FROM A DISTANCE – REFLECTIONS AS THE NIGHTS START DRAWING IN

Ain’t it just like the night to play tricks when you’re tryin’ to be so quiet?
We sit here stranded, though we’re all doin’ our best to deny it

Bob Dylan – Visions of Johanna

I’ll spare you the embarrassment of me breaking into song but, as has been made very clear of late, a GPs lot is not an entirely happy one.

The last year and a half has been difficult professionally. And especially so in recent months during which time our workload has rocketed. But although it hasn’t helped, for me at least, it hasn’t simply been the busyness of the job that has made it less enjoyable. Rather it has been how we have been made to work.

I know I’ve banged on about this before but working remotely isn’t a remotely good way to work. It’s not good for our patients and it’s not good for us either.

It’s not good for our patients because, as research has shown, the more distant we are from those we interact with, the less we care about them. And the less we care about them the less we will be inclined to help. I suspect that my concern for my patients has been less this past year than perhaps it once was, and I feel that I’ve not been as good a doctor as a result, not that for one minute I’m suggesting I was ever all that great a one in the first place.

It was Bette Midler who wrote the song ‘From a distance’. In it she suggests that ‘form a distance’ it appears that we all have enough and that no one is in need. ‘From a distance’, she continues, there are no guns, no bombs, and no disease. And it would seem that there are no hungry mouths to feed.

Which only goes to show that ‘from a distance’ we haven’t got a clue about what is really going on. To live our lives separated from what hurts has its appeal of course ‘A rock feels no pain’ sang Simon and Garfunkel, ‘and an island never cries’. Looking on ‘from a distance’ makes life simpler, tidier, less painful. Even so the reality remains that life is generally complicated, it is frequently messy and all too often it hurts.

But being close enough to care makes us better doctors. And being better doctors is ultimately what will make us happier in our work despite the sadness we will undoubtedly experience in the process. That’s not to say that as doctors we will always be able to help. Often we can’t, not, at least in any material way. Henri Nouwen once wrote:

‘When we honestly ask ourselves which persons in our lives mean the most to us, we often find that it is those who, instead of giving advice, solutions, or cures, have chosen rather to share our pain and touch our wounds with a warm and tender hand. The friend who can be silent with us in a moment of despair or confusion, who can stay with us in an hour of grief and bereavement, who can tolerate not knowing, not curing, not healing and face with us the reality of our powerlessness, that is a friend who cares.’

Perhaps that is also the type of GP who cares. One who is not satisfied to look on dispassionately from a distance but who instead is willing perhaps to take a leaf out of the Beatles songbook. One who realises that it is only by letting others into our heart that we can we start to make things better. One who well knows that ‘it’s a fool who plays it cool by making this world a little colder’.

A couple of years ago retirement seemed an age away for me. Now it seems a lot closer. A few weeks back, after chatting about the imminent retirement of one my colleagues, a patient said to me, ‘You’re not thinking of retiring too are you?’. I replied: ‘All the time!’. But my partners needn’t worry, I’ve no immediate plans to go. But it’s only my being able to be close to patients again that will keep me in the job.

Because that’s what I enjoy. I need to enjoy my job, and my patients need me to enjoy my job too. For it is better to be cared for by someone who enjoys their work than someone who is dutifully going through the motions.

So let me hang some of these ideas on an example or two. On things that have brought me pleasure this year.

Firstly there was helping out at the local Covid vaccination centre. Without a doubt the most rewarding work I’ve done this year. To be part of a team doing something so simple and yet so genuinely worthwhile was immensely satisfying. Back then the daily death rate was at its highest – peaking at 1820 in a single day if memory serves me right. At the time it was tempting to console oneself with the thought that it was only the frail and elderly that were actually dying in any numbers, and that as such it somehow didn’t really matter. But in those early days it was the self same frail and elderly that were attending the vaccination centres for their jabs, each a representative of the cohort of people who were largely making up those whose deaths were being reported daily on the news. And what a warm, friendly, appreciative bunch of people they were. ‘From a distance’, it was just old people who were dying. Up close they were a group made up of delightful men and women.

And secondly there was that time up at one of the local nursing homes. I admit to having been a little frustrated to be called to visit a demented old man late one evening at the end of what had already been a busy on call day. He was ninety if he was a day and clearly close to death. The junior nurse showed me his TEP form which suggested that I should be admitting him to hospital but to my mind that seemed a far from sensible course of action. The nurse manager who, incidentally, started working at the home the same year I first worked at my practice, was there that evening. She said how she’d be sad if the man she’d known for 15 years died in hospital. So I spoke to his only relative, a younger brother, who agreed that he should be left where he was and simply kept comfortable. But what I found hugely touching was what the brother said next. ‘I want you know something doctor. That man is my hero – for caring for me when nobody else would.’

He didn’t say ‘He WAS my hero’ – he said ‘He IS my hero’. From a distance the patient was a demented old man with no quality of life, but up close he remained somebody who was someone else’s hero. It was good for me to be at that nursing home that evening. I was glad I was there.

We need to get close to our patients if we are to care for them as people rather than merely manage them as problems. Furthermore getting close to our patients increases the chance of them caring about us. Keeping our distance diminishes our patients even as it dismisses us as doctors. I hope we never think a contactless existence is the goal to which we should aspire.

Because there are too many people living contactless lives already. And some of those lives are immensely sad as a result.

Leonard Cohen, sometimes known as the ‘Godfather of Gloom’ on account for his reputation for writing songs that some consider depressing once wrote: ‘We all love a sad song. Everybody has experienced the defeat of their lives. Nobody has a life that worked out the way they wanted it to. We all begin as the hero of our own dramas in centre stage and inevitably life moves us out of centre stage, defeats the hero, overturns the plot and the strategy and we’re left on the side-lines wondering why we no longer have a part – or want a part – in the whole damn thing. Everybody’s experienced this, and when it’s presented to us sweetly, the feeling moves from heart to heart and we feel less isolated and we feel part of the great human chain which is really involved with the recognition of defeat’.

Sometimes I feel that sense of defeat at work, and sometimes outside of work too. But that’s ok. At least it is in my saner moments. Because I am of course getting older. I’m way passed my best, finished with growing stronger, and done with constantly striving to get better. Mine is a ‘necessary fallibility’. At my next appraisal I hope to talk with my appraiser, not about what I need to improve nor even what I can do to simply maintain the position I now find myself in but rather how I might best manage my inevitable decline! But though being defeated may be painful at times, it is not without meaning. Like Leonard Cohen in his song ‘The Goal’, I need to be able to smile a ‘smile of defeat’. For me that will only come from understanding that it is OK for me to lose when the one by whom I am defeated is one to whom I can happily surrender, one who is able to rule my life far better than I could ever rule it myself and is the one whose own apparent defeat led to what I consider to be the greatest victory of all, that over even death itself.

‘Anthem’ is another of Leonard Cohen’s songs. In it he sings ‘Ring the bells that still can ring, forget your perfect offering. There’s a crack, a crack in everything, that’s how the light gets in.’. I take that to mean that we should be content to do what we can and stop imagining we can ever be perfect. We learn through our mistakes, and sometimes it’s our mistakes that enable us to better understand. Bob Dylan expresses something similar in lines reflecting the fact that he knows he’s getting older and will soon die. ‘It’s not dark yet’ he says, ‘but it’s getting there’. Even so ‘behind every beautiful thing there’s some kind of pain’. I love these songs. I find them helpful. And I think the reason for that is the one that Cohen suggested, the connection that they make between those who feel the same.

I am of course grateful too for all the support that I have received from those I work alongside, both my clinical and non clinical colleagues some of whom are themselves finding life difficult. I hope I am never so wrapped up in my own problems that I am not a support to others. Because I really do like them, they are amongst my best friends and I couldn’t wish for a better bunch of people to go through life with. Or perhaps I could. I wish the colleague who is soon to retire could hang around longer. I am going to miss him. When he’s not there. Hugely. Because not only is he the best doctor I have ever had the pleasure to work with but he has also been a genuine and generous friend, someone I have known I could ring anytime day or night if I had need. And over the last twenty five years there have been times when I have had just such a need. When we first met in 1996 he promised me that he’d make me a millionaire as a result of some scheme he had back then of exporting medicines to America. Well I’m still waiting for that but I’ll forgive him because his friendship has been worth vastly more than a mere million pounds. His replacement has big shoes to fill!

But before you imagine that my life is all doom and gloom, let me assure you it’s not. Somerset had quite a good season this year and I enjoyed introducing my sons girlfriend to the joys of singing ‘Sweet Caroline’ with thousands of others one memorable August evening at the county ground in Taunton. There was the evening of laughter with my wife watching Ed Byrne at a packed Bridgwater Art Centre. Hilarious! And Bob Dylan recently had a cracking new album out and, at the age of 80, 24 years after he first noted the light was fading, he has, perhaps optimistically, just announced a new three year world tour. Hopefully I’ll get to see him on stage once more before he dies – because everything is better done live. The Korean food beautifully cooked by my daughter is best experienced when tasted rather than when seen via a photo shared on messenger. Things done remotely don’t come close! Oh and I nearly forgot, I have become a grandad too and after a hairy start my grandson is doing just fine. He too can now smile as well as cry. I’ve some lovely photos I could show you but he’s even more gorgeous in the flesh. It feels good to hold him.

In what has been a difficult year, these are things that have brought me pleasure. I have long considered that we make a mistake if we wait until there is nothing in life that makes us sad before we allow ourselves to be happy. Because, as it seems to me, happiness and sadness sit constantly alongside one another, we must allow ourselves to be happy even though there are things that make us sad just as we must allow ourselves to be sad even though there are things that make us happy.

Finally back to that song by Bette Midler. For me the saddest lines of the song are the ones suggesting that God is watching us from a distance. I don’t believe that’s true. Rather, I believe that He is close, intimately involved in my life, in all our lives and indeed in the lives of those who are struggling in circumstances far, far greater than our own. And though I’m aware that not everyone will share my faith I nonetheless believe that God really does knows what we are all facing, that He is in absolute control of it all, and that He will ultimately make everything right.

Written shortly before his death, ‘You want it darker’ contains, for me, one of Leonard. Horn’s finest lines. It goes like this: ‘There is a lullaby for suffering and a paradox to blame. But it’s written in the scriptures and it’s not some idle claim’

And it’s in those scriptures that I read that though weeping may tarry for the night, joy will come with the morning, that though I may fall I will nonetheless one day rise and that a day is coming when God will wipe away every tear from our eyes, and death shall be no more.

It’s promises like these that provide me with the hope I need to enable me to keep on keeping on irrespective of how dark it sometimes still seems.

And, from where I’m standing, I reckon that we can all have good cause to believe that that hope, that ‘hope of hopes’, is one which is very well founded indeed.

And so, for me at least, for this and for many other reasons, a GPs lot is not an entirely unhappy one either.

Continue reading “FROM A DISTANCE – REFLECTIONS AS THE NIGHTS START DRAWING IN”

A GRIMM TALE

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

THE HAPPY PRACTICE – A CAUTIONARY TALE

Once upon a time, not so very long ago, in a town close to where you live, there was a medical centre. It was positioned at the top of a hill where the people of the town could look up and see it as they went daily about their business. The people loved the medical centre and even those who rarely made use of it were glad to know that it was there. Even the Mayor spoke of how much it was valued and loved nothing more than to court popularity by praising its beauty. In time the medical centre became known as ‘The Happy Practice’ and the people would, on occasions, show their appreciation for all that it stood for by stepping outside of their homes and applauding all those who worked there.

But the ‘The Happy Practice’ was not really so happy because it was all too aware of how great the suffering was of so many of the people who lived in the town. One day, aware of the medical centre’s sadness and conscious of his own, having himself been disappointed by love, Dr Swallow, joined the practice in the hope that he might find some consolation for what might have been in his life by being a help in the lives of others.

The work was hard and Dr Swallow found that he was invariably tired by the end of the day. Even so, such was the sense of satisfaction that he gained from serving others that he found that he was always contentedly looking forward to the following day’s work when each night he at last came to rest his head on his pillow before slipping into a deep and peaceful sleep,

But no matter how hard he worked the suffering of the people never ended. And so the time inevitably cane when the medical centre asked Dr Swallow and all the others who worked there with him if they would do just a little more. And because they all wanted to help if they possibly could, Dr Sparrow and all his colleagues agreed.

So the doctors, the nurses, and the HCAs, the receptionists, the admin staff and the practice managers, they all worked a little harder. And as they did so they all grew a little more tired. The joy of the job began to wane a little as the time available to spend with friends began to be cut short and family occasions were not always made.

But despite their efforts the suffering of the people still continued. And soon the Mayor told the medical centre that it had to try and do more. And so, as well as working longer hours, Dr Swallow and those he worked with began to provide ever more complex care, care that once had only been given in hospitals. Everybody tried to do their very best but, with more to do but no more time to do it, sometimes things could not be done as quickly or as well as would have been like. In time a few of the people in the town started to become a little frustrated by ‘The Happy Practice’ and the Mayor began to say that he now thought the medical centre was not such a thing of beauty after all.

Meanwhile Dr Swallow and his colleagues just kept on – working ever more hard and growing ever more tired. So tired, in fact, that sometimes they couldn’t sleep at all.

But no matter how much the medical centre tried to meet the needs of those who came to them for help, the suffering of the people continued. The requests for help kept on coming, not only from the people but also from those who courted the favour of those who suffered despite they themselves being the cause of that suffering.

And soon the requests became demands with the Mayor warning the medical centre that it would ‘suffer the consequences’ if it didn’t work harder, if it didn’t do better.

So the medical centre strived all the more to provide all that was being asked of it even though, without the necessary additional sources, it became increasingly difficult to do so. Waiting times steadily increased until, in time, the delays which once were merely inconvenient for the people became unacceptable. Seriously unacceptable. Soon even ambulances were unavailable to attend the critically unwell.

But rather than being supported to do the job that was being asked of it, the medical centre was merely blamed for anything that went wrong. Even the local press joined the clamour insisting that the practice should deliver the impossible. A long letter was written claiming that the problem was simply the sheer laziness of those who worked there. Everyone quoted it so full was it of arguments that nobody understood.

And so in time, more and more of those who worked at what now could no longer truthfully be called ‘The Happy Practice’ became so tired that they were no longer able to work at all. Soon, understandably, they began to give notice, leaving behind an ever more struggling healthcare team.

And ‘The Happy Practice’ became less happy still. So unhappy that to many it became unsightly, something that many no longer seemed proud to have situated at the top of the hill in their town. The people no longer applauded and, though many, even most, remained quietly appreciative, not infrequently the sound now heard on the doorsteps of the people’s homes was that of criticism. And from a few, there came a hostility that would not even have been imagined possible only a few years previously.

And slowly the heart of ‘The Happy Practice’ was broken. And Dr Swallow decided one night to finally call it a day.

Soon after the Mayor, declaring that it was nothing but a disgrace, decreed that ‘The Happy Practice’ be pulled down. He insisted it was for the best. But he was wrong – it wasn’t for the best at all. For what had once been admired and appreciated soon came to be greatly missed by the people of the town. For, though their still suffered, and in time increasingly so, they no longer had anywhere to go for help.

Not now that Dr Swallow and the ‘The Happy Practice’ were gone.

Forever.

After Oscar Wilde’s ‘The Happy Prince’

But with the Guardian reporting that 23% of GPs are set to retire in the next few years this is not a fairy tale. And, as with Wilde’s original, not all stories can be guaranteed to have a wholly happy ending. If General Practice falls, the NHS falls too


Other GP related stories:

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

THREE LOCKDOWN SONGS

Three songs of lockdown…

TO MAKE YOU FEEL MY LOVE

As coronavirus cases climb
And locked down it feels we’re doing time
How I long to take your hand in mine
To make you feel my love

As the news it goes from bad to worse
And we lose those things we cherish most
How I wish that I could hold you close
To make you feel my love

They say restrictions they must stay for now
And so imprisoned we must be
They say one day that it will end, but how
If nobody has the key

And so behind a mask we still must hide
Concealing all of the tears we’ve cried
Until I walk again close by your side
And let you feel my love

Instrumental

The world is changing as is plain to see
Much that is precious has been lost
Perhaps some day we’ll all be virus free
But what will have been the cost

How much longer must we live like this?
How much longer must your touch I miss?
I hope that one day soon your lips I’ll kiss
To make you feel my love
To make you feel my love

IMAGINE

Imagine there’s a.country
It’s easy if you try
Where you must not give comfort
To grieving ones who cry

Imagine all the people
Living all alone

Imagine loved ones dying
It isn’t hard to do
Who as they face their final days
Are kept from seeing you

Imagine all the people
Kept always apart

You may say that I’m mistaken
That these thing could never be
But take a look around you
It’s already plain to see

Imagine no more parties
No sport, no theatre too
No singing songs together
What would you find to do?

Imagine all the people
Scared to show their face

Imagine empty high streets
No parks for kids to play
No jobs for those without them
So unemployed they’ll stay

Imagine all the people
Living lives concealed

You may say that we’ve no option
If we are to all survive
But if this is what is called living
Do we really want to be alive?

Now know that there’s a heaven
A better place to be
No pain no death no sorrow
A place where we’ll be free

Imagine all the people
Living there at peace

You may say that I’m a dreamer
Well I’m not the only one
I hope some day you’ll join us
And the world will be as one

LOCKDOWN DAY

Just a lockdown day
I don’t try to, even dress
Just eat and drink, to excess
That ain’t on

Just a lockdown day
Spend the time, so alone
Can’t do this all on my own
It’s no fun

Oh, it’s such a lockdown day
(I wish) I could spend it with you
All of these lockdown days
They just keep lingering on
They just keep us lingering on

Just a lockdown day
Loved ones I long to see
All of them kept from me
For too long

Just a lockdown day
Sadness fills every hour
Freedom no longer ours
It’s all gone

Oh, it’s such a lockdown day
(I wish) I could spend it with you
All of these lockdown days
They just keep lingering on
They just keep us lingering on

We’re going to reap, just what we sow
We’re going to reap, just what we sow
We’re going to reap, just what we sow
We’re going to reap, just what we sow

After Lou Reed


For more song adaptations please follow the links below:

To read ‘The Wild GP’, click here

To read ‘A Hard Year For us All’, click here

To read ‘Baggy White Coats’, click here

To read ‘What a wonderful job this can be’, click here

To read ‘I am the very model of a General Practitioner’, click here

To read ‘I’ve got a little list’, click here

To read ‘On Call Days and Mondays’, click here

To read ‘My Least Favourite Things’, click here

To read ‘My Most Favourite Things’, click here

To read ‘Yesteryear’, click here

To read ‘GPs – Do You Remember?’, click here

To read ‘Summertime’, click here

To read ‘GP Kicks’, click here

THE WILD GP

I’ve been a GP now for many a year
To all the NICE guidelines I’ve tried to adhere
But I’ve no idea why the CQC thinks
That urine samples can’t be poured down our sinks.

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

East Quay is a practice in Bridgwater town
The patients are lovely, the river is brown
At EQMC we all work as a team
And everyone’s awesome except for Doreen*

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

Each day you will find us we’re all hard at work
The phones in reception are going berserk
The patients who ring in then all indicate
The hue of the phlegm that they expectorate

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

These days of pandemic have made us all sad
But not everything at the practice is bad
The one very good thing ‘bout Covid 19
Is now our door handles are shiny and clean

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

We all wear our masks and our gloves of bright blue
My glasses mist over obscuring my view
But please do not worry, though blind I’ll not stop
I’ll still somehow muddle through your minor op

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

When busy on call days make stress levels rise
To drink too much coffee is really not wise
For there’s every chance when one’s bladder is full
There won’t be the time to answer nature’s call

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

On duty doc days though we’re jolly and bright
We’re cheery, and smiley, we’re just a delight
We grin and we laugh and we’re happy and gay
But that’s only when it’s the end of the day

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

And it’s no, nay, never
No, nay never no more
Will I play the wild GP
No never no more

An unplugged and frankly unhinged rendition of this poor excuse for song can be found here. Be warned it may be a learning four minutes.

https://share.icloud.com/photos/0cdtbd3RSysT4CQtI4MW2seDA#Bridgwater

*With apologies to ‘The Dubliners’…and Doreen who, though I wouldn’t want her to hear me say so, is actually awful awesome too!

The picture above is a photo of Luke Kelly one of the founding members of The Dubliners.


For more song adaptations and woeful attempts at poetry, all with a GP flavour, please follow the links below:

To read ‘A Hard Year For us All’, click here

To read ‘Baggy White Coats’, click here

To read ‘What a wonderful job this can be’, click here

To read ‘I am the very model of a General Practitioner’, click here

To read ‘I’ve got a little list’, click here

To read ‘On Call Days and Mondays’, click here

To read ‘My Least Favourite Things’, click here

To read ‘My Most Favourite Things’, click here

To read ‘Yesteryear’, click here

To read ‘GPs – Do You Remember?’, click here

To read ‘If’, click here

To read ‘Spare me a doctor’, click here

To read ‘I knew a Man’, click here

To read ‘Room Enough’, click here

To read ‘Old Hands’, click here

To read ‘Summertime’, click here

To read ‘GP Kicks’, click here

To read ‘How the grinch and Covid-19 stole General Practice’s Christmas’, click here

To read ‘’Twas the week bedore Christmas – 2020’, click here

THE THREE LITTLE GPs AND THE BIG BAD SECRETARY OF STATE FOR HEALTH

Once upon a time there were three young doctors who set out to be GPs.

The first little GP built his practice on enthusiasm.

One day the big bad Secretary of State for Health came knocking on the door of the practice where the first little GP was busy working hard.

‘Little GP, Little GP, let me come in’, said the the big bad Secretary of State for Health.

‘Not by the hairs on my chinny chin chin’, replied the first little GP.

‘Then I’ll huff, and I’ll puff, and I’ll bring your practice down’, said the Secretary of State for Health.

And with that the big bad Secretary of State for Health huffed and he puffed and, as a result of years of systemic underfunding of primary care services, he brought the first little GPs practice down. The first little GP had no enthusiasm left to rebuild the practice so he took a job as a barista in a local coffee shop instead.

As well as enthusiasm, the second little GP built his practice on good will.

One day the big bad Secretary of State for Health came knocking on the door of the practice where the second little GP was busy working hard.

‘Little GP, Little GP, let me come in’, said the the big bad Secretary of State for Health.

‘Not by the hairs on my chinny chin chin’, replied the second little GP.

‘Then I’ll huff, and I’ll puff, and I’ll bring your practice down’, said the Secretary of State for Health.

And with that the big bad Secretary of State for Health huffed and he puffed and, by introducing more and more red tape which made it increasingly difficult to get on with the job of caring for patients, he brought the second little GPs practice down. The second little GP had no good will left to rebuild the practice so he took a job stacking shelves in a local supermarket instead.

As well as enthusiasm and good will, the third little GP built his practice on evidence based medicine, an exceptional ability to adapt to change and large amounts of pragmatism and common sense.

One day the big bad Secretary of State for Health came knocking on the door of the practice where the third little GP was busy working hard.

‘Little GP, Little GP, let me come in’, said the the big bad Secretary of State for Health.

‘Not by the hairs on my chinny chin chin’, replied the third little GP.

‘Then I’ll huff, and I’ll puff, and I’ll bring your practice down’, said the Secretary of State for Health.

And with that the big bad Secretary of State for Health huffed and he puffed and announced that GP surgeries would be open in the evenings and on Saturday mornings for routine care.

But although the practice shook a little, the third little GPs practice stood firm.

The Secretary of State looked unhappy. He knocked on the door of the third little pigs practice again and, in as sweet a voice as he could manage, promised the third little GP lots of extra GPs to help get all the work done.

But no extra GPs were forthcoming and the big bad Secretary of State for Health stopped pretending to be nice.

And he began to huff and puff a second time.

This time he tacitly supported a media campaign making GPs out to be lazy ne’er do wells who were being paid large salaries whilst hiding behind locked doors and refusing to see those patients they were supposed to care for.

And again the third little GPs practice was shaken. But still, even with morale at an all time low, it did not collapse.

So the big bad Secretary of State for Health started to huff and puff for a third time and demanded that, despite the fact that they were working harder than ever before, little GPs across the country must work even harder still and promised to ‘name and shame’ any he felt weren’t pulling their weight.

And again the third little GPs practice was shaken. But still, even though it was on its knees, it did not collapse.

The third little GP carried on working and with the rest of the practice team did as good a job as they possibly could. But, over time, fewer and fewer young doctors decided to become GPs and as those who continued to work came to retire, many sooner than they had planned as the result of the job becoming ever more impossible, General Practice eventually was no longer sustainable and so became a thing of the past.

And the big bad Secretary of State for Health was happy at last.

But everyone else was sad and nobody lived happily ever after.


Other GP related stories:

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

A MISSION IMPOSSIBLE?

Bond looked at ‘M’, his hand shaking as he lifted the vodka martini to his lips.

‘Let me check that I’ve understand you sir. You want me to work undercover in a primary care setting. You want me to manage unprecedented patient demand, deal with ever more complex clinical cases and battle an increasing hostile press. The only gadget that ‘Q’ has come up with to assist me is a pulse oximeter. And I’m to kill no one?’

‘That’s right James. It’ll be your most challenging mission yet. Can I rely on you?’

‘I’m sorry sir. Such a mission is beyond even my astonishing capabilities. For that you’re going to need someone genuinely exceptional. For that you’re going to need… a GP’.*


[*And just to be clear, that GP will have to be far better than the one I am and will also have to be supported, as I am by an exceptional support team made up of other doctors, practice nurses, HCAs, receptionists, administrators, secretaries, pharmacy staff and, of course Practice managers. And let’s not forget those oh so vital cleaners!]


Other, all be it longer, GP related stories:

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

A GP CALLED PADDINGTON

Paddington woke up. He stretched out his arms and yawned the yawn of a bear that had grown accustomed to the comfort of sleeping in a soft bed in a warm house in Notting Hill rather than in a leafy tree in the rainforests of Peru. He emitted a contented growl as he slid his legs over the edge of the bed and made his way to the bathroom. Having washed his hairy face and attended to his impressive teeth, being a bear who was always careful to obey instructions, Paddington left the cotton buds in their packet and, as had become his custom, proceeded to clean his ears out with an electric toothbrush. Then, with a couple of puffs of Otomize, sprayed into each of his auditory canals to treat his unaccountably persistent otitis externa, he finally completed his morning ablutions.

Downstairs breakfast was almost over and Mrs Bird was already beginning to clear the table. Mr Brown however was still sat there reading the morning paper. Paddington noticed the headline on the front page. Once again it was being reported that GPs were irresponsibly refusing to see patients in their surgeries for face to face appointments.

‘I don’t know’, Mr Brown said to Paddington, noticing him as clambered onto a chair and began to help himself to a bowl of cereal. ‘Who’d be a doctor these days, what with all the bad press they seem to be getting? Sometimes I worry about whether Judy has done the right thing by going to medical school. Surely there must be better ways for her to make a living’.

Paddington continued to eat his breakfast. He was making something of a mess of things and it wasn’t long before Mrs Bird was fussing around him, mopping up the milk that was dripping off the table and collecting in small pools on the floor.

‘I hope you’re not planning on spending the whole day at home’, she said to Paddington. ‘I’ve already got plenty enough to do today without you making more work for me.’

Paddington thanked Mrs Bird for the breakfast and assured her that he had other plans for the day.

‘I thought I might go and see my friend Mr Gruber’, he said to her. ‘There’s something rather important I’d like to talk to him about’.

Paddington made himself a packed lunch made up solely of marmalade sandwiches which he then proceeded to balance on his head before covering them with his hat. Then he put on his old blue duffel coat and bright red Wellington boots and stepped out of the front door of number 32 Windsor Gardens. As he began to make his way down the steps to the street below he heard an angry voice coming from his neighbour’s house. Mr Curry was leaning out of the front window holding a phone to his ear.

‘Oi bear’, he shouted at Paddington ‘I need you to make yourself useful for once and post a letter for me. It needs to be in the post box at the end of the road before 10 o’clock. I can’t do it as I’m stuck here on the phone trying to get through to the GP surgery. I’ve already been kept waiting for 15 minutes and apparently there are still 37 other callers in front of me in the queue. What kind of service do you call that?’

‘I’m sure they’re all doing their very best’, replied Paddington, ‘I hear they are exceptionally busy at the moment and are struggling to cope with…’

Mr Curry was having none of it and interrupted Paddington mid sentence. ‘Don’t you start with all that rubbish about GPs being busy. The truth is that GPs are overpaid and lazy. They’re just scared of a hard days work and are taking advantage of all this nonsense about Covid-19 to make excuses as to why they can’t do their jobs properly. It’s not good enough. Some of us have urgent medical problems that need sorting. I’ve had a nasty wart on my finger for nearly a week now and I’m going to absolutely insist that somebody sees me about today.’

With that Mr Curry threw an envelope out of the window which landed at Paddington feet. Paddington picked it up and waved it cheerfully at Mr Curry. He then carefully slipped it under his hat explaining that that was where he kept everything that was important. He assured Mr Curry that he’d be sure to post it promptly.

‘Just be sure that you do’ Mr Curry growled at Paddington before slamming his window shut with such force that the glass rattled in the frame and Paddington thought for a moment that it might break.

Paddington continued on his way and before too long he was stood on the Portobello Road, outside the antique shop owned by Mr Gruber. Paddington pushed open the door, and as he did so a small bell chimed to announce his arrival.

‘Ah Mr Brown!’ Mr Gruber exclaimed emerging from the room at the back of the shop, ‘How very lovely it is for me to see you. Come in, come in. You are just in time for elevenses. I was just making some tea. Please join me and tell me what it is that I have done to deserve the honour of your company’.

Paddington sat down on an old chair. Mr Gruber poured them both a small cup of a tea from an old China tea pot and then, noticing that Paddington had a troubled expression on his face, asked his dear friend if anything was the matter.

‘Well it’s like this, Mr Gruber. Everyone seems to be blaming GPs for everything. Almost every day the newspapers have something unpleasant to say about them. Are they really the cause of all the problems in the NHS? And what about Judy? She seems such a kind young lady. Will she become mean and uncaring too after she’s been studying medicine for a few years?’

Mr Gruber walked over to where Paddington was sitting and sat down next to him. He smiled to himself as he placed the cups of tea on the small table that was positioned between them.

‘GPs aren’t the problem’, Mr Gruber began in his strong Hungarian accident. ‘And most of the people know it. But there are those who like to have somebody to blame and though it’s only really a very small number who have it in for GPs at the moment, they are making such a lot of noise just now. So you see Paddington, you shouldn’t believe everything that you read in the papers. If there’s one I know for sure it’s that not everything that’s reported there is strictly true. And something else I know for sure is this. You absolutely needn’t worry about Judy. She’ll always be as lovely as she is today.’

‘But why would reporters not want to tell the truth?’ asked Paddington.

‘Why indeed, Mr Brown Why indeed? Now drink your tea and l’ll see if I can’t find us something nice to eat’.

Paddington and Mr Gruber sat and chatted about how busy the NHS was and discussed what, if anything, could be done to make things easier for those who worked in what was, they both agreed, an organisation that needed to be supported rather than constantly criticised. After a while, Paddington stood up.

‘I think, Mr Gruber, that I had better get going. I think I’ll pop along to the doctors surgery that the Brown’s are registered at and see for myself just how busy they really are. Perhaps I could even lend a helping paw.’

And with that Paddington said ‘Goodbye’. He left Mr Gruber’s shop and made his way to the medical centre. It was about a twenty minute walk away and when he arrived it was approaching midday. Outside the front door of the building was a long queue of people. Paddington made his way to the front where a man was shouting at a receptionist and insisting that he be allowed to speak to the practice manager.

Paddington didn’t like the way the man was speaking to the lady behind the desk who was clearly close to tears. He gave a couple of firm tugs on the man’s sleeve in order to gain the man’s attention. The man duly stopped his tirade towards the poor receptionist and turned to look at the furry faced figure that was standing by his side.

‘Excuse me, sir,’ Paddington began. ‘I’m sorry to interrupt what I am sure is a very important conversation but I thought you might like to hear something that my Great Aunt Lucy used to say. She lives in a home for retired bears in Lima now but she always told me that ‘If we are kind and polite, the world will be alright’.

And with that Paddington wandered on into the main body of the medical centre, the man looking incredulously on as he did so. Slowly the man turned back to the receptionist, seemingly lost for words.

‘Was there anything else’, the receptionist asked him, her mouth now breaking out into a broad smile.

‘No, No, Nothing at all. thank you’, said the man. ‘Other than…’ He paused turning to watch as Paddington slipped out of sight. ‘Are you aware that you have bear in your health centre?’

Paddington, meanwhile, was making his way along a quiet corridor. At the end was a door. He pushed it open and found himself in what appeared to be a small store room. In front of him was a cupboard labelled with the words ‘Blood Bottles’. Paddington was a little concerned as to what might lie within so it was with some relief that, when he eventually summoned up the courage to open the door, he found that the shelves were all empty.

To his right was a trolly on which lay a strange looking machine, the like of which Paddington had never seen before. He looked at it closely and saw written over what appeared to be two handles, the words ‘Lift here’. Doing only what he was instructed, Paddington took hold of the handles noticing as he did so their shiny undersides. As he picked them up a light appeared on the machine and a voice that seemed to come from within the machine announced that a shock was advised. Paddington wasn’t quite sure what that meant but as he was pondering what he should do next the voice in the machine spoke again helpfully suggesting that he should press the button that had now started flashing insistently. Paddington clasped the two paddles to his chest with one hand and in so doing freed up the other hand to press the button as he had been directed.

Paddington wasn’t entirely certain what happened to him at that point but the next thing he knew he was he was lying on the floor looking up at the ceiling. Amazingly his hat was still on his head but the fur on his chest was badly singed, his body was covered with a soot like material and he noticed that wisps of smoke were spiralling out of both his ears.

‘Well that was a shock’, Paddington said to himself getting to his feet and brushing himself down. ‘Perhaps it would be better if I moved on and see if I might be able to offer my help more fruitfully elsewhere.’

Paddington made his way back down the corridor passing the reception area again and continuing on until he eventually came to a large room in which were a number of chairs placed in pairs, each pair a couple of metres away from any others. Only one chair was occupied. A young woman sat with her head down staring at the ground. She was fidgeting with her hands and she was having difficulty keeping her feet still. Paddington thought she looked sad and he went over to her seating himself in the chair next to hers.

‘What’s the problem’, he said to the woman who looked up at him, seemingly not registering the fact that she was being talked to by a bear.

‘Oh just everything’, she answered and with that she began to cry and proceeded to tell Paddington so many things that she was concerned about that Paddington didn’t know what to say. He thought it would be best therefore if he said nothing at all and decided instead to gently place his paw on the woman’s hand.

‘I’m sorry you’re sad’ he said, and as he did so a tear began to trickle down his cheek. As he sat there he remembered something else his Aunt Lucy had once told him, something she’d once read about how a real friend, a friend who truly cares, is someone who knows how to share the pain of another, who can stay with that person in their hour of grief and can face with them the reality of their powerlessness.

After a few minutes of silence, the woman looked up and smiled at Paddington, ‘Thank you’, she said. ‘It’s been lovely having you sat with me for a while. You’re a very kind bear.’

Just then a man stumbled into the waiting room. He staggered around until eventually he collapsed onto one of the chairs on the other side of the room to where Paddington and the young woman were sitting. He looked unwell. Very unwell. His skin was sweaty and he appeared confused. Paddington walked over to man and tried to make conversation but Paddington couldn’t make any sense of what the man was saying.

Paddington looked at the clock on the waiting room wall and noticing that the time was a little after one o’clock, had an idea. Perhaps, he thought, the problem was simply that the man was hungry. And with that Paddington lifted his hat and took the marmalade sandwiches that he’d made earlier down from off his head.

“Would you like to share my lunch?’ Paddington asked the man, ‘I never feel my best if I go without something to eat around this time of the day.’

The man didn’t appear to understand what Paddington was saying. He only seemed to be getting more and more unwell. Paddington, confident now that he’d diagnosed the problem correctly, forced open the man’s lips and pushed a little of one of the sandwiches into the man’s mouth. At first nothing happened but slowly the man’s colour returned and his speech became more coherent. Within a minute or two he’d stopped sweating and was sat upright in the chair smiling.

At that moment a doctor rushed into the room having been called by a receptionist who had noticed the sick man when he had first lurched into the building a few minutes previously.

‘What’s up?’ gasped the doctor, catching his breath after running as fast he could from his room on the other side of the building. He’d been busy all morning seeing other folk who were unwell and had just been admitting a patient who was acutely short of breath with what he suspected was a pulmonary embolus.

‘Nothing now, doc!’ smiled the man. ‘thanks to this ‘ere bear! I’d given myself too much insulin this morning and I was having another one of my hypos. But this young bear’s marmalade sandwich has put me right good and proper so it has!’

Paddington didn’t really understand what the man was saying but was glad he was clearly feeling very much better. A number of other people were now gathering in the waiting room and every single one of them was looking at Paddington. Paddington smiled back at them, taking a mouthful of what was left of the half eaten sandwich. ‘Would anyone else like I bite?, he asked. ‘I find that most things seem better after eating a small amount of marmalade’.

It was then that another receptionist walked into the room. She was looking somewhat alarmed. ‘Dr Mungo’, she said nervously. ‘There are some people here to see you. They say they are from the CQC’.

The receptionist stepped to one side revealing the two men and one women who were stood there behind her. They were all wearing smarts suits and clutching clipboards. None of them were smiling. The woman, who seemed to be the leader of the group, stepped forward.

‘We’ve come as a result of reports we’ve received that there is a bear on your premises. As you’ll be aware this is entirely unacceptable and if true will undoubtedly lead to the practice being rated as inadequate and having to shut down immediately’.

The room fell deathly silent. But then the man who had until recently been so unwell, stood up and approached the group of officials. ‘I’ll have you know this young bear just about saved my life’.

‘That’s as maybe sir. But how well a bear may or may not have managed your particular condition doesn’t change anything. The presence of a bear within the walls of a GP practice is a clear contravention of the guidelines that have been laid down to ensure the safe running of medical centres and I am afraid that I therefore have no option but…’

At this point the CQC inspector stopped talking, her eyes drawn to Paddington who had also stood up and was now looking at the woman intently. In fact, so intently was he looking at her, he might even be said to have been staring, one of those hard stares that Aunt Lucy had taught him to give to those who were acting in ways of which they should be ashamed. The inspector flushed, obviously embarrassed by her behaviour.

‘…but perhaps’ the woman continued slowly, ‘we can make an exception in this case. In fact, it will be my recommendation that this practice be rated as ‘Outstanding’, and I will see to it that you won’t face any further inspection for at least three years’.

With that the team of inspectors turned and left the building and everybody started clapping in delight. Somebody shouted ‘Three cheers for Paddington’ and before long a song started up, the gist of which seemed to be that everyone was happy to agree that Paddington was ‘a jolly good fellow’. Paddington however was feeling uneasy and his ursine features could not conceal the fact. Dr Mungo, noticing something was up, stepped over to where Paddington was sat and asked him what the matter was.

‘It’s this letter’, said Paddington, holding out the envelope that Mr Curry had thrown at him earlier. ‘I promised my neighbour that I’d post it by 10 o’clock but I completely forgot. It was only when I went to get my sandwich out from under my hat coat and it fell on the floor that I remembered. And now it’s too late and I won’t be able to post it on time’.

Dr Mungo took the letter form Paddington and laughed. ‘It’s OK, Paddington’, he said. ‘look at the address. It’s a letter for here! And if I’m not very mistaken I recognise the handwriting. It’s that of somebody who is always writing letters of complaint to the practice. I’ll file it with the others!’

Paddington was delighted by the news that Mr Curry’s letter had safely arrived at it’s intended destination. ‘Oh I am glad’, he said, ‘because it is so important one keeps one’s promises’. He paused for a moment. ‘Dr Mungo, try not to be too hard on Mr Curry. I don’t think he means to be unpleasant, it’s just that he doesn’t seem to have much that makes him happy. I think perhaps his life may have been rather hard’.

‘Don’t worry Paddington‘ said Dr Mungo smiling, ‘I’ll do my best to follow the advice of an old Peruvian bear who I believe once said that, ‘If you look for the good in people, you’ll generally find it’.

Paddington smiled. ‘Oh that’s so true, Dr Mungo. Aunt Lucy certainly is a wise old bear. But before I leave you to get on with your work, here’s something else she used to say. ‘However busy you are – always stop for lunch’.

And with that Paddington removed his hat and held out to Dr Mungo what was left of his lunch. ‘How do you fancy a marmalade sandwich?’ he said.


For those of you who may be wondering where Aunt Lucy gets all of her considerable wisdom from, the answer, at least in part, may be from Henri Nouwen. In his book ‘Out of Solitude’ Nouwen wrote these words which seem to be the basis for what Paddington was trying to remember his Aunt Lucy telling him when he was sat with the young woman in the story:


Other GP based stories:

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

Other related posts:

To read ‘The Repair Shop’, click here

To read ‘General Practice – a sweet sorrow’, click here

To read ‘Eleanor Rigby is not at all fine’, click here

To read ‘Hearing the grass grow’, click here

To read ‘The Dig – it’s well worth it’, click here

To read ‘On managing disappointment’, click here

To read ‘Reintroducing GPs Anonymous’, click here

And lastly a couple of blogs which, just so as you know, contain expressly Christian content.

To read ‘Sleep well’, click here

To read ‘Waiting patiently for the Lord’, click here

THE GENERAL PRACTITIONER – ENDANGERED

THE GENERAL PRACTITIONER

Clinicus resilensus

DISTRIBUTION:

First introduced in 1911, General Practitioners rapidly became indigenous across the United Kingdom and Northern Ireland following the establishment of the NHS in 1948. They have been considered ideally positioned for pretty much everything ever since.

HABITAT

Although commonly found walking the aisles of the local supermarket during late night shopping hours or overseeing the secondhand book stall at the school summer fête, the principal habitat of the GP is the medical centre. Leaving their burrows and making their way to their consulting rooms an hour or two before dawn they typically remain at their desks until long after dusk. During the middle part of the day, however, they will often venture out and be found in peoples homes, instinctively drawn there by their desire to help the most frail and infirm. Whereas once they could be encouraged to prolong their visits by being proffered cups of tea and pieces of cake, GPs have latterly found it unsettling to leave their medical centres for longer than strictly necessary, preferring instead to return to deal with the countless phone calls that will have come into the medical centre whilst they’ve been away, determining which will require a face to face appointment and then working out how they are to be squeezed into that afternoon’s already busy schedule.

IDENTIFICATION:

GPs come in a wide range of shapes and sizes and vary greatly in the extent to which they employ displays of colour to stand out from their otherwise often drab surroundings. Early in the morning some GPs can be seen clad in brightly coloured lycra riding their high spec bicycles. A more portly subspecies of the genus can be identified by the threadbare jumpers that they wear and the way that they gasp and wheeze as they make the short walk from their car to the back door of the practice building. The characteristic call of the GP is however universal and consists of a high pitched wail often heard alongside the sound of somebody banging their head against a brick wall. Under extreme pressure, such as might be the case when having to deal with a global pandemic, most GPs will revert to a plumage made up entirely of blue. This makes them entirely indistinguishable from one another especially given the obligatory blue latex gloves and surgical face masks that are also worn at such times.

BEHAVIOUR:

Though at times they are active at night, GPs have a principally diurnal existence. They are both industrious and highly pragmatic creatures that are, by nature, capable of dealing with the wide range of problems that are presented to them with a combination of ingenuity and patience. They are easily startled when approached aggressively but if treated gently are by and large amiable souls who will generally try to help those who come to them in some kind of need with a degree of kindness and compassion. Reports of adverse events following GP encounters are mercifully low, with comparable patient mortality rates being recorded irrespective of the gender of the GP encountered thus giving the lie to Kipling’s assertion that ‘the female of the species is more deadly than the male’.

DIET

By day GPs are largely dependent on the coffee and custard creams brought to them by kindly receptionists at designated feeing times. In addition they will sometimes forage for additional foodstuffs in the practice’s kitchen area. In contrast, at weekends GPs confine themselves to the consumption of orzo and fennel along with any other ingredients that may have been mentioned in the Ottolenghi recipe they stumbled across in that Saturday’s edition of The Guardian.

LIFECYCLE:

GPs are hermaphrodites with both male and female GPs being able to bring forth young GPs. The parent GP then takes on the responsibility for the nurturing of their offspring with the fledgling GP typically remaining under their wing for the first year of his or her GP life. During these formative months they are encouraged to act increasingly independently by being asked to take on the most complex of home visits solely because they have been identified by the parent GP as those which will afford ‘the most excellent training opportunities’. Having demonstrated the skills necessary to survive on their own, the young GP then leaves the safety of the training nest to join a separate colony of GPs with whom they will spend the rest of their adult life.

SURVIVAL PROSPECTS:

In recent years GP numbers have been in decline. Whereas once the GP could be expected to survive well into their 60s, the increasingly hostile climate means that few now achieve this degree of longevity having previously either drowned under the excessive workload or, alternatively, killed themselves trying to deliver the impossible. Furthermore, many younger GPs are now considering a change of career with many looking at retraining as HGV drivers seeing the delivery of fuel and other essential items as a more sure way of fulfilling their childhood dreams of wanting to help people. Matters have been made worse with the proliferation of attacks on GPs by a new predator that has recently emerged. These Journalists (Reporteramus deceptionus) are employed by national newspaper editors who love nothing more than having a GP headline displayed on the front page of their daily periodicals. Sadly, calls to introduce legislation to ban the hounding down of GPs have fallen on deaf ears with many to whom such calls have been made enjoying taking part in a spot of GP baiting themselves. In recent years the government has pledged to increase GP numbers by releasing thousands more into the community but as yet this boost to the GP population has not materialised.

SURVIVAL STATUS: ENDANGERED


Related posts:

To read ‘Professor Ian Aird – A Time To Die?’, click here

To read ‘What Price Resilience?’, click here

To read ‘Mr Benn – the GP’, click here

To read ‘The Dr Scrooge Chronicles’, click here

To read ‘Jeeves and the Hormone Deficiency’, click here

To read ‘Reintroducing GPs Anonymous’, click here.

To read ‘My Back Pages’, click here

MY MOST FAVOURITE THINGS

Patients you help and who start to feel better
When you receive an appreciative letter
Duty doc days when the fat lady sings
These are a few of my most favourite things

Those in the office who suffer frustration
Making some sense of my dodgy dictation
Those in reception whose phone always rings
These are a few of my most favourite things

Helpful consultants who hear my entreaties
Practice Nurses who can treat diabetes
She who each morning hot coffee me brings
These are a few of my most favourite things

When the day’s hard
And I’m left scarred
And I’m feeling sad
I simply remember my most favourite things
And then I don’t feel so bad

Health care assistants who though lunch approaches
Don’t meet my heart trace requests with reproaches
Stories of patients with happy endings
These are a few of my most favourite things

Patients who know of my love of malt whiskey
How every evening my dog shows he’s missed me
Those who each year send me Christmas greetings
These are a few of my most favourite things

Those on the days that the workload it tests you
Friends who are colleagues who come to your rescue
Managers skilled at what work at them flings
These are a few of my most favourite things

When the press lies
It’s no sur-prise
That I’m feeling blue
But then I remember my most favourite things
And focus on what is true.

After Oscar Hammerstein II and Richard Rodgers


For more song adaptations and woeful attempts at poetry, all with a GP flavour, please follow the links below:

To read, ‘My Least Favourite Things’, click here

To read ‘What a wonderful job this can be’, click here

To read ‘GPs – Do You Remember?’, click here

To read ‘Baggy White Coats’, click here

To read ‘If’, click here

To read ‘I am the very model of a General Practitioner’, click here

To read ‘A Hard Year For us All’, click here

To read ‘On Call Days and Mondays’, click here

To read ‘Yesteryear’, click here

To read ‘Spare me a doctor’, click here

To read ‘I knew a Man’, click here

To read ‘Room Enough’, click here

To read ‘Old Hands’, click here

To read ‘I’ve got a little list’, click here

To read ‘Summertime’, click here

To read ‘GP Kicks’, click here

To read ‘How the grinch and Covid-19 stole General Practice’s Christmas’, click here

To read ‘’Twas the week bedore Christmas – 2020’, click here