The doctor will see you now

By Richard Dickenson

For almost twenty years of my medical life I was a country GP. It was a great job, a way of life, really. I doubt that there is any other job quite so rewarding.

Of course it has its lousy times too. There were all too many times in the middle of a bitter cold winter’s night when, and it’s always about three in the morning, the local midwife called and asked me to come. District midwives in those days were the cream of the crop. That meant that when one of them called for help you dropped everything and went running.

At times like that I’m sure I really did wish I had never seen a stethoscope or a clinical thermometer. Straight from the cold into a tiny little over-heated bedroom where anxiety reigned and doubts were thick on the ground. Mum’s face when the doctor got there was usually a study in pain, fear and gratitude. I can’t describe it.

The first job was to get rid of everyone. The best way was to give everyone something to do. That was just to get them all out of the place, sort of clearing the decks for action. At times like that one had no need of anxious faces just taking up space. Dad would be sent downstairs to boil a kettle. Grandmother to find some spare towels that might not be usable again later, and so on.

But what a treat it all was an hour later when that sweet, wet, slippery and utterly beautiful baby was in my arms. The look on the tired, grateful Mum was worth a dozen Rembrandts to me, and the drive back home through the fresh, cold sunshine turned everything into a massive and wonderful reward. I did all that hundreds of times and the upside won every time. And I loved all my babies.

There were plenty of other times when it was the best job in the world. I remember the little mite with his thumbs against mine and his eyes fixed on my own as I hypnotised away the demon that was contracting his bronchial muscles into a blue-faced asthmatic gasping.

I remember the urchins at the front door with handfuls of grass mopping up the blood of grazed knees, or maybe clutching an injured magpie fledgling rescued from a marauding cat and clearly needing swift medical assistance.

I remember the ‘Good Children Jar’ on my desk and from which every child knew from the grapevine that they’d be invited to take a sweet if they were good and didn’t cry when they had their injections.

Today’s doctors don’t know what they’re missing, because that warm and comforting friendship of medicine seems to have dwindled almost to nothing.

Perhaps it’s more efficient, or financially cheaper, but today the patient after a two or three weeks wait for an appointment sees a different doctor every time. They hardly know one another. When they meet the patient sits quietly as the doctor scrutinises his indifferent computer screen then ticks a few check-boxes. I tell you now that medicine cannot be practised that way. Next minute it’s the issue of a machine printed prescription before ‘next please’ shows that that five minute slot is up. I swear that a lot of those bits of paper would work just as well if the patient simply hung them round his neck.

And now there is nonsense talk about putting an end to home visits. Yet this is part of the backbone of medicine. It’s when people feel too sick to go to the surgery and know they don’t need the hi-tech of A&E that they really need their friendly family doctor. Loss of that option is a deeply worrying prospect, and to older folk in particular. Furthermore, a timely home visit will often obviate the need for a hospital admission.

Damn it, today you click a button on the keyboard and next day something is delivered to your front door. Yet doctors are talking about moving the other way. Fortunately there were a lot of doctors wise enough to question the entire idea, so it may well not happen anyway.

But whatever the outcome I insist that everyone involved with any of the medical services should be taught and retaught the single most fundamental rule of all medicine, it is the patient that is at the centre of the medical universe and around whom everything else revolves.

The doctor’s job is to treat when necessary, to cure sometimes, but to listen, understand, and comfort always. That takes more than five minutes of a stranger’s time.