Confessions of a GP

I fully accept that there are drug and alcohol addicts out there. To add to those numbers many more addicts created by doctors and, principally GPs, seems such a shame. There is still a strong culture of prescribing sleeping tablets among some GPs. It is the quick fix for both patient and doctor. The patient gets a pill that makes them feel relaxed and able to sleep and the doctor gets the patient out of the room quickly. It is much tougher for both patient and doctor to try to identify the underlying cause of the sleeping problem. Depression, pain and anxiety are all difficult issues and ten minutes isn’t nearly enough time to handle them. For my patients who can’t sleep, I usually ask why they think they can’t sleep. I then move on to something called ‘sleep hygiene’ and offer advice about exercise during the day and having a hot bath and cocoa just before bedtime. I even add in a bit of feng shui and advise never to use the bedroom for anything other than as a place to sleep so that the bedroom tunes the brain into sleeping rather than thinking. Some patients like all this holistic stuff, others just want a magic pill and are disappointed when I say no.

Magic wand

My niece was five and for her birthday she got a pink fairy outfit that she insisted on wearing every day. The outfit came complete with a pink glittery magic wand, which, upon waving, lit up and made a ‘didledidledidledidledeeee’ magic wand-type sound. I would love to borrow the fairy outfit and magic wand for some of my more difficult patients…

So, Kelly. Let me summarise, you’re a 25-year-old single mum with three screaming children. You live in a cold, damp two-bedroom council flat and you’ve just had a big row with your mum and sister. It is a miserable wet day in late November and you’ve got no money for Christmas. You’ve been depressed for years and have already tried several different types of antidepressants but nothing has helped and today you’ve come to see me so that I can give you a pill to make you happy. Hold on, I’ll just get my magic wand… Didledidledidledidledeeee.

So, Mr Jackson, you’ve been having headaches everyday for 30 years. You’ve had multiple brain scans and blood tests and have been seen by three very good neurologists. A cause for your headaches has never been found and no medication has ever helped resolve them. You’ve come to see me today because you have a headache and want me to cure it… Didledidledidledidledeeee.

You have a cold and feel like shit… Didledidledidledidledeeee.

Of course, if I really had a magic wand, I wouldn’t waste it on my heart-sink patients. There are much more important problems in the world to resolve:

Didledidledidledidledeeee… West Ham win the Premiership.

Didledidledidledidledeeee… Man United get relegated and Alex Ferguson cries on Match of the Day.

Didledidledidledidledeeee… Kylie lives next door to me but is otherwise unchanged.

Didledidledidledidledeeee… Kylie finally realises that she has always found slightly geeky, big-nosed doctors really quite attractive.

Didledidledidledidledeeee… Various other stuff involving myself and Kylie that I couldn’t possible put into print because my wife would kill me.

Okay… Didledidledidledidledeeee… World peace, end to poverty, reversal of climate change, etc. Yawn. Yawn.

Finally then I might find the energy to use my magic wand for the benefit of my heart-sink patients or I might just magic them off to another doctor.

I know that most of my patients with chronic health problems realise I don’t have a magic wand or expect miracle cures. They want some of my time for support, reassurance and practical advice to help get them through difficult times. I’m quite happy to offer that but you’d be surprised about how many of my patients really do want a magic cure.

Didledidledidledidledeeee… My book outsells Harry Potter and I’m played by Brad Pitt in the Hollywood film adaptation.

Cannabis

Sometimes, even when my surgery is full, the receptionists sneak a couple of extra patients on to the end. Up on the screen next to their name is a little justification as to why they have been squeezed in. These might be: ‘Baby with fever — mum worried’ or ‘Lost prescription — catching flight this afternoon.’ After a recent busy afternoon surgery I had a 16-year-old boy added on to my list and the receptionist had put ‘overdose’ next to his name. I thought this was a bit odd, as normally the receptionists are fairly sensible and would send an overdose straight to A&E.