minor skiing accident in 2009.
The sensible thing in such cases is to
call a helicopter and have the casualty airlifted to hospital. But,
since this is drama, we decided to complicate things by making a
helicopter unavailable, leaving Doc Martin to come up with his own
solution to a pressing problem.
Moobs: One of Dr Scurr's male patients grew breasts after accidentally coming into contact with his wife's hormone replacement therapy medicine
His answer is to borrow an electric DIY drill and open a hole in the victim’s skull, thus letting out the blood and reducing the pressure inside it.
Initially, I objected to this plotline, because it seemed so unrealistic. But then we heard of a case in Australia, where a GP in a small town had done exactly the same thing in an emergency, in the process saving the life of a boy who had fallen off his bicycle and landed on his head.
Another episode was based on a case where I had conducted a home visit to a man who was suffering from cardiac trouble.
I had hooked him up to a portable ECG (electrocardiograph) machine to monitor his heart but, in the middle of the test, he unexpectedly had a stroke and died.
I had to go downstairs, find his wife,
sit her down and gently explain what had happened. I must have looked
rather pale as I did so.
real-life incidents in my surgery that have inspired storylines include
a patient who had taken so many vitamin D pills that it weakened their
bones, as a result of which their leg had fractured after just the
slightest of knocks.
However, in the TV version of this story, the details were changed so that no one could identify the real people involved.
If they had, we would have been in trouble for breaching patient confidentiality.
There are some issues I am keen to
address in the series, but which the scriptwriters won’t allow. Cancer
stories are banned, for example, on the basis that they would be far too
emotional for people to watch.
DIY: In one episode Doc Martin treats a man with a subdural haemmorhage by using a household drill to make a hole in his head, relieving a build-up of pressure
Medical stories are always liable to strike some people as being in questionable taste, particularly if they are being used for dramatic or humorous purposes. It has to be said that doctors develop a rather black sense of humour about such matters, especially compared with the general public.
Over the years, the Doc Martin series has become increasingly averse to stories about sex. Perhaps this is because the series has become internationally successful and some countries have more prudish attitudes to sex than us.
We had one story about a pub landlord who had contracted a condition called Reiter’s syndrome, which can manifest itself as pains in the bones and muscles. I wanted him to have caught it by being promiscuous and getting a sexually transmitted disease (STD).
The fact is that STDs are the cause of nine out of ten cases of Reiter’s. The other cause is a foodborne infection, such as dysentery.
The scriptwriters got their way, though: in the story they came up with, the landlord caught a tummy upset from eating a contaminated meal on a cross-Channel ferry. I would have preferred the cause to have been an STD, not just because the script would have been more interesting, but also because it would have been more accurate. Still, you can’t win them all.
Expert: Dr Martin Scurr has been a medical adviser on Doc Martin since 2003
I feel Doc Martin storylines are an excellent opportunity to communicate health education, even about simple issues such as how high blood pressure can be addressed simply by cutting down on dietary salt and losing weight.
In a world where we all seem to have become deaf to the usual nannying way of transmitting this information, humour can often get the message across much more effectively.
In real life, being asked to help in
strange situations is often part of a doctor’s everyday existence. At
least, it has been in mine.
Once, during a family holiday in Greece, a woman burst into our hotel room at 2am, screaming with abdominal pain.
Someone had told her I was a doctor, and she was certainly in need of urgent help.
area round the woman’s gallbladder was particularly tender, so I
deduced that she had gallstones and needed to go to hospital for
treatment. In the meantime, however, another holiday guest said that
they had a stock of strong emergency painkillers because they suffered
from gout and offered them to the stricken woman.
The only problem was that the painkillers were in the form of suppositories, and the poor woman did not know how to use them. In the end, I had to help her . . .
As part of my work on Doc Martin, I travel to the set in Port Isaac in Cornwall and sit in on the cast read-throughs.
They rehearse the script to ensure that everything, from fake wounds to Martin Clunes’s pronunciation of medical terms, is accurate.
I only have to tell Martin something once and he has it down perfectly. He is a natural comic with an innate gift for mimicry: once you’ve shown him how to conduct a mock medical procedure on a patient correctly, you never have to show him it again, not even from series to series.
A new series of Doc Martin is now looming and I am beginning to collate a portfolio of ideas in a file on my desk.
Filming starts a year from now and we have already decided to introduce something never seen before in the series.
In one of the episodes, Doc Martin decides drinking too much is the cause of one of his patients’ problems. Only later does he realise that the patient is actually suffering from Parkinson’s disease.
Finally, Doc Martin gets something completely wrong, showing in the process that he is fallible after all.
Well, as I mentioned earlier, we strive for realism to make the series as true to life as possible — and doctors are people, not gods.