Early morning taking bloods Thinking we looked cool in scrubs Spot tests in anatomy Lectures in virology Teaching rounds consultant led Stood around the patient’s bed Asked what we could not recall Made to look a silly fool
Oh what fun we had But did it really turn out bad Learning at med school How best to bend not break the rules Oh what fun we had But at the time it seemed so bad Trying different ways To make a difference to our…
Hours spent on labour ward Trying not to look too bored Four foot primip Mum to be Not much chance of an NVD Incidence and prevalence Being taught the difference Epidemiology Always was a mystery
Oh what fun we had But did it really turn out bad Learning at med school How best to bend not break the rules Oh what fun we had But at the time it seemed so bad Trying different ways To make a difference to our…
Folk in pain from retention Wanting speedy attention Catheters brought quick relief Gratitude beyond belief Clerking patients whilst on take Trying hard to stay awake Through the night ‘till break of day Post take ward round’s on its way
Oh what fun we had But did it really turn out bad Learning at med school How best to bend not break the rules Oh what fun we had But at the time it seemed so bad Trying different ways To make a difference to our…
Long white coat and stethoscope Oxford Handbook our one hope Telling us when we’d no clue What it is that Doctors do Patients who were feeling icky Venous access proving tricky Siting venflons back of hand Seldom went as well as planned
Oh what fun we had But did it really turn out bad Learning at med school How best to bend not break the rules Oh what fun we had But at the time it seemed so bad Trying different ways To make a difference to our grades
Baggy white coats, baggy white coats, Baggy white coats, baggy white coats, Baggy white coats, baggy white coats, Baggy white coats, baggy white coats.
After Madness
And if it’s madness you’re after a rendition of this song is available here
Related Posts:
To read, ‘What a wonderful job this can be’, click here
‘Some people think football is a matter of life and death. I assure you, it’s much more serious than that.’
So quipped Bill Shankly, the former manager of Liverpool F.C. Even so, a week on from England’s defeat in the Euro 2021 final, most of us, if we ever cared at all, will have got over our disappointment that, once again, football wasn’t coming home after all. Despite Shankly’s assertion, we will have come to realise that, whilst an enjoyable distraction, whether England won or lost wasn’t really all that important at all. It is perhaps only those whose lives have nothing of greater value to worry about who will still be struggling with the heartbreak of yet another penalty shootout defeat and only those who are so insecure in who they are themselves that will feel the need to vilify those they see as responsible for the disappointment that they continue to feel.
Even so, we all know what it is to feel disappointment when things that we have looked forward to don’t materialise in the way we had hoped they would. Many of us, if we haven’t holidayed already, will be anticipating times away from work and all the more so given how pressurised General Practice has been of late. Though it will be good to have that much needed break, it won’t be just a few of us who will experience some disappointment related to our holidays this year. For some of us it will be because our week or two away won’t turn out to be as enjoyable as we had hoped, others of us won’t quite be able to avoid taking with us some of the sadness that we would have liked to have left at home, and for others of us our disappointment will come simply because, however great our vacation experiences turn out to be, they will inevitably eventually come to an end and we will be forced to return to a normality that, for some of us at least, is far from how we would like it to be.
But if we can experience disappointment because our two weeks in the south of France is ruined by the lack of a decent local boulangerie, how much more must the disappointment be for many of our patients who don’t have the luxury of being able to look forward to any time away from the difficulties that they face. For some of them it is not merely disappointing individual incidents that they struggle with but rather an overall, all encompassing, disappointment with how their lives have turned out, be that on account of the social deprivation that they have to encounter daily, the poor physical health with which they suffer or the deep personal sadnesses from which there is never any prospect of any even temporary escape. And then there are those who are facing the prospect of death which, after even the most satisfying of lives, is still unwelcome and a cause for disappointment that the good times are now forever over.
So how are we to help those with whom we consult who come to us with such a sense of disappointment that it is hard for them to carry on. And how are we to cope with our own disappointments when they inevitably materialise in our own lives. Because unlike a lost game of football, not all disappointments can be dismissed by a realisation that the thing that brings us sorrow never mattered at all in the first place.
Whilst it is true that we are all sometimes more disappointed about things than we need be, to sing along in nihilistic agreement to the closing lines of Bohemian Rhapsody that ‘nothing really matters, nothing really matters to me’, makes fools of us all. Because some things really do matter. Our disappointment is a measure of how far things are from how we want them to be. Though unpleasant, it is not an unhelpful feeling, given how it speaks to us, not only of the difficulties that we are currently experiencing but also the better circumstances that we all so long for, testifying perhaps that things can and indeed should be better.
This last week I was sat on Whitesands Beach not far from St David’s in Pembrokeshire watching people enjoying themselves playing in the sea. For some reason, despite wanting to, I didn’t feel able to join them irrespective of how awesome I would undoubtedly have looked with my wetsuit on and ‘Atom’ emblazoned across my chest like some modern day comic strip superhero! My feelings were similar to those I almost always experience at discos, if indeed discos are what they are still called. On such occasions you will always find me on the edge of the dance floor, too self conscious to show off my highly original and frankly alarming dance moves and resorting instead to clutching a pint and simply wishing I could enjoy myself by joining in with those who are dancing and clearly having such fun in the process. I wonder if this somewhat melancholic experience is one that others of us sometimes have, one in which we are all too aware that genuine happiness really is to be found out there somewhere but that it somehow always remains elusively just out of reach.
It was C.S. Lewis that wrote ‘Most people, if they had really learned to look into their own hearts, would know that they do want, and want acutely, something that cannot be had in this world. There are all sorts of things in this world that offer to give it to you, but they never quite keep their promise…If I find in myself a desire which no experience in this world can satisfy, the most probable explanation is that I was made for another world.’
As I say then, our disappointment has real meaning, speaking to us of a better tomorrow that really is out there for us to enjoy. And, welcome though it would be, I am not referring here to an England victory in next year’s World Cup! On the contrary, regarding our desire for something better, Lewis continues that ‘Probably earthly pleasures were never meant to satisfy it, but only to arouse it, to suggest the real thing. If that is so, I must take care, on the one hand, never to despise, or be unthankful for, these earthly blessings, and on the other, never to mistake them for the something else of which they are only a kind of copy, or echo, or mirage. I must keep alive in myself the desire for my true country, which I shall not find till after death; I must never let it get snowed under or turned aside; I must make it the main object of life to press on to that other country and to help others to do the same.’
If Lewis is right then medicine needs to stop imagining that it can bring about a utopia of perfect health, still less that which not even a fortnight on the Côte d’Azur can bring about, a world characterised by perfect happiness that never ends. That is something that medicine simply cannot deliver, not with a pill, not with a procedure, not even with a course of therapy. On the contrary, even the happiest of lives come to an end and when death does eventually inevitably draw near, medicine has no answer save to ease an individuals passing. This is not to say that palliative medicine isn’t hugely important, only that we make a mistake if we believe that there is ever such a thing as a truly good death. Because there isn’t, not at least for those who believe that our lives matter and that death, however less bad it can be made, is never truly good given the loss it entails and the end of what might otherwise have been.
Rather then than imagining itself to be the answer to everyone’s problems and in so doing only serving to disappoint those who do come to rely on it too heavily, medicine needs instead to play its part in helping others to press on to that other country of which Lewis speaks.
And so, whilst not being it’s main role, I believe medicine needs to make room for other philosophies and, acknowledging it’s limitations, be honest enough to at least suggest to patients that the answers to their greatest needs may be better found somewhere other than in the treatments we sometimes all too readily offer, in something bigger and better than all that even medicine has to offer. And, for me at least, that will, on occasions, involve me encouraging my patients to consider God, in whose presence, ancient wisdom tells us, can be found both fullness of joy and pleasures for evermore. [Psalm 16:11].
Recognise this and perhaps both we and our patients will be better able to cope when the bad times come, regardless of whether the associated disappointment is caused by circumstances, others, or ourselves. Furthermore we may be better able to enjoy more fully the good times when they come without our requiring them to be more than they actually are, without our requiring them to be perfect. Instead we can enjoy them, recognising them to be the echoes of those endless yet better times to come which so many of us continue to look forward to. And when that hope is finally fully realised, as I believe it one day will be, when every tear is wiped away and death is no more [Revelation 21:4], we will discover that it will more than amply compensate, not only for those missed opportunities to go wild on the dance floor, the absence of fresh croissants on our holiday breakfast tables and the consequences following a missed penalty kick, but also for all the genuinely heartbreaking disappointments in our lives, even that of death itself.
For then it will not be football that’s coming home – it will be we ourselves who are homeward bound. And having arrived there and found that we are home for good, I for one can’t imagine ever being disappointed again!
Postscript:
Later in the week I finally overcome my former reticence and adopted my altered ego of ‘Atom Man’ and so braved the waves of Newgale. It was good to forget myself and to feel, not lost or insignificant, but still wonderfully small, happily caught up and enveloped in something immensely bigger and vastly more impressive than I will ever be.
But by golly it was cold!
Related blogs:
To read, ‘Because sometimes not even chocolate is good enough’, click here
To read, ‘Covid-19. Does it suggest we really did have the experience but miss the meaning’, click here
To read, ‘Something to reflect on – are we too narcissistic?’, click here
To read, ‘Towards a more compassionate resilience’, click here
To read, ‘Health – it’ll be the death of us. Is there institutional arrogance in the NHS?’, click here
To read, ‘Waiting patiently for the Lord’, click here
Apart from that incident involving a lemon, a stained glass window and the irate members of the parochial church council, I haven’t picked up a golf club in anger for many years. Whilst it is true that I was soundly beaten over 18 holes last summer by my octogenarian father-in-law, it should be remembered that that was just a friendly encounter without any competitive element whatsoever.
Well at least that’s my story and I’m sticking to it. And no you don’t want to know the score. And whilst it’s true that he was 81 at the time, it should be remembered that he was, and indeed remains, remarkably good for his age!
Furthermore, what he didn’t tell me when I agreed to the match, was that, not only had the cataract in his one good eye been dealt with, but also the artificial limb fitting he’d been waiting months for had been brought forward and he was thus now able to stand upright without the support of a walking aid.
Unbelievable!
But the reason why my lack of proficiency at golf has been on my mind lately is that, like my dog, who, though formerly always eager for his early morning walk, now looks at me as if I am mad if I so much as even hint that we might start the day with more than a single circuit of our local field, I too am getting older.
As for Barney, we were thinking of sending him to ‘The Repair Shop’, that wonderful place where things of great personal value are restored to their former glory. Our hope was that ‘The Bear Ladies’ would be able to work their magic and thereby be able to blacken his nose, re-fur his balding back leg, and freshen up his breath.
But sadly of course, none of that is possible and instead the fact that he is ageing has to be accepted. And so, just as Emily loved a saggy old cloth cat, one who was a bit loose at the seams, so we too love a dog who has long been dear to us and will always remain so despite his sometimes pungent aroma.
I’m not sure if it was ever really a thing, but the idea of a GP finding time for a round of golf between morning and evening surgeries has long gone – these days we’re lucky if we’re able to squeeze in a cup of tea and a trip to the tiniest room in the practice building. But though playing golf seems to be something that a good number of retired folk enjoy spending their latter years doing, I can’t see myself following their example.
The other reason that retirement has recently been on my mind is that a few weekends ago I went to a reunion of the eight partners who worked in the practice when I joined it almost 25 years ago. Only two of us are still working, and in five months time that number will be reduced to one when I become the longest serving doctor in the practice.
As we dodged the showers in the garden where we gathered, it was good to reminisce about the good times we had shared together – and to be reminded also of how fortunate I was all those years ago to land myself a partnership with such a lovely bunch of people. And to realise how my good fortune has continued as, with each successive retirement, a replacement partner has been found who has been just as much a joy to work with as those who have left. It seems odd to think that the partner we are now seeking is likely to be the last who will join the practice before the search begins for someone to replace me.
And when that time comes, as it surely will, a replacement will most certainly be found. Because for every Andy Murray whose best years are in the past, there is an Emma Raducanu starting out with a bright future laid out before them. This is not to imply that my racket skills are any better than my prowess with a driving iron, only that, like a certain dour Scotsman, I too have passed my best before date.
Which got me thinking as to how I might approach my next appraisal. Rather than striving to set targets by which I might pretend to seek to ever improve, perhaps now is the time to get real and instead identify goals by which I might manage my inevitable decline.
This is not to suggest that we cease being useful once we retire, on the contrary, there is of much that we can contribute as we get older, but it is nonetheless true that what we can offer others does, in time, inevitably reduce.
But before anyone thinks this is simply me being all maudlin and questioning what worth we have as our capacity to be useful begins to diminish, let me tell you about somebody I once met who was also past his best.
Visiting the nursing home which had been his home for some 15 years, I was ushered into a room to see a frail elderly man, not quite yet 90 years of age. Not being my patient I’d not met him before but as I looked at him sitting uncomfortably and uncommunicatively in his chair, his mouth hanging open and his eyes tightly shut, it was clear that his life was drawing to a close. It was tempting to dismiss him as a demented old man whose apparent imminent death would surely be of little significance.
My attention was then drawn to a TEP form which seemed to be out of date since it suggested that hospital admission should be considered in the event of becoming unwell. And so I spoke to those who knew him best.
Firstly I chatted to the senior nurse manager who had been acquainted with him throughout his time at the home and who cared enough about him to express that she would be sad if he were to die in hospital. And then I spoke to his only relative, a younger brother who, after saying that he felt sure that hospital was best avoided, added words which I will not easily forget.
Barely able to control his voice, I was only just about able to make out what he said:
‘I want you to know something Doctor. That man is my hero. As a boy, he looked after me when there was no one else to’.
I found those words intensely moving on account of the fact that he didn’t say ‘He WAS my hero’, but rather ‘He IS my hero’.
Four words that whispered something that needs to be heard loud and clear.
The fact that a ‘demented old man’ remains somebody else’s hero is worth pondering. Or at least it is for me. Because it is all too easy for me to sometimes self importantly, mistakenly imagine that I am more significant than others and foolishly dismiss as of no value those I casually deem to have no practical use.
Furthermore we all need to recognise that we too will all one day pass our best before date. Even as we do though, our worth will remain, just so long as someone, somewhere cares enough to remember who we are, who we once were and who, despite our palpable defeat, we might yet one day become.
The truth is that, even as we mentally and physically decline, when we don’t know one end of a golf club from the other and are unable to walk five metres in a day, let alone in the four seconds that we are required to if we are not be considered frail, our worth nonetheless remains.
Because even though our best before day might have long since passed, our value remains.
And extends well beyond our sell by date.
To read ‘Bleak Practice’, a story based around the home visit described above and another genuine real life home visit, click here
Don’t know much about anatomy Don’t know much physiology Don’t know much about the CCG Don’t know why we have the CQC But I do know that as a GP ‘Cos of those who work along with me What a wonderful job this can be
Don’t know much about nephrology What the ‘C” is for in CRP Don’t know how to read an EEG Why no Zantac’s in the pharmacy But I do know that I can see ‘Cos of those who still consult with me What a wonderful job this can be
Now I don’t claim to be a good doctor But I’m trying to be For some day by being a good doctor – maybe I could please the GMC
Don’t know much about anion gaps Don’t know how to do those pleural taps Don’t know much about such a lot Don’t know quite what’s in my pension pot But I do know that it’s still OK If I only help just one today What a wonderful job this can be.
After Sam Cooke.
Far from a wonderful job however is the rendition of this song that can be found here
take full responsibility, follow the links below. Audio versions are available for those marked with an asterisk. There are others, but these are the least worst!
For me, the last few weeks have been crazy busy and, I suspect, they will have been no less so for you. Nevertheless I have had some fun moments. A highlight for me was meeting one of the Mister Men. Patient confidentiality prevents me from mentioning his name but it will I think suffice to say that, not only was his skin not as vibrant as I’d expected, but neither were his arms as long as I’d been led to believe they would be.
And then there was the patient who, noticing that she had a lump ‘down below’, thought she might have a uterovaginal prolapse.
Being a lady of a certain age she was initially a little reticent at exposing that most intimate part of her body to me on account of my being a chap but, eventually, she rationalised her decision to allow me to have a look with her assertion that I’d no doubt seen more of the anatomical structure in question than she’d had hot dinners.
So we did a calculation.
Hazarding a guess that the days on which she had eaten nothing but cold food would be no more than 20% of the total number that had made up her life, we came up with a conservative estimate that the number of cooked meals she’d eaten during her almost 95 years was 27,695.
At which point I assured her that I’d not seen anywhere near the number she imagined I had of the aforementioned body part.
It made us both laugh – and that seemed to matter.
But even so, the last month ot so has been busy – dangerously busy. And oftentimes it has been hard. The phrase ‘unprecedented demand’ has considerable precedence when used in the context of GP workload but these last few weeks certainly have seemed to have been busier than I can remember it ever having been before. General Practice has felt like it has been under siege with every day seeing us called upon to deal with far more patients than anyone could possibly conceive that we could ever manage properly. As such the work, as well as being less enjoyable and satisfying, has, for me at least, felt less worthwhile too.
The reasons for the surge in demand are many and varied but amongst them would be that some patients are now feeling brave enough to come forward with problems that previously they had felt too anxious to bring to our attention, that long hospital waiting times have resulted in patients repeatedly having to turn to their GP for the care that they might otherwise have received from specialist teams and, of course, that the uncertainty and fear generated as a result of the pandemic has seen a huge increase in the number of mental health problems being presented to primary care.
There will be undoubtedly be many other reasons for why demand has increased but over and above these understandable and appropriate reasons for patients wanting to consult with us, I wonder if there is another, more existential, cause.
With increasing numbers of people no longer believing that there is a better world to come, be that in this life or the next, and fewer of us experiencing any hope for a brighter tomorrow, too many of us are insisting on our best life now. We are increasingly unwilling to wait for what the media tells us we should expect our lives to be characterised by, namely an absence of pain and inconvenience and an abundance of happiness and fun.
But real life is not like that. Though we may be able to airbrush our social media profiles, we cannot airbrush out those aspects of our life that are not to our liking. And, despite the best efforts of health care professionals, neither can medicine.
Even so, the expectation remains and the attempt to do so goes on. When medicine is portrayed as possessing a god like omniscience, is it any wonder that so many people bring their problems to us, promised as they have been that we can provide for them the solutions they desire.
The truth though is that medicine does not posses the resources or ability to deliver the answers it does not have.
If things are ever going to get better, we, our patients, and the policy makers who continue to demand of us what we cannot deliver, are all going to have to recognise both our limitations and the limitations of the profession that we are a part.
Because good health begins, not with good medical care, but with having something worth being healthy for. And that’s something that increasing numbers of people are finding that they do not have, some, for the first time perhaps, as a result of the wider consequences of the coronavirus pandemic.
And for as long as a packet of fags, a bottle of scotch and a Happy Meal are the highlights of our lives, so we will continue to seek, and fail, to find our happiness in such things.
In his book ‘Walden’, Henry David Thoreau wrote that ‘the mass of men lead lives of quiet desperation’. That may have been true once but now that same desperation is becoming ever louder such that now it is a deafening roar. Even so, still the desperation remains and many are still set to ‘go to the grave with the song still in them’
As more and more people experience what Leonard Cohen once said we sooner or later all come to know, that is the ‘defeat of our lives’, the question becomes will they continue to expect medicine to provide a way back? Or will they instead be encouraged to look elsewhere for the help that so many of them so desperately need?
And that, of course, includes us.
Many of us are increasing feeling overwhelmed and threatened by the demands put upon us. Under siege we continue to try to fend off all attacks yet succeed only in finding ourselves imprisoned behind the barricades we have erected in our forlorn attempts to stave off defeat. Perhaps it is time instead to at last appreciate that since medicine does not equip us for the battle in which we are engaged, ours is a fight that we can not ultimately hope to ever emerge as victors. Recognise this and we may find ourselves free from always having to win, free from always having to be the ‘NHS Heroes’, that, inundated as we are now, it is all to clear none of us were ever cut out to be.
And then who knows, we might just find that we are able to find some satisfaction, some enjoyment, even some fun, in our work once more.
We might even meet Mr Happy!
Related Blog:
To read, ‘Luther and the Global Pandemic – on becoming a theologian of the cross’, click here
‘Ah, but I was so much older then, I’m younger than that now.’
As a boy, I spent my early years playing. I did not endeavour to please anyone as I did so, though my parents no doubt were happy to see me having the fun that all children ought. I did not seek to play better than those I played with – what would be the point? I simply played, and was glad to do so.
Then came school and, though I did not seek to impress, I was, from time to time, rewarded. Stars for pleasing the teacher. And I saw that the number of stars I received was compared with those that were bestowed on others. I was, I realised, in competition with my peers.
School continued and the tasks set me became more complex – the rewards more contingent on my reaching a certain standard. ‘Work hard’, they said, ‘and you might do well – you might progress’. Which I did. But there was always a next stage, never a point beyond which one could simply stop and rest.
And so I continued on to university – where those who strived hardest secured the best jobs. Then, inevitably, came work. And the rewards dried up, replaced now by the threat of sanctions. Instead of rewards for achieving, now there were punishments – even for those who were simply standing still. Good enough was no longer good enough. ‘You must improve’, they said, ‘You must be better, you must do more’.
And then, finally, came criticism. Initially implied, then explicit. It was not merely that I was not good enough, rather it was that I was to blame.
So harder and harder I worked until, finally, I stopped – exhausted – defeated.
And I realised I had grown old. And not only in years
Oh for a lesser load, and a little rest, for a yoke that was easy and a burden that was light. Oh to be treated gently, by someone strong enough to cope with my weakness, someone who, rather than treating me harshly and constantly demanding of me ever increasing levels of perfection, was lowly of heart. Oh to be cared for by someone accepting, someone forgiving, someone who could, and would, provide for me the long desired perfection I had long been striving for and thereby offer me rest for my soul.
And so I remembered my days as a boy. And I sought to become like a child again, someone who was wiser than the foolish adult I had become, someone who accepted his need of help. And as I did so I looked to simply enjoy doing what it was that I was meant to do.
Because the world can be a cruel taskmaster and competing in a misguided attempt to prove our perfection makes losers of us all.
Perhaps though there is someone out there who, even now, is glad to see me imperfectly endeavouring to do what is right, someone who cares for me, someone who isn’t only out to criticise and condemn. Perhaps there is someone out there who loves me that much.
I happen to believe there is.
If I’m right, what a relief that would be!
[‘My Back Pages’, is the title of a song by Bob Dylan from which the line ‘Ah, but I was so much older then, I’m younger than that now.’, is taken. It appears on the 1964 album, ‘Another Side of Bob Dylan’. This blog is an updated version of one originally written in 2018. It expresses, of course, more of an aspiration of where I would like to be rather than where I actually am. As with much in life, we journey on to become what we already really are.]
Sometimes, being a GP feels like something akin to being a Womble – that’s right, sometimes it seems that we are dealing with rubbish all day long!
But that’s not the only reason I feel an affinity to those inhabitants of Wimbledon Common that scurry around, diligently clearing up after others. Nor is it simply because one of those fury little creatures takes his name from the town in which I live. And no, I do not live in Tomsk and, though I may be a little on the short side (5’4” thank you for asking), neither am I particularly hirsute. My Wombleness is much more layered than that.
‘People don’t notice us, they never see.
Under their noses a GP might be
We GP by night and we GP by day
Looking for ways to take problems away.’
Furthermore we all sometimes find ourselves having to dance. But even though the one on which we are led may seem a merry one, it is a dance that we are accompanied by nothing as delightful as the Minuetto Allegretto. Instead we are encouraged to quick step to the cacophony of sound that emanates from NHS England and the media, and to waltz to the unearthly din generated by the government, QoF and the appraisal process.
‘Oh slave now like your partners
Young GP’s were told
With satisfact’ry colleague feedback
You will work ‘till you’re old’
Unless of course you burnout young.
More positively though, like Wombles, GPs are organised, work as a team. GPs are tidy and’, for the most part at least, ‘GPs are clean’. Furthermore we are ‘so incredibly utterly devious’, that lesser known Womble characteristic that enables us to make good use of the things that we find, irrespective of how limited those resources that we come across actually are. Just as it is with Wombles, so it is with we GPs – our communities would be a lot messier without us. Our work is hugely valuable and, though our efforts may not be valued by some, most of our patients, really do appreciate all that we do.
So…
When the sun doesn’t shine and it’s cloudy and gray
And it’s only the beginning of the GP-ing day
And the CQC inspectors say that they’re on their way
…
When the phones are going crazy and you just can’t see
How you will even find the time to drink a cup of tea
And every patient says that you must see them urgently
…
When the newspapers are saying things that just aren’t true
And everyone is laying blame for everything on you
And they’re telling you exactly what it is you’ve got to do…
Remember you’re a GP (Remember you’re a GP) Remember you’re a GP (Remember you’re a GP) Remember you’re a GP (Remember you’re a GP) Remember you’re a GP (Remember you’re a GP)
Remember, member, member, what a GP, GP, GP, you are.
And remember too just how loveable and cuddly you really are!
And with that, like Orinoco, I’m off to get an extra 40 winks!
Oh, where have you been, my GP team? Oh, where have you been, whilst you I’ve not seen? We’ve worked every day of this dreadful pandemic We’ve managed all kinds of conditions systemic We’ve delivered shots at the Covid vaxs clinic We’ve tended the folk whose hearts are ischaemic We’ve been close at hand to those emphysemic And it’s a hard, and it’s a hard, it’s a hard, it’s a hard It’s been a hard year, for us all
Oh, what did you see, my GP team? Oh, what did you see, whilst you I’ve not seen? We’ve seen face to face those we needed to We’ve seen desperation in not just a few We’ve seen the dyspnoeic as they became blue We’ve seen all the poorly requiring review And palliative people their dying all through And it’s a hard, and it’s a hard, it’s a hard, it’s a hard It’s been a hard year, for us all
Oh, what did you hear, my GP team? Oh, what did you hear, whilst you I’ve not seen? We’ve heard news reports that caused us to bridle We’ve heard people saying that GPs were idle We’ve heard some denying the pandemic viral We’ve heard people crying – fighting for survival We’ve heard those describing their thoughts suicidal And it’s a hard, and it’s a hard, it’s a hard, it’s a hard It’s been a hard year, for us all
Oh, who did you meet, my GP team? Oh, who did you meet, whilst you I’ve not seen? We’ve met with so many their mood melancholic We’ve met young and old with a too high systolic We’ve met those in pain from their biliary colic We’ve met breathless people from causes embolic We’ve met those depressed by hardship economic And it’s a hard, and it’s a hard, it’s a hard, it’s a hard It’s been a hard year, for us all
Oh, what’ll you do now, my GP team? Oh, what’ll you do now, you who I’ve not seen? We’ll watch as the problems towards us they throng And lean on each other to somehow stay strong And wonder how long all of this may go on And whether or not we still want to belong In a job where some things they seem sometimes so wrong Cos it’s a hard, and it’s hard, it’s a hard, and it’s hard It’s been a hard year, for us all.
After Bob Dylan’s ‘A Hard Rain’s A-Gonna Fall’ – in the week of his 80th birthday.
And if you want to make this year a little harder still for you to bear, a rendition of this song is available here
For more song adaptations and woeful attempts at poetry, all with a GP flavour, please follow the links below:
Today is the Glorious 13th – the day that marks the start of the GP shooting season. Admittedly, this year, many seemed to have jumped the gun but, with headlines a plenty in the national papers, it is clear that the annual tradition of having a bop at your local provider of primary care services is, once more, well and truly underway.
This is not to suggest that the criticisms aren’t entirely appropriate, it’s not as though we’ve been experiencing unprecedented demand of late, or that we have had to struggle to balance the twin concerns of managing patients safely whilst avoiding unnecessary contact in light of a global pandemic. On the contrary, we have all been enjoying more time on the golf course having finally been able to take up that executive club membership as a result of the vast profits we’ve made from administering Covid-19 vaccinations.
In recent years it’s been increasingly accepted that GPs are to blame for most of the problems in the NHS and being a GP is now, quite rightly, seen as something for which we ought to be ashamed. Surely, then, it’s time we considered getting ourselves some help.
Whether it be our delayed diagnoses, our inappropriate admissions or our failure to offer enough appointments, it’s time to face up to the uncomfortable truth, GPs are the problem. Having for years been told this repeatedly it’s finally time we listened. The facts, as they say, speak for themselves – it really is all the fault of we GPs.
We must deny it no longer. We must stop trying to convince ourselves we’re OK and instead acknowledge our failings. After all, if we don’t, how can we expect anything to be done to help us. We will just go on making our own life, and everyone else’s, miserable.
Everyone’s aware of how embarrassing GP behaviour can be. You know the kind of thing, how we love to spoil people’s fun by advising those with a fever and a new continuous cough not to visit their great aunts for tea or how we refuse to allow our waiting rooms to fill up with patients who wish to discuss the sudden loss of their sense of smell. Without a doubt it is selfishness such as this that leads to A&E departments being inundated with such patients who are thus forced to waste precious hours of their time seeking a proper medical opinion.
And then, of course, there is our wilful ignoring of patients whose symptoms clearly suggest that they have cancer but who we deliberately neglect to refer preferring instead to put an unnecessary burden on secondary care services by recklessly admitting patients to hospital just for the fun of it.
So let’s all face up to our problem. I’ll go first by introducing myself:
My name is Peter – and I’m a General Practitioner.
If you’re similarly afflicted, come and join me – I’m setting up ‘GPs Anonymous’ in the hope that together we can support all those who are stricken with the affliction that is ‘being a GP’.
But perhaps you’re still not convinced that you have a problem. If so, can I urge you to ask yourselves these four screening questions? Answer two in the affirmative and you may have a problem – answer ‘Yes’ to all four and you’re in real trouble.
C – have you ever felt you wanted to cut down how much general practice you do?
A – have you ever been annoyed by criticism of your actions as a GP?
G – have you ever felt guilty for what you have done as a GP?
E – have you ever started doing your ‘GP thing’ early in the morning?
Extra phone lines will be installed should demand for this new service prove overwhelming.
But why do people fall into the destructive behaviour patterns that are characteristic of general practitioners? Some have suggested that in some cases there may be a genetic component – seeing your parents behaving as GPs seems to predispose some to follow a similar path. Mercifully, however, this is becoming less common. Others experience a little bit of general practice early on in their medical career and naively imagine that it’s a good thing – something that they can control. After all, just one attempt at a ten minute consultation can’t hurt can it? But before long they’re out of control – only in it for the extortionate pay, the long hours of ‘off duty’ and the kicks one gets from the systematic mismanagement of those who thought they were there to help.
It’s a tragic condition but now, with the arrival of ‘GPs Anonymous’, there is at last some real hope for change. So please give generously, together with your help, this year we can rid the country of the blight that GP’s have become.
And then won’t everyone be happy?
[This is a reworking of something I wrote previously. Apologies to those who may have seen it before but sadly it continues to seem ever more relevant today.]
Today I sat outside a shop, the rain it pitter pattered, But even though ‘twas cold and wet to me it hardly mattered. For I took consolation in, something that’s quite unhealthy, A shortbread slice adorned the way so loved by those who’re wealthy.
.
But as I then about me gazed, beneath those skies of grey I saw ‘twas only me who ate that treat baked in a tray. No millionaire did with me share, as I sat there and shivered, On days like this I guess the rich have their cakes home delivered!
unrelenting sadness lingers hope slips through her outstretched fingers no pill can tend a grief like this and words well meant their target miss with soulful eyes replete with tears she sinks beneath a sea of fears together though, we stand in line her breaking heart now breaking mine.
It was Good Friday, but now, as surely as day follows night, sunshine follows rain, and a more normal life will surely one day follow this pandemic, it’s Easter Sunday. A day to both remember and celebrate the most significant event in history, a source of hope powerful to sustain in even the darkest of days.
The following is an updated version first posted last year.
Easter Morning. The tomb is empty and Jesus is raised. Obviously.
I say obviously because it never could have been any other way. Some people have a problem with that – they say irrational things like ‘Dead people don’t come back to life – that’s simply impossible’. But the Bible says just the opposite, the Bible says it was impossible for Jesus to stay dead!
‘God raised him up, loosing the pangs of death, because it was not possible for him to be held by it.’ (Acts 2:24)
Granted, the dead rising to life again is not a common occurrence. But if the rationale for you not believing in the resurrection of Jesus boils down to, ‘It can’t happen, so it didn’t happen’, then you are not being intellectually honest with yourself, drawing your conclusions on preconceived assumptions which are not based on fact. And it’d only take a resurrection to happen once for you to have to change your point of view.
At the end of a lecture he had given on the reasons for his atheism, noted philosopher Anthony Flew, was once asked the question, ‘But what if Jesus was raised from the dead?’. ‘Well,’ he replied ‘If Jesus was raised from the dead, that would change everything’. His response was consistent with his lifelong commitment to go where the evidence led, a commitment that would, a few years before his death in 2010, ultimately lead to him coauthoring a book which was entitled ‘There is a God’.
It was the apostle Peter who made the above statement regarding the impossibility of Jesus staying dead. It is interesting to note the change that had occurred in Peter since Good Friday. After Jesus’ arrest he had been running scared, denying to everyone that he had ever even known Jesus. But here, on the day of Pentecost, just seven weeks later, he stands and publicly proclaims, to a crowd of thousands, the reality of the resurrection. The reason for the change in Peter isn’t hard to find: ‘This Jesus, God raised up,’ he says, ‘and of that we all are witnesses.’ (Acts 2:32).
Like Anthony Flew, Peter had followed the evidence.
The evidence for the resurrection is well documented and a couple of links follow for those interested:
But why was it not possible for Jesus to stay dead? This is a philosophical argument and is based on the nature of death and the underlying reason for it. We tend to think that death is normal – the inevitable end to the wearing out of our bodies after long years of use or, alternatively, the tragic result of some violent insult, overwhelming infection, or malignant growth, something that our bodies cannot withstand. But the Bible says that there is a more fundamental reason for why we die. And that, it says, is because of sin.
Death is not part of how things should be – rather it is a travesty, the consequence of the presence of the wrong that is in the universe, the penalty for the sin of which we are all guilty – myself more than anyone. An awareness of this opens the door to our being able to better understand how Peter can make his assertion that it was not possible for Jesus to stay dead.
It is because Jesus was sinless, that death could not hold him.
If we struggle to believe anything about the Easter story, it shouldn’t be the resurrection of Jesus – that bit stands to reason. The amazing part of the story is that he ever died at all. That the author of life should die is a great mystery – but die he unquestionably did. As it is for his resurrection, the evidence for Jesus’ death is overwhelming, even being attested to by a paper published in the Journal of the American Medical Association in 1986. You can read it here:
So what then was the reason for Jesus’ death? The answer to that can be given in one word: Love. The love he had for those he came to save, those he was willing to lay down his life for, [John 10:15], those for whom his death would bring eternal life.
The reason that Jesus’ was born in the first place was ‘to seek and save the lost’ [Luke 19:10]. As the apostle Paul once wrote, the ‘saying is trustworthy and deserving of full acceptance, that Christ Jesus came into the world to save sinners’ (1 Timothy 1:15).
Jesus knew this and understood that the salvation he had come to achieve would be realised through his death. ‘The Son of Man must suffer many things’ he said, ‘and be rejected by the elders and chief priests and scribes, and be killed, and on the third day be raised.’ (Luke 9:22). That is the reason why, when the time of his crucifixion drew near, Jesus ‘set his face to go to Jerusalem’. (Luke 9:51).
Jesus went to Jerusalem on purpose, with the expressed intention of dying there.
But why did he have to die? More than that, why did he have be killed? Why couldn’t he have simply slipped away quietly in his sleep at a ripe old age? The answer to that question is that ‘the wages of sin is death’ (Romans 6:23). If justice is to be upheld, sin must be punished, and the penalty for sin is death.
We all want to live in a just universe – we cry out for justice when we see others maltreated especially when that injustice is particularly great or when we are find that it is who are the ones who are experiencing the injustice. The only time we are unhappy with justice is when we are guilty! I believe speeding drivers should suffer a penalty but many were the excuses I had for why I shouldn’t have had to attend the speed awareness course I was invited a few years ago!
God is, by his very nature, holy. He is perfectly right, perfectly just. And if he is to remain just, His standards must be he upheld. We, on the other hand, are not what we should be. We know, if we are honest, that we don’t live up to even our own standards let alone those of a holy and righteous God. Therefore, since as has been already been said, the ‘wages of sin is death’, we have a problem. We all deserve death, myself included and, unless a suitable substitute can be found, we face the prospect of experiencing that punishment ourselves.
But this is where the bad news of the law of God becomes the good news of the gospel. Because, not only is God holy and rightly angry at injustice he is, at the same time, merciful and gracious. God gave his only son to be a penal substitute, one who would act as the wrath absorbing, justice satisfying, atoning sacrifice for our sins. One who would gladly take our place and suffer for us the punishment we deserve.
At this point it is important to remember the mystery of the Trinity. God, though one, is three persons. We are not, therefore, seeing here a loving Jesus who absorbs the wrath of an vengeful despotic God. On the contrary, Jesus is himself fully God even as he is fully man. And the Father and Son, along with the Holy Spirit are one. As the Father loves the son, so the son loves the Father. Therefore, the death of Jesus, planned and agreed by all three persons of the Godhead before time began, and pointed too throughout the Old Testament [see for example here and here] reveals a loving Father every bit as much as it reveals a loving son,
The Old Testament prophet Isaiah had, some 700 years prior to the crucifixion, prophesied how God would one day lay on Jesus our sin and punish him in our place: ‘But he was pierced for our transgressions;’ he wrote, ‘he was crushed for our iniquities; upon him was the chastisement that brought us peace, and with his wounds we are healed. All we like sheep have gone astray; we have turned, every one, to his own way; and the LORD has laid on him the iniquity of us all.’ (Isaiah 53:5-6).
Jesus, because of his love, both for his Father and for us, willingly took on our sin and died in our place so that we need not suffer that punishment ourselves. He was put to death so that ‘whoever believes in him should not perish but have eternal life.’ (John 3:16). For our sake [God] made [Jesus] to be sin who knew no sin, so that in him we might become the righteousness of God. (2 Corinthians 5:21).
That is, God treats Jesus as if he had lived like us so that he can justly treat us as if we had lived like Jesus. This is what it means to say that God loves us. It’s not that he thinks everything about us is just peachy, but rather that he treats us well despite how little we deserve his kindness. He loves us, not because we are lovely, but because he is loving.
And how great is that love with which he loves us. We cannot conceive how vast that love is. ‘For as high as the heavens are above the earth, so great is his steadfast love towards those who fear him; as far as the east is from the west, so far does he remove our transgressions from us’ [Psalm 103:11-12]
‘In this is love, not that we have loved God but that he loved us and sent his Son to be the propitiation for our sins.’ (1 John 4:10). ‘The wages of sin is [indeed] death, but the free gift of God is eternal life in Christ Jesus our Lord.’ (Romans 6:23). ‘And this is eternal life, that [we] know…the only true God, and Jesus Christ whom [he has] sent.’ (John 17:3).
This then is how God loves us. Jesus death is not just a sign of God’s love, it is an act of love too, one that achieves our salvation. One that achieves our rescue. If I’m walking along the river with my wife and I turn to her and say ‘Darling, I love you so much and because I want to show you how much I love you I’m going to throw myself into the river’, and then, having made my declaring, I promptly proceed to do just that and drown, I am, what is commonly known as, an idiot! If however, as we walk along the riverbank she falls in and begins to drown, and I jump in to rescue her but, in so doing, lose my own life, then I have acted out of love. I will have demonstrated my love by my actions, by what I have done, by what I have achieved. I will have done a loving thing, but one that is no where near as loving as that which was done by the son of God who, of infinitely greater worth than I, died for those who were only deserving of death.
God then, in the death of his beloved son, at great personal cost, rescues us from himself so that we might enjoy knowing him forever, no longer having to live in fear of his righteous anger towards us. God’s justice was satisfied by his wrath being directed toward another, toward Jesus, the one who willingly absorbed it all for us on the cross. So completely did Jesus’ death pay the penalty for our sin that there is now no longer any of God’s anger left over to be directed at us. That is what is meant by Jesus’ death atoning for the sins of those he died for. That is the meaning of ‘propitiation’ in the verse above. God hasn’t merely laid aside his anger at sin only for it to rise up again at some later date, on the contrary, it has gone for good, even as it was fully poured out on Jesus.
That is why Jesus, as he hung on the cross, cried out ‘My God, my God, why have you forsaken me?” (Mark 15:34). Remarkably God was turning his back on the son he loves so deeply in order to save we who have ourselves turned our back on God. And it why the apostle Paul can write that ‘There is therefore now no condemnation for those who are in Christ Jesus.’ (Romans 8:1). All condemnation towards those whose only hope for salvation lies in Christ is gone! The job of satisfying the requirements of the law and thereby maintaining God’s justice even as he forgives we who have sinned and deserve death is complete. As Jesus died he said ‘It is finished’ (John 19:30). He wasn’t talking about h8s life, rather he was talking about his work of atonement. And he was right, the resurrection on Easter morning proving that his sacrifice really was fully effective in paying the price for all that we have done wrong. God’s grace really is completely sufficient for even the chief of sinners.
Rest assured, knowing God for all eternity will not be dull like some people imagine. We have all had moments in our lives when we have experienced something truly beautiful – a glorious sunset perhaps, a magnificent mountain view maybe or perhaps waves crashing powerfully against a rocky coastline. These are awesome sights, ones to be fully enjoyed enjoyed. But they are mere a faint echo of what we will one day experience, they will pale into insignificance when we see God face to face, when heaven is on earth and the dwelling place of God is with man. ‘He will dwell with [us], and [we] will be his people, and God himself will be with [us] as [our] God. He will wipe away every tear from [our] eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things [will] have passed away.’ (Revelation 21:3-4).
Seeing God and experiencing that future new creation will be infinitely more satisfying than the happiest times this world has to offer, better even than Easter Day. And the prospect of that future joy might just be enough to sustain us through the saddest times this world affords – days like Good Friday.
Easter morning – the tomb is empty and Jesus is raised.That’s good news – but not unexpected. It was always going to happen.
It was Good Friday.
But now it is Easter Sunday.
Obviously.
Happy Easter.
Addendum:
If you have read thus far, I am (a) surprised [I believe the expression is TL:DR – Too long: didn’t read] and (b) grateful. Thank you.
I am aware that this has been long but some things need more than the length of a tweet if one is to have any chance of conveying their importance.
I am also aware that there will be some, perhaps many, who will consider what I have written as naive, irrelevant and perhaps even offensive. If that is you I trust you’ll accept my words as a genuine attempt to explain things I hold to be of first importance for us all to know and understand. If, as a doctor, I genuinely believed I had a life saving cure for your terminal illness, you’d consider it cruel of me if I withheld that treatment from you even if you didn’t share the belief in its effectiveness. So consider me foolish by all means, but I hope you’ll not consider me unkind in writing as I have. If one can not write of these things at Easter time, then when can one write of them? For all that however, I hope that there may be others who will agree with what I have written and, rejoicing with me at the news of Jesus’ life death and resurrection know that this news is simply too good not to share.
I saw it again this week, tears amidst the laughter, smiles amidst the sorrow.
The first occasion came whilst I was watching an old episode of ‘The Repair Shop’. As an item of great sentimental value was returned to its owner, the recipient’s joy at its restoration was evident even as they were overwhelmed by the sadness brought on by the distant memories of the one with whom it was once associated. There was pleasure in the sadness, heartache in the delight.
And there it was again, in my patient. Distraught, she sat crying in my room, all hope seemingly lost. And yet, as we chatted, there was a smile, and then a laugh. Not one that indicated, even for a moment, that the sadness had gone. But there it was none the less, evidence that even in the darkest of moments there was still a glimmer of light.
And it’s there in my own life too, genuine causes for sorrow sitting alongside sources of real joy, not least that associated with the excitement of hearing the news that I’m to be a grandfather. Sadness and happiness coexisting, neither one ever entirely absent, each simultaneously both intensifying and diminishing the other
Sorrowful yet always rejoicing.
Even in the good times, we can not deny the existence of sadness. And neither, on the darkest of days, must we imagine that there is nothing we can take pleasure in. Perhaps we cannot know what happiness really is without knowing the pain of sorrow and, for sorrow, to be fully realised, perhaps it requires the experience of knowing what it is to be truly happy. If so, if we are to be happy, it must be alongside our sadness. We must neither wait for the absence of sorrow before allowing ourselves to be happy nor deny our sadness because there are things to be happy about. Life is not black or white, it is a kaleidoscope of grey. It is not that we can not be happy because we know sadness, nor that we can not be sad because there are things to be happy about, but that, paradoxically, we can be happy and sad at the same time.
We can smile, therefore, even as we cry.
We too need to learn what it is to be sorrowful yet always rejoicing.
Today is Good Friday, a day like no other to ponder such things, as we wait for Easter Sunday.
What follows is something I originally posted a year ago. I find it helpful to consider these things, so as to make life more meaningful, more understandable, and more bearable. Perhaps you will to.
Because even the eternally happy God knows what it is to sometimes cry.
One Maundy Thursday I wished a good friend of mine a happy Easter break. He hesitated however to return my good wishes because, he said, that he understood that Good Friday was a day for Christians like me to be miserable. It got me thinking to what extent he was he right.
Paul, writing in his second letter to the Corinthians, describes Christians as, ‘Sorrowful yet always rejoicing’ [2 Corinthians 6:10]. If such a paradoxical existence was the reality for Christians back in Paul’s day, it is surely no less true a reality for Christians living the 21st Century. ‘Good Friday’, the name we give today, is itself a paradox – for how can we apply the adjective ‘good’ to describe the day of Christ’s crucifixion? For sure, it is a day on which Christians should grieve over their sin and what it was that Jesus had to suffer in order to secure their redemption, but, at the same time, it is a day for rejoicing in the triumph of his sacrifice as we anticipate and remember his subsequent resurrection from the dead on Easter Sunday.
‘Sorrowful yet always rejoicing’ – it was the experience of Paul and it was also the experience of Jesus himself. For he was himself ‘a man of sorrows and acquainted with grief’ [Isaiah 53:5]. Matthew recalls the words of Jesus to Peter, James and John, in the Garden of Gethsemane:
“My soul is very sorrowful, even to death; remain here, and watch with me.” [Matthew 26:38].
And yet the writer to the Hebrews has it that Jesus, ‘for the joy that was set before him endured the cross’ [Hebrews 12:2].
Suffering, then, is not the end of joy – it can even be the passage to joy. Again this is not a contradiction – but it is a paradox! A paradox that the second thief, even as he was being crucified alongside Jesus, understood. There he was, in just about as bad a position as it is possible for a person to be in, minutes away from an excruciating death, when he, nonetheless, made his remarkable request:
‘Jesus,’, he said, ‘remember me when you come into your kingdom’ [Luke 23:42].
Like everybody else that day, the second thief saw Jesus suffering and dying on a cross. But unlike the religious rulers, the Roman soldiers and the other thief who was also being crucified that day, he didn’t see defeat. He continued to speak of Jesus as one who was coming into his kingdom. For him Jesus’ death didn’t mean an end to all the kingdom and salvation talk. Whilst all those others, those who mocked Jesus as they watched him die, were looking for a salvation FROM death, the second thief saw that the salvation Jesus was bringing about was a salvation THROUGH death.
Jesus’ death wasn’t the end of Christ kingdom, on the contrary, his death was its beginning.
This is a profound truth – one we do well to try and grasp some understanding of.
Far from a simple faith, the second thief’s faith was remarkable. And it is on account of his wonderful faith that we should not be surprised by Jesus when he responds to him with these words:
‘Truly, I say to you, today you will be with me in paradise’ [Luke 23:43].
Jesus saw in the second thief somebody who got it! Somebody who trusted the power of God despite seeing that which to unspiritual eyes was nothing but weakness. Somebody who saw victory where most saw only defeat. Somebody, indeed, who understood the paradox of Good Friday.
That suffering is not irredeemable,
That sorrow is not incompatible with joy,
That even the darkest nights can be followed by the brightest days.
‘Sorrowful yet always rejoicing’? It was the experience of Paul. It was the experience of Jesus. It was the experience of the second thief. And it will be our experience too.
Some of us are sick? Some of us mourn the loss of loved ones? Some of us worry over our future? Some of us have experienced great tragedy in our lives – some recently, some longer ago but who nonetheless still feel the pain just as keenly as if it were yesterday.
There is indeed much today for us to be sorrowful over. Some Christian types can sometimes well meaningly suggest we should always be happy. ‘Smile’, they say, ‘Jesus loves you’. But though they are right to proclaim the truth that God really does love us, they are wrong to suggest that we should never be sad, for even the eternally happy God knows what it is to cry. [1 Timothy 1:11, Luke 22:62]. Even Jesus wept at the tomb of his friend Lazarus, his grief no less intense for knowing that he would soon bring him back to life. [John 11:35].
Perhaps, then, even God knows what it is to be sorrowful yet always rejoicing.
So it’s not wrong to be sad, it’s simply normal. The Bible never tells us to masochistically rejoice about our suffering. But it does tell us to rejoice in our suffering.
Because despite our sorrow – there is much to rejoice over! We truly are loved with an everlasting love, a love that transcends our current struggle, a love that means that we too can be sorrowful yet always rejoicing.
As we suffer we can rejoice because of the Gospel. The good news is that Good Friday was followed by Easter Day, that Jesus died for our sins, bearing the punishment we deserve, and that when he rose from the dead Jesus proved the sufficiency of his sacrifice. By it we are justified, counted righteous, declared to be ‘not guilty’.
Some of us grieve over our unrighteousness and can not even lift our eyes to heaven. We beat our breasts and cry out, ‘Have mercy on me, a sinner’ [Luke 18:13] But because of Jesus’ work on the cross on our behalf we are made right with God – regardless of our current situation.
Not because of our worth – but because of his grace.
Not because of what we do – but because of what he did.
Not because we are lovely – but because he is loving.
So, if you’re sorrowful today, remember you’re not alone, God weeps with you. And know that, because of Jesus, his life, death and resurrection, ‘Weeping may tarry for the night, but joy comes with the morning.’ [Psalm 30:5].
It’s Good Friday – but Easter Sunday is coming. Because of what took place over those two days nearly 2000 years ago, we can know real forgiveness for all those sins that we so bitterly regret, no matter how great they are.
But if that were not enough to rejoice over this Eastertide, we can also look to the future with a certain hope. Suffering is all too real today but the day is coming when God ‘will wipe away every tear form [our] eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things [will] have passed away.’ [Revelation 21:4]
‘So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal’. [2 Corinthians 4:16-18]
It’s Good Friday – but Easter Sunday is coming.
So may we all know happiness this Eastertide – even those of us who are sorrowful.
Having read this week ‘The Book About Getting Older (for those who don’t want to talk about it)’, I have a few problems with its author, Consultant Geriatrician, Dr Lucy Pollock.
The first is that, since she is of a similar age to me, should I be fortunate enough to make it to a ripe old age, it is extremely unlikely that she will still be working when I have need of someone to oversee my medical care. With luck, however, the poor soul who will one day be called upon to advise me in my dotage, will have read her book and taken on board all that she has written there, for it sums up what, to my mind, good medicine is all about.
And so the second problem I have with Dr Pollock is that she is liable to cause me to run out of the superlatives necessary for describing what she has said.
For this is a book that, along with considerable humour, oozes wisdom, overflows with compassion and is chock-full with sensible counsel which really does make it a must read for hospital consultants, general practitioners and anybody who cares for an elderly person. And that, of course, includes anybody who is themselves elderly or one day hopes to be so. No wonder Dr Pollock is so highly regarded by those I work with who refer into the hospital where she works and who, on occasions have had the very great pleasure of hearing her speak.
Much of the book is written like a novel with exquisitely drawn descriptions of patients, written by somebody who clearly cares deeply about those she is writing about. The reader is drawn into their stories and made to care for them too.
Here then is somebody who cares enough to notice the little details of an individual’s character, somebody who listens attentively to what it is they are saying, spoken or otherwise, and somebody who makes every effort to understand those who come to her for help – surely the foundation upon which all good care must rest.
Here too are elderly folk, described as they truly are, not as burdensome individuals who drain the healthcare system with their multiple problems, but people who have lived and loved and still have much to offer despite the level of their current need for support.
The book takes an honest look at the problems that increasingly longevity brings with it. As more and more of us are living longer, with those added years inevitably being at the end of our lives, greater numbers of us are consequently spending our final years increasingly dependent on others. The book urges a thoughtful consideration of how medicine can be best applied to those individuals for whom yet another medical intervention will not always be in their best interests.
But Dr Pollock never suggests that old people are not worthy of being treated. On the contrary, as she helpfully puts it, some treatments are simply not good enough to be used on some elderly folk. It is the treatments, not the patients, that aren’t worthy.
Rather than thoughtless adherence to medical protocols and treatment algorithms, it is for Dr Pollock an understanding of her patients, and what it is that is important to them as individuals, that should drive the decisions that are made by the clinician, the patient and their families, as to what should and should not be done.
Just because something can be done doesn’t mean it should be.
The book is full of cases of how this principle is not one that is held merely theoretically. Her sadness and frustration at the case of the elderly patient who, over the course of a previous three month hospital stay, suffered 77 blood tests, undertaken for reasons that were no doubt well meant but were nonetheless almost entirely unnecessary, is a case in point.
Rather than yet another investigation being ordered, a discussion of what was important to the patient leads to the individual going back home to enjoy watching football on the TV with his son whilst taking a few sips of cider. That really is good practice, medicine that, rather than vainly seeking to add years to life, aims to add life to the limited time those who of an advanced age inevitably have.
The book also has a useful discussion about advance care plans, a realistic look at the success or otherwise of attempts at cardiopulmonary resuscitation and the challenges of dementia. There are also some practical chapters on assessing capacity, powers of attorney and considerations around driving.
It really is a superb book in which the author clearly cares about the reader every bit as much as she does her patients as evidenced both by the gentle way she softens the delivery of less palatable truths and by the slightly larger font that has no doubt deliberately been employed whilst mindful of the deteriorating eyesight of some of her readers.
Please do read it, and then recommended it to your family and friends and, for those of you working in healthcare, recommend it to your patients. It really does deserve a very wide readership.
Which brings me to my final problem with Lucy Pollock. In the unlikely event that I am ever cast away on a desert island, I am now going to have an even more difficult task choosing what book I might like to take with me alongside the Bible and the complete works of Shakespeare. For this is a book, full of delightful characters, that is in turns both moving and inspiring, one that makes me want to live better and practice better. It is also one that, marooned on a desert island far from any medical attention, might just reassure me that perhaps we don’t always need quite as much medicine as we sometimes foolishly think we do.
Even so, all alone on an island I would undoubtedly miss doctors like the writer of this excellent book and the wonderful patients I, like her, have had the joy or caring for.
But never mind this review, read the brilliant Lucy Pollock’s, brilliant book. Easily worth six stars.
To read ‘Paddington and the Ailing Elderly Relative’ in which Dr Pollock, or someone very like her, makes a special guest appearance, click here!
To read, ‘Vaccinating to remain susceptible’, click here
As some day it may happen that a victim must be found
I’ve got a little list — I’ve got a little list
Of medical offenders who might well be underground
And who never would be missed — who never would be missed!
There’s the patient who believes that he has suffered every ill
And even those he hasn’t yet he knows someday he will
The CQC inspector who insists the rules are kept
And pouring urine samples down the sink he won’t accept
The turmeric advisor – yes that dreadful herbalist –
I don’t think he’d be missed – I’m sure he’d not be missed.
.
He’s got them on the list — he’s got them on the list;
And they’ll none of them be missed — they’ll none of them be missed
.
There’s those who deal with teeth and gums who aren’t there to prescribe
The elusive dentist – I’ve got him on my list
And patients who have symptoms that they simply won’t describe
They just do not assist – they never would be missed
The chap who takes his jacket off and hangs it on the door
The halitotic sufferer whose breath you can’t ignore
The ones who by their actions make it clear that they’re acopic
The bloke who needs a blood test but who says he’s needle phobic
The one advised to see you by their crystal therapist –
I don’t think she’d be missed — I’m sure she’d not be missed!
.
He’s got them on the list — he’s got them on the list;
And they’ll none of them be missed — they’ll none of them be missed
.
The fellow feigning sickness who requires of you a note
That symptom fantasist – I’ve got him on my list
The ones, cos you were running late, complaining to you wrote
I wish they would desist – they never would be missed
The folk you ask what pills they take who haven’t got a clue
They only know that some are red and others they are blue
The ones who think they’re dying since they did that Google search
Who fear that cos their tongue is white they’ll soon fall off their perch
The medicines advisor who on certain drugs insists
I’d like to slap his wrist – I’m sure he’d not be missed.
.
He’s got them on the list — he’s got them on the list;
And they’ll none of them be missed — they’ll none of them be missed
.
And then there are the patients who have issues that are legion
They’ve got a long long list, I’ve got them on my list
Who seem to have a problem with their every bodily region
Their think perhaps a cyst, they never would be missed
Those moaners at prescription costs despite their untold wealth
And those who want a call from you who say they’ve ‘mental ‘elf’
And those who say it’s urgent though they’ve had their problem years
The chaps who come with issues with their gentlemanly spheres
Who really would be handled best by a vasectomist
He’d give them both a twist, I’m sure they’d not be missed.
.
He’s got them on the list — he’s got them on the list;
And they’ll none of them be missed — they’ll none of them be missed.
.
Those saying the pandemic was by Bill Gates orchestrated
The conspiracy theorist – I’ve got him on my list
And all those antivaxers who unfounded fears created
They never would be missed, they never would be missed
The one who says that Covid caused his cough in ‘92
And won’t accept a single thing you ever say is true
The people who in parliament who only cause us hassle
The government advisor that once went to Barnard Castle
Who should instead have gone to see, a skilled Optometrist
I don’t think he’d be missed – I’m sure he’d not be missed.
.
He’s got theem on the list — he’s got them em on the list;
And they’ll none of them be missed — they’ll none of them be missed
.
After W.S Gilbert and Arthur Sullivan
A rendition of this song, performed by Lenny the Lion can be found on my Facebook page on April 30th 2022.
For those unfamiliar with the song, the original appears in the comic opera, ‘The Mikado’, first performed at London’s Savoy Theatre in 1885. Sung by The Lord High Executioner, modern productions include topically updated versions of the song with tongue in cheek suggestions of those people whose loss, were he to be called upon to act professionally, would be a distinct gain to society. If you’d like to hear an example of a fairly recent version, a link to one follows.
Because, in reality, having always enjoyed good relationships with both patients and colleagues alike, and that includes dentists and medicine management advisors, there are many I’ll miss when my time comes to retire from General Practice. Please be assured that the truth is that I am really very fond of everyone that my job brings me into contact with and no more mean to suggest real criticism in the above than, presumably, Gilbert and Sullivan did when, in their original song, they identified children who had an impressive knowledge of historical dates and those with irritating laughs as those deserving of the attention of the Lord High Executioner.
.
As one day I’ll retire when my working days are done
I’ve got a little list, I’ve got a little list
Of people I will want to thank, who’ve made my job such fun
They’ll all of them be missed, they’ll all of them be missed
There’s the patients who forgave me for mistakes that were my fault
The folk who every Christmas gave me smokey single malt
And those who every morning, at half ten knocked on my door
And brought me cups of coffee and those biscuits I adore
They’re none of them draconic, those kind receptionists
They’ll all of them be missed – they’ll all of them be missed.
.
I’ve got ’em on the list — I’ve got ’em on the list;
And they’ll all of ’em be missed — they’ll all of ’em be missed.
.
And then there are the nurses who were always sympathetic
I’ve got them on my list, I’ve got them on my list
When I got into a pickle managing a diabetic
They’ll all of them be missed, they’ll all of them be missed
The HCAs who helpfully squeezed in those ECGs
And never made me beg for one whilst down upon my knees
The times when I had issued drugs whilst just a tad distracted
And someone pointed out the way they may have interacted
Indeed I am so grateful to our helpful pharmacists
I know that they’ll be missed – I’m sure that they’ll be missed.
.
I’ve got ’em on the list — I’ve got ’em on the list;
And they’ll all of ’em be missed — they’ll all of ’em be missed.
.
The team up there in admin, those who type what I dictate
I’ve got them on my list, I’ve got them on my list
Who hear the words I mumble that they’ll first have to translate
Though I sent them round the twist, they’ll all of them be missed
The practice manager who I have driven up the wall
By not reading my emails and by changing my on call
My partners who I have been glad to have close by my side
Who’ve been there as I’ve laughed a lot, who’ve been there as I’ve cried
Well I am very sure now that you all have got the gist
They’ll all of them be missed, they’ll all of them be missed.
.
I’ve got ’em on the list — I’ve got ’em on the list;
And they’ll all of ’em be missed — they’ll all of ’em be missed.
A rendition of this song, performed by Lenny the Lion can be found on my Facebook page on May 13t 2022.
To read ‘I’ve got a little CRICKET list’, click here
To read ‘A Very Model of a General Practitioner?’, click here
This week I watched another episode of The Repair Shop. It’s an excellent programme in which items of great personal worth that have fallen into a state of disrepair, either as a result of neglect, misuse or simply the passage of time, are brought to a team of expert craftsmen and craftswomen for repair. We then watch as they apply all of their skill and experience to the task of restoring the inner workings and external appearance of the precious items. Slowly they are given back their former glory before being returned to their owners, all of whom are invariably delighted with what has been achieved in making what was once broken whole again.
Despite my utter incompetence in all things practical, why anyone would ever allow me to perform minor surgery on them I’ll never know, I found myself feeling envious of those I was watching, wishing I too worked in The Repair Shop. Until, that is, I realised how similar our job is to theirs.
Those who come to us are also of great value but have become broken, likewise due to having been either neglected, treated badly or as a result of simply becoming old. And it is our job to use all our skill and experience to bring about some kind of repair.
The artisans in the programme clearly derive a huge amount of satisfaction from their job and it left me wondering why it is that, if our jobs are alike in so many ways, we do not always experience the same sense of satisfaction that they do.
As I watched this weeks episode I was struck firstly by how all those who work in The Repair Shop seem to really care about the item they are working on, both in terms of appreciating its intrinsic worth as well as recognising its value to the one who brought it. And then there is the obvious love that they have for what they do, the enjoyment they get from the challenge of applying all of their expertise to the task in hand as they work out how best to effect a repair. And finally there is the the very apparent pleasure they experience when they see the joy their efforts bring about in those for whom they have worked.
All of which might give us some clues as to why we sometimes struggle to find the same degree of joy that those in the Repair Shop seem to experience and, more importantly perhaps, thus offer some pointers as to how we might go about deriving greater job satisfaction ourselves.
But before we do, it needs to be acknowledged the differences that exist between our world and that of those who appear on the TV programme. To watch ‘The Repair Shop’ is to spend an hour in a wonderfully reassuring place where everything can be fixed, where everything can be put right. The hectic reality of our daily working lives is, however, very different to the serenity of the world within The Repair Shop where only things of genuine value are brought and where those who work have all the time, space and equipment required to do their job properly. We, in contrast, with our limited resources, sometimes struggle to find the time to do properly those things that are of value, bombarded as we are by the constant demand to also attend to the seemingly relatively trivial. Furthermore, whereas those working in The Repair Shop are always hugely appreciated, we not infrequently feel like we are sometimes being taken for granted. And unlike those in the programme who invariably achieve all that they set out to do, we know all too well that we can’t fix everything. Inevitably we are not always as successful as we would like to be and, as a result, often have to face the fear of being criticised by those who cannot accept that we are unable to bring about the impossible.
Even so we would do well to value those who come to us for help. They really are of immense value. People have huge intrinsic worth and their health is something that is of the utmost importance to them. In the busyness of our working day this is something that is frequently lost as we all too easily end up seeing patients, not as individuals with genuine needs but as merely nuisances instead, ones who seem set on spoiling our day with their difficulties. In reality however, the majority of the problems that are presented are genuine, even if some are more significant and more appropriately brought to a doctor than others. Furthermore, people really are amazing creatures, intricately knitted together, a beautiful and complex amalgamation of the physical, emotional and spiritual, too complex indeed for any of us to fully understand. Perhaps then, if we are to recover some job satisfaction, we need to try to rediscover that sense of wonder that our increasingly frantic working lives have succeeded in squeezing out of us. And perhaps we also need to gain a greater appreciation of what a privilege it is to be involved in the important work of seeking to restore such a precious thing as a fellow human being who finds themselves in need of repair.
That said, it is of course not only our patients who are broken. Some of us are broken too, physically, emotionally and spiritually, as a result of our neglecting ourselves, being treated badly by the job and others or simply as a result of long years in a career that has taken its toll. We all sometimes need the help of others if we are going to make it through – it’s no shame to ask for it. Because we too would sometimes benefit from being taken aside by a master craftsman, to put ourselves in the hands of one who genuinely values us, understands our inner workings and has all the skill, patience and kindness required to put us back together.
Perhaps then we too need to visit The Repair Shop. If we do we may find ourselves reassured that everything really can be fixed, that everything really can be put right. Furthermore, having spent a little time there, someone, somewhere might just experience the joy of having us back, a little less broken than we were before.
‘I’ll go along with the charade until I can think my way out’
Bob Dylan
Recently a patient presented at the practice where I work having been sent to us by a doctor from the local minor injuries unit. She had been advised to request an urgent blood test to determine her blood levels for a certain heavy metal after an ECG she’d had had shown some minor abnormalities. It subsequently turned out however that the automated report had attributed these abnormalities not, as had been believed, to lead poisoning but merely to lead positioning!
An embarrassing mistake to have been made by somebody who had clearly not been thinking properly. But before we laugh too loudly, I wonder how many times we too have stopped thinking for ourselves, failed to see what was there to be seen and addressed only our own ideas, concerns and expectations rather than those of our patients.
As time pressured clinicians it is all too easy for us to stop thinking for ourselves and fall into stereotypical patterns of behaviour based on the assumptions we make and which, though they may speed our decision making, too often serve our purposes more than they do our patients causing us as they do to draw conclusions which steer us down those familiar paths along which we find it more comfortable to travel.
Might it be that we too have stopped thinking properly, failed to see what was in plain sight and thereby absolved ourselves from any responsibility to help as we have passed blindly by on the other side? I don’t doubt that I have, on occasions, done just that and am left asking myself why that might be.
Of course the easy answer to that question would be to say that it’s because I’m either too lazy, too incompetent or too busy to address the problems that are presented to me properly. I suspect that, if I am honest, each of those explanations have almost certainly sometimes been true, but another explanation might be that, rather than face the distress of a problem that cannot be solved, it has sometimes been easier for me to not notice what medicine cannot fix.
In his book, ‘How to think’, Alan Jacobs writes of how, once established, the consensus is hard to challenge because there is great comfort in sharing the commonly held position. He quotes Marilynne Robinson who suggests we have a ‘collective eagerness to disparage without knowledge or information’ alternative or unpopular views ‘when the reward is the pleasure of sharing an attitude one knows is socially approved.’
If this is true, as doctors we are, in the medical setting, predisposed, without thinking, to endorse the view that medicine can solve all our problems because we know that, given they have presented to us, those we are talking to are likely to share this view, and will approve of us for so doing. This is, perhaps, particularly true on account of how so many of us in medicine do so want to be liked.
We are, in the moment of the consultation, invested in not thinking because, it would feel too uncomfortable to disagree because, as Robinson puts it, ‘unauthorised views are in effect punished by incomprehension…as a consequence of a “hypertrophic instinct for consensus”.’
Jacobs asserts that if we want to think, then we ‘are going to have to shrink that “hypertrophic instinct for consensus.” But, he says, ‘given the power of the instinct, it is extremely unlikely that [we will be] willing to go to that trouble”
Jacobs believes that the ‘instinct for consensus is magnified and intensified in our era because we deal daily with a wild torrent of what claims to be information but is often nonsense’. That is certainly true in the medical world where nonsensical demands are too often unjustifiably imposed upon us. Jacobs quotes T.S. Eliot who, almost a century ago, wrote, ‘When there is so much to be known, when there are so many fields of knowledge in which the same words are used with different meanings, when everyone knows a little about a great many things, it becomes increasingly difficult for anyone to know whether he knows what he is talking about or not.’ And in such circumstances, ‘when we do not know, or when we do not know enough, we tend always to substitute emotions for thoughts.’
That is, confused about what to believe, we will default to what feels comfortable and agree with the consensus, the perceived wisdom. Could it be then that when we are presented with a problem we cannot fix, a problem for which medicine is not the answer, the cognitive dissonance we therefore experience serves to make it less likely that we will see that problem at all and and end up seeing only those with which we feel we can deal.
Jacobs believes that ‘anyone who claims not to be shaped by such forces is almost certainly self-deceived.’ We are social beings who need to feel accepted and, since agreeing feels good, we are prone to toe the line. ‘For most of us’, Jacobs suggests, ‘the question is whether we have even the slightest reluctance to drift along with the flow. The person who genuinely wants to think will have to develop strategies for recognising the subtlest of social pressures…The person who wants to think will have to practice patience and master fear.’
So could we as General Practitioners do that? Could we practise patience and master fear and thus resist the ‘hypertrophic instinct’ which insists that medicine is the answer to all our problems.
I’d like to think we could but it will be uncomfortable, as speaking the truth often. It’ll mean giving up the charade that as doctors we have all the answers and accepting instead that there are times when we can do no more than simply notice the distress our patients are experiencing, acknowledge it for what it is and, perhaps, try to ease it a little by being human enough to sit alongside them and share in it with them for a while.
Which will be a whole lot more use than another unnecessary blood test.
‘Those who feel the breath of sadness, sit down next to me
Those who feel they’re touched by madness, sit down next to me
Those who find themselves ridiculous, sit down next to me’
James
Back in the 1960’s, in the days before research required ethical approval, American social psychologist Stanley Milgram carried out a series of experiments designed to investigate the extent to which subjects would submit to the demands of those in authority. Individuals, believing that they were assisting research into how punishment influenced somebody’s ability to learn, were, on the instruction of an ‘experimenter’, asked to act as ‘teachers’ and administer electric shocks to ‘learners’ every time they failed to answer a question correctly. With each wrong answer the ‘learner’ gave, the strength of the administered electric shock increased. Unbeknownst to the ‘teachers’ however, it was they and not the ‘learners’ who were the real subjects of the experiment. In reality, no electric shocks were being given and the ‘learners’ were merely actors who were simulating the effects of the shocks that they were supposedly receiving. The study revealed an alarming willingness on the part of subjects to act against their conscience when told to do so by authority figures with some, on the say so of another, even prepared to give potentially lethal electric shocks to vulnerable individuals with supposed heart conditions.
But what, to me at least, is more interesting still, is how the subjects of the study were prepared to give significantly higher shocks, when those supposedly receiving them were at a greater degree of separation from they who were administering them. That is, as the strength of the shocks got increasingly more dangerous, subjects were more inclined to refuse to administer them when they were able to see the one supposedly being shocked than when they could only hear their apparent cries of anguish. And they were more willing to administer the most dangerous shocks to those from whom they more separated, those who they were kept from both seeing and hearing.
It would seem therefore that the less contact people have with others the less they are concerned about their welfare and the more they are prepared to act against conscience in order to just get the job done.
I wonder if this has something to say us who, over the last year in particular, have been encouraged to remain remote from our patients. Leaving aside the dangers of missing important diagnoses and the withholding of human contact from those who really would profit simply from sometimes seeing us, could it be that working remotely has adverse effects on us too? Might it be that the less contact we have with those for whom we are supposed to care leaves us less concerned about their welfare than we might otherwise have been and result in our being more likely to simply going through the motions as we too just seek to get the job done? Furthermore, as a result of less time with us, might our patients also end up caring less about us?
A year ago we heard a lot about the so called ‘new normal’ but make no mistake, there has been nothing normal about the virtual world we have been living and working in this last year. We are all diminished by such a virtual existence. As tentative steps now begin to be made towards a life without restrictions I hope we won’t seek to hold on to our remote methods of consulting, or, at least, not too tightly. For though some problems may genuinely benefit from such an approach, many do not. And even though some conditions can be managed perfectly safely over the phone, that doesn’t mean that they aren’t better dealt with face to face. I know for sure that this week I have made at least one better, more humane, decision as a result of seeing a patient I might otherwise have even tempted to manage from a distance.
Since, as Milgram’s experiments seem to suggest, remote care runs the risk of us not remotely caring, avoiding patient contact is detrimental for both patients and doctors alike. Furthermore, by working at arms length from our patients, we have allowed much of the satisfaction that the job once held to slip though our fingers. As restrictions begin to lift, rather than holding onto the remote consulting that some see as more efficient, I believe we would do well to once again make face to face consultations with patients our normal working practice. By doing so, not only will we providing better care, we will begin to grab back some of the job satisfaction that has been lost in the last year.
Two years ago I wrote of my unease about how medicine was being encouraged to adopt more remote ways of delivering healthcare. That article can be read here. I never imagined then that I would be practicing the way I have been forced to this past last year, encouraged as I have been to avoid patient contact wherever possible. For me it has not been a happy transition and it has not been one I have found terribly easy. Nor is it something that I have done terribly well, for which I am not sure I’m sorry. Even so, as we now move slowly out of lockdown, such a remote existence must not be allowed to become the norm, not for medicine, nor, indeed, for any other area of our day to day lives. Because it’s simply not healthy.
Humans are social creatures, to fully live we need to have contact with one another, we need to touch. When lovers kiss, it’s more than just a sign of their love, it is an act of love too. And that’s important because more than simply knowing we’re loved, we need to feel it too.
We need to be present in each other’s lives. As in the words of the song, ‘It’s hard to carry on when you feel all alone’. Sometimes, when it seems there is nothing one can do, to simply be there is of genuine value. In ‘Out of Solitude’, Henri Nouwen 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. If Milgram’s experiments have anything at all to teach us, perhaps it is this: that it is not simply that those who care will draw close to those in difficulty but rather it is those who draw close to those in difficulty who will find themselves caring for others in ways that they wouldn’t otherwise have been able.
We have all had to endure it for nearly a year now, but over the coming months let’s look to leave social distancing behind – in all its forms. And let’s look to sit down with, and care for, each other once more.
Because living a contactless life isn’t a remotely good idea. It would be shocking to think otherwise.
To read ‘Contactless’, the article mentioned in the above post that was written two years ago, click here
To read ‘Eleanor Rigby is not at all fine’, click here
To read ‘Hannah Arendt is completely fine, click here
To listen to the song ‘Sit Down’ by James, click here. You can even sing along – you know you want to!
Spare me a doctor, who makes the mistake Of telling me how, I must stop eating cake Who hasn’t a hint of the apologetic When he tells me at 90 I’m pre-diabetic One who in truth is a silly old fool Who’s not learnt a thing since at medical school One who insists he must always keep trying And solemnly swears that he’ll keep me from dying.
After W.H. Auden
And Auden’s original.
Give me a doctor partridge-plump Short in the leg and broad in the rump An endomorph with gentle hands Who’ll never make absurd demands That I abandon all my vices Nor pull a long face in a crisis, But with a twinkle in his eye Will tell me that I have to die.
Some musings 