Once upon a time there was a Miller and he lived in a house with his only daughter Nessie. Though her name was but a poor approximation to that of the well known healthcare organisation that she is meant to personify in the tale that follows, Nessie was renowned throughout the land for her great beauty. But hers was not just skin deep, rather hers was a beauty that ran deep, a beauty that was most clearly seen in the way she sought to tend to the sick who came to her for help – a help that was always free at the point of need.
Her father loved Nessie and enjoyed nothing more than to boast of her beauty. ‘My daughter’, he would say to any who cared to listen, ‘is the envy of the world. No matter what ails you, Nessie will make you well. She will solve all your problems, big and small’.
This though was not strictly true. But the Miller was so insistent that Nessie really could solve everybody’s every problem, that, in time, many began to believe that it really was so.
One day the King was visiting the village where the Miller and his daughter lived and heard Nessie’s father exalting his daughter’s charms. The King asked the Miller if what he was saying was true and the Miller, hoping that if he were to find favour with the King he might be richly rewarded, assured him that it was.
‘Then bring your daughter to me tomorrow’, said the King, ‘and if I find that what you say is indeed true I will give you half my kingdom.’
And so, early the next morning the Miller and his daughter made their way to the king’s castle where Nessie said goodbye to her father and promised him that, as far as she was able, she would do all that the King asked of her.
Nessie was then led to the great hall where the King was sat upon his throne. The King then showed her to a large room in which lay dozens of people each clearly suffering from some disease or another.
‘Do you see these poor souls?’, the King asked Nessie. ‘It is my wish that you would make them all well by morning. If you succeed I will show you kindness. But if you fail you will be locked in the highest tower of the castle and you will never see your father again’.
With that the King left the room and, locking the door behind him, left Nessie with the sick individuals who were coughing and vomiting in front of her.
Nessie did not know where to begin for in truth she had but a rudimentary knowledge of medicine. She looked around her in the hope of finding somebody who might be able to help but, finding no one, she fell to her knees and started to cry.
But she had not been crying long when she felt a tap on her shoulder and, looking up, saw behind her a wizened old imp like figure who was wearing a tunic, tight stockings and pointed leather boots.
‘Who are you?’ Nessie asked the stranger, ‘And why are you here?’
‘As it happens I’m the Professor of Medicine at the local university. And I have come to help you make all these people well. But it will cost you. If I help you fulfil the king’s wishes you must promise me that you will give up something that is important to you. Might I suggest your lunch break?’
Nessie readily agreed and so the peculiar fellow began to teach Nessie the basics of antibiotic prescribing and how to administer parenteral antiemetics. Nessie started to put into practice all that she had been taught and soon all those who had been unwell were beginning to feel very much better. When she had finished tending to the last patient Nessie looked around for the Professor of Medicine in order to thank him for all his help but he was nowhere to be found. He had disappeared as mysteriously as he’d appeared the evening before.
When at last morning came and the king returned to the room he was delighted to find that all those who had been unwell were now completely cured. He rewarded Nessie with the most marvellous breakfast before leading her to a luxurious bedroom. There Nessie climbed into the bed, the largest and most comfortable that she had ever seen, and fell instantly asleep.
That evening Nessie was once again brought before the King who once again showed her to a room. This one was several times larger than the one in which she’d spent the previous night. Within it were hundreds of people, each one clenching their chests, gasping for breath and turning a far from healthy shade of grey.
‘Do you see these poor souls?’, the King asked Nessie. ‘I command that you make them all well. If you succeed then I will not treat you harshly. But if by morning you have failed in your task then you will be locked in the highest tower of the castle and you will never see anyone ever again’.
Once again the King left Nessie in the room and locked the door behind him. Nessie looked around for someone to help but finding no one sank once more to her knees and started to cry.
But it wasn’t long before she again felt a tap on her shoulder and looking up saw once more the strange looking man who had visited her the night before.
‘If you like, I can help you again’, the strange looking figure said to Nessie, grinning at her in a way that made her feel a little uncomfortable. ‘But it will cost you. If I help you fulfil the King’s command you must promise me that you will give up something that is important to you. Might I suggest your evenings and weekends?’
Nessie had no choice but to agree and soon she was being taught how to insert cardiac stents into coronary arteries, all that is required for the secondary prevention of cardiovascular disease and, on at least a couple of occasions, the timely administration of CPR and the effective use of a defibrillator. By morning everyone was fit and well and in the corner of the room was a mountain of GTN sprays that the patients found they no longer required. Smiling contentedly to herself Nessie looked round for the Professor of Medicine but found once more that he had mysteriously disappeared.
Soon the King arrived and was again delighted to see all those who had seemed so close to death the night before now looking so hail and hearty. Nessie was looking forward to a hearty breakfast and a restful sleep but instead the King led her to a small pokey office and insisted she write up comprehensive case notes on all those she’d spent the night treating and then produce a report explaining why three patients still hadn’t had their cholesterol reduced to optimal levels.
At the end of the day Nessie felt more tired than she’d ever felt before but still there was no time for her to rest. Instead she was once more brought before the King who showed her to yet another room. This one was several times larger than even the one she had spent her second night in the castle. And the room was heaving, filled with thousands upon thousands of people, many of whom looked close to death.
‘Do you see these poor souls?’, the King asked Nessie. ‘I demand that you make them all well. If you succeed then I will know that I can ask even more of you tomorrow night. But if by morning you have failed in your task then you will be locked in the highest tower of the castle and you will never see the light of day again’.
Once more the King left Nessie in the room and locked the door behind him. Nessie looked at the people who filled every inch of floor space before her. As well as the many who looked extremely unwell, Nessie noticed that there were some who seemed only a little poorly and who she thought she could probably manage to treat with her current level of medical knowledge. Even so, Nessie knew that, even with help, she couldn’t hope to come close to curing everyone by morning.
In addition to those who were clearly in need of some medical attention, there were many others who Nessie thought could expect to get better without medical attention. As she talked to them, she discovered that they had come along because they were worried that their symptoms could be due to some more sinister underlying disorder. A wizened old imp like man, one with an undeniably curious way of dressing, had, it seemed, encouraged them to come, advising them that they really ought to be checked over because, as he had told them, ‘One really can’t be too careful’.
As Nessie chatted with the good folk who were gathered before her she also came across many who seemed to be completely well but who nonetheless had problems which, though genuine, didn’t seem to Nessie to require a medical solution at all. ‘Why’, Nessie wondered to herself ‘does the King expect me to be able to solve all these problems by myself. And why isn’t he here to help. Rather than simply burdening me, couldn’t he lend a hand. After all, as far as I can tell, many of the problems that these people are experiencing are down to how he’s choosing to run his kingdom.’
Nessie looked behind her hoping that the Professor of Medicine might once again be found there tapping her on the shoulder. But, alas, tonight he was nowhere to be seen. In the face of such demand not even medicine appeared to help.
Nessie realised then that she didn’t know the Professor of Medicine’s actual name. Mind you, she didn’t much care, she had plenty of names she could think of for the one who, having created such demand, had now abandoned her when she needed him most.
Tonight then, there was nothing for it. Nessie would have to go it alone. Even so, stretched as she was, she knew that good medicine would in large measure have to go out of the window. The room had but one and, looking through it, Nessie could see a long line of ambulances queuing far into the distance each one containing yet more individuals bringing with them their own unique and pressing needs.
Nessie’s heart sank. She’d already given up her lunch breaks, her evenings and her weekends. Now it seemed she would have to give up everything, trapped in a system she could not hope to ever escape.
And so Nessie fell to her knees for one final time. And she wondered if she’d ever get up off them again.
After ‘Rumplestiltskin’ by The Brothers Grimm.
Other GP related stories:
To read ‘The Happy Practice – A Cautionary Tale’, click here
To read ‘The Three Little GPs and the Big Bad Secretary of State for Health’, click here
To read ‘A Mission Impossible’, click here
To read ‘A Bear called Paddington’, click here
To read ‘Mr Benn – the GP’, click here
To read ‘Jeeves and the Hormone Deficiency’, click here
To read ‘The Dr Scrooge Chronicles’, click here
And now three blogs which, in my mind at least, make up a trilogy on the subject of burnout:
To read ‘Somewhere over the Rainbow’, click here
To read ‘When the Jokes on You’, click here
To read ‘With great power…’, click here
And one blog on the dangers of perfectionism:
To read ‘Professor Ian Aird’ – A Time to Die?’, click here
Some musings 
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