We GPs are solitary creatures; we don’t have the comfort of colleagues, we are far away from the comforting nipples of the general hospital, and alone we must face the cold indifference of this imperfect world.
Even in the brightest sunlight, we are aware of the shadows to come, and when the night is falling like blood-dark wine, our heaviest burdens are fear, memories and loneliness. We must march or die, because if we don’t do it, who will? The buck stops with us, the Thin Red Line in a pasture of savage beasts.
Flaubert once said that no man had really lived until he had walked out of a brothel in the early hours of the morning wanting to throw himself in the river.
Now of course I can't comment on that; in rural general practice we don't have the opportunity to drink the cup of sensuality to its bitterest and most depraved dregs, or bury ourselves headlong into the fleshpots of the city. But we do have our own stark truth; no-one has really done a home visit until they've been called out in the small hours on a freezing winter's night in the deepest countryside.
You look back longingly at your bed, your very heart’s desire to return to its comforting embrace. It’s warm and clean, and there’s no-one dying, no blood or vomit. But you don't, do you, because you're a doctor and you gotta do these things; and because it's real medicine, one of our reasons to be.
No one should be so sick or vulnerable or remote or alone that a doctor won't be there, reaching out a hand to cure or comfort. And whatever the challenge is, we're the boys and girls who can handle it.
'What hath the night to do with sleep?' said John Milton, and we GPs know just what he was talking about; just call me Dr Acula.
- Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell