legends · 4 min read ·
Locum
A locum doctor covering a village practice finds a whole village with the same dry cough, and a sinkhole that breathes.
I was a locum for eleven years, which means I was paid to be nobody's doctor. You arrive in a town you will never see again, you are given a login and a room, and for a week you are the person who tells the village what is wrong with it. You learn to read a practice by its waiting room. Flowers on the sill, good. A laminated sign about aggression, less good.
The surgery at Thornby End was a converted farmhouse with a gravel drive, two doctors' rooms, a nurse, and a receptionist named Maureen who gave me the keys and a look I took for fatigue. The senior partner was off with his back. I was to cover his list for a fortnight.
**Consultation 1. Mon 09:10. Female, 61.** Presenting: a dry cough, three weeks, worse at night. No fever. Chest clear. Lungs normal. I asked about smoking; she had never smoked. I asked if she lived near anything: a mill, a quarry. She said, "Only the Dale." I prescribed a simple linctus. She thanked me and left.
**Consultation 2. Mon 09:25. Male, 44.** Presenting: a dry cough, three weeks, worse at night. No fever. Chest clear.
**Consultation 3. Mon 09:40. Female, 28.** Same.
I mention the pattern lightly. A virus goes round a village. I made a note to check the district surveillance returns. But by the end of the morning I had seen nineteen patients, and seventeen of them had come in with the same dry cough, the same duration, the same clean chest. I noted it in the system. I wrote *? local outbreak, query environmental cause*.
When I listened to the chests, I heard something. I would not call it a sign. A faint, almost musical quality at the end of the breath. A kind of thin whistle, like wind through a gap in a window frame, so faint I was never sure I had heard it. I tried it on myself and heard nothing. Maureen, at lunch, said I was imagining it. "It's the Dale," she said. "It gets in."
**Consultation 31. Wed 11:15. Male, 72, retired farmer.** I asked him what the Dale was. He gave me a long look, then laughed in a way that made him cough.
"It's the hole," he said.
"What hole?"
"At the top of the valley. A sort of sinkhole. It was fenced years ago. It doesn't smell, it doesn't do anything. It breathes out. Every night, a bit. We're used to it. Has been for generations. It's why Thornby has the best grass in the county."
I asked what he meant by breathes out.
"Air comes up," he said. "Warm, in winter. A bit damp. It's got a taste in it. You get used to the taste. And a cough."
I asked whether anyone had had it checked. He said the council had done tests, in the nineteen-sixties. Methane, carbon dioxide, all clean. "It's just air," he said. "Nothing wrong with it. Except it's old."
"What do you mean, old?"
"It's air that's been somewhere else," said the farmer. "For a very long time. You can tell."
I walked up the Dale on Thursday afternoon, after surgery. A grassy hollow, a stone wall, a rusted fence. A hole thirty feet across, grassed over at the lip, going down into the dark in a smooth funnel. I stood at the edge. The air that came up was warm. It carried the faint, clean smell of a cellar with a stone floor. And it had a rhythm. I stood and I counted. It came out slowly, in a long breath, over about nine seconds, and then there was a pause, and then it drew in again.
I do not think I can explain that standing there I did what a doctor does without thinking. I put two fingers to my own wrist and timed the pulse. It was seventy-two. And the hole, I realised, was breathing in time with me. Slightly out of phase. Not mirroring. Following.
I left on the Friday. A week early. I told Maureen I had a family emergency. I handed over the login. In the car I was sick, in a lay-by, quite violently, and what I brought up was nothing more than water, but it was warm, and it had a taste.
I cough sometimes at night now. A dry, tickling little cough. My GP, a young woman, says my chest is clear.
I asked her to listen to the end of the breath. She did, for a long time, with her head on one side, and she said, "That's odd." She said it with a small crease between her eyebrows. "I thought I heard something. Like wind in a gap."
I told her not to worry. It's only air. It's only old.