A Highland GP on life the universe and anything…

Avoiding the shame and blame game

I’d forgotten how massive VHS videos are. And how satisfying the whirring sound when you load one into a video player and press fast-forward. But the other day I had cause to borrow a video player from our neighbours who keep hens, in order to reach into the past, 2002 to be precise, to watch a taped recording of an interview with a patient and remind myself of a lesson learned.

Earlier that day, I’d had an unremarkable consultation with the woman in the video during which I’d asked about her smoking habit. I saw that she had been upset by the question, but her response was dignified and assertive.  So much so, that I’d asked if I could explore her thoughts a bit more closely and video her replies. I recall I had a workshop planned on the topic of changing damaging behaviours and she had been so eloquent that I knew I could learn from her. She very kindly consented and the video whirring away in the elderly tape machine was the result.

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Emotional Labour

Stepping out of the patient’s house and down the path I could feel tears welling up. By the time I reached the car I was sobbing. During that visit I had provided technical care and the best advice I could, but I was also there as a witness to a family calmly and gracefully giving exceptional care to their dying older relative. Tenderly moistening dry lips and adjusting the pillows. It is hard emotional labour to see patients I have often known for years suffer or die, especially when in most cases, I also care for – and about – their family.

GP’s desk

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The Visit

 

I arrive at a home visit, doctor’s bag in one hand, computer summary printout in the other, and knock.  No answer. I knock again. I start to wonder how concerned I should be. The door is unlocked, so I enter.

“Hello? It’s the doctor.”

Nothing. A search of the downstairs fails to locate my patient. Upstairs, nothing. I put on my reading glasses and double check my notes.

Ah. I am in the wrong house.

Red-faced, I retreat back down the path, wondering if the neighbours have called the police, and compose myself to find where I should have been all along. Read the rest of this entry »

A fish called Orange

This piece was first published in the Press & Journal newspaper on January 11th 2019

In a fish tank at Dingwall Heath Centre lives a goldfish named Orange. She, or is it he (can anyone tell?), is now at least fourteen years old. I know this because she was given to my daughter, along with a companion named Peach, for her ninth birthday. Orange and Peach were soon joined by my son’s fish, Apricot and finally, by the black and swishy-tailed Sharon. All four spent years amusing us as they swam in circles round their tank, which sat on a windowsill in the kitchen. One by one, the inevitable happened. Read the rest of this entry »

2018 hasn’t been the best year. But it has harboured one joyous milestone: the 70th anniversary of the foundation of the NHS. Yet whilst we celebrate this jewel of the British way of life it has also been a year when the sustainability of this method of delivering our healthcare has been questioned. Beset by spiralling costs and staff shortages, where we go next? In the North of Scotland this has become especially evident in rural areas. We know from the press that Moray, Caithness, Skye and Argyll are struggling to deliver the care we have come to expect. What is less known is how, over one hundred years ago, a previous crisis in health care provision led to the very creation of the NHS Read the rest of this entry »

Continuity

Last month marked twenty-five years of me being a partner at Dingwall Medical Group, astonishingly, consulting from the same room throughout all those years. During this awesome quarter-century I have developed many strong and meaningful relationships with my patients, – some of whom I did not find easy in the early days, though I’m pretty sure they may have felt the same way about me. However, it is many of these patients of whom I now find myself the most fond. I have grown to understand what matters to them and, having walked with some of them though their medical journey over the last 25 years, I get great satisfaction from not only understanding what they most need from me but also, learning what they see as of no benefit to them whatsoever. Read the rest of this entry »

“So, are you just a GP?”

I can feel Erica, my wife, stiffen whenever I’m asked this question – and I’m asked it a lot.

That little word just. With its hints of hierarchies; implying GPs are lesser doctors than others.

I am a GP. It is the most rewarding, challenging and satisfying job I can imagine. There is nothing I would rather be doing.

Who else can look after peoples’ complex medical problems and mental health issues often in the most deprived social environments? GPs are uniquely placed to forge the long-term relationships which provide comprehensive and coordinated care to people, right from their very first contact with the NHS – work that has repeatedly been shown not only to save lives but also to prevent the most vulnerable from falling through the cracks in our society. Read the rest of this entry »