As an emergency, an itch doesn't come up to scratch

"MORNING Mr Jacobs. What can I do for you?"

"Itchy bum."

"Splendid. Were you aware that Saturday morning surgery is for emergencies only?"

"Yes."

"Well in my book, that ain't an emergency. Bum on fire, fine. Bum concealing baby crocodile, fair enough. But itchy bum, no. Good day."

"Oh you think you're so clever, don't you?"

"Clever enough to know you can wait until Monday."

"But this is an emergency. You told my son he had worms."

"Your son does have worms. He brought one in to show me in a Playdoh jar."

"I don't believe you."

"Well I haven't kept it - it was only a threadworm. Nothing to lose any sleep over."

"How can you say that? You told my wife the whole family was probably infected - I haven't slept since, thinking of all those horrible little things crawling around inside me."

"They're only in your bowels."

"You told my wife that the eggs can get under the fingernails."

"So?"

"Well, the wife's got long fingernails and she likes to draw blood during sex."

"Anywhere special?"

"My back, mainly. So she could have passed eggs straight into my bloodstream, right?"

"Look, there are worms that live in the bloodstream - such as the dreaded schistosome fluke - but threadworms only survive in the intestines."

"How do you know it was a threadworm?"

"It looked like one."

"But you didn't send it to the lab, for conformation?"

"No."

"So you were guessing?"

"Look, it wasn't a fluke."

"Why not?"

"Because flukes are flatworms with oral and ventral suckers. This worm was a thread."

"It could have been a fluke fluke."

"Also, schistosomes are unheard of in Walthamstow, whereas threadworms aren't."

"So how did Lance get it?"

"Probably from nursery."

"That's a shame."

"Why?"

"Because he's settled in really well at Mrs Pope's."

"You don't have to take him out of it."

"No son of mine's learning to read in a wormn hole."

"Look, threadworms are no big deal. Five-hundred-million people on this planet have got them as we speak. Many have no symptoms at all and others just have an itchy bum."

"But surely Mrs Pope should have spotted the worm in Lance's lunch?"

"You don't swallow the worm, you swallow the eggs."

"And where are the eggs?"

"Like I said, under someone's nails."

"How do they get there?"

"Well, the adult worm lives in the large bowel but pops out to lay eggs around the anus."

"I've heard enough."

"But the good news is that nearly all patients are cured by a single dose of wormicide - and you can buy it over the counter to avoid troubling your doctor on a Saturday morning."

"I don't like giving the kids drugs."

"Well, if you cut everyone's nails, wash the eggs off bedclothes and towels and have scrupulous personal hygiene, the worms die out after a month or so."

"That's a bit of a fag."

"Or just live and let live."

"But I'm itching like mad. Does that mean I've definitely got them?"

"No, it could just be that the suggestion you might have them has brought it on. If you can't find a worm in your stool, the best way of making the diagnosis is to sleep with Sellotape around your tail end, to catch the eggs as the worm pops out at night to lay them. Now, if that's all..."

"Do you sell Sellotape?"

"No. Bye bye,"

"One more thing. Why did you call the schistosome dreaded?"

"Good grief. Because the eggs get stuck absolutely everywhere - in your bladder, in your liver, in your lungs, in your brain ... it's not pretty ... Mr Jacobs? Come back! Look, I've got some cracking photos of it in Post Mortems Weekly ..."