Abstract
When I first planned this article, I had visions of a piece discussing why things are always worse at night. At the time of writing, the days are short and the nights long. Anxiety worsens in the small hours of the morning when you feel most alone. The worse outcomes flit through your mind as you lie in bed, thinking everyone else is asleep. I had planned to compare the current ‘permacrisis’ that we are all experiencing to a long, dark night. I thought I would write an article about the mental health crisis and how to regulate access to negative news.
Really though, that’s not what anyone needs. I’m sure everyone reading this has had enough of that kind of gloom. Instead, I want to remind us all of what can be wonderful in our work.
Mr X, a patient, changed my mind.
Mr X has been mentioned in this column before (in a different guise). He is not the easiest of patients and many of his issues can’t be cured. It has been hard, over the years I’ve known him, to tread that line between honesty and negativity. There are many things modern medicine can’t heal but I’ve tried my best to offer him what I can and to encourage him to help himself at every opportunity.
I bumped into him in the corridor at the practice today and we said a polite hello. He then complained about how hard it is to get an appointment with me these days. I apologised, telling him that I spend more time in management now. He said, ‘you don’t always do anything for me, but I always know that you care’.
I stopped in my tracks. This patient – who comes across as a pithy Geordie with a healthy dose of cynicism and more than a pinch of suspicion towards doctors – had articulated exactly what I hope to do every day of my career. Years ago, I came across the maxim that is so often misattributed to Hippocrates: ‘Cure sometimes, treat often, comfort always’. Surely, it is the very essence of general practice. There is often so little we can do – but we can always bring our humanity to the situation.
It has been a hard day wading through mounds of paperwork. It can be easy to forget that every piece of paper represents a person, someone you can help by being efficient, or discerning or simply careful.
By telling me that I had made a difference in his life, Mr X reminded me that it truly is worth it.
There are few big wins in general practice. You’ll never know how many myocardial infarctions you prevent by prescribing statins. You’ll never know how much invasive group A strep you prevent with antibiotics. While much of what we do is interesting, few of our treatments enact dramatic cures. Many of our diagnoses are not glamourous. You need to be able to find glimmers of joy in routine results, incurable diseases and inexplicable symptoms.
Mr X gave me a glimmer of hope that I am making a difference. I shall keep calm and carry on.
I thanked him and managed not to cry. Just.
