Viewpoint: Why I'm Choosing General Practice: Kush Patel

At around five feet and nine inches, Thomas had been one of the slighter members of my tutor group since I started medical school.

Kush Patel: 'The politics and bureaucracy are long forgotten and a simple cathartic conversation takes place.'
Kush Patel: 'The politics and bureaucracy are long forgotten and a simple cathartic conversation takes place.'

But aside from his unkempt hair, bespectacled face and extensive book collection, Thomas had one unfaltering dream: to be a surgeon,   and he missed no opportunity to indulge his passion - watching surgeries and joining clinics, he ate his fill of what was on offer.

I put this focus down to his academic and cerebral nature.  But Thomas’s case was not a unique one. Sean was looking at Plastics, Sally enjoyed Respiratory and Mo was set on Obs & Gynae… and on the list went for the several other hundred or so people I knew, of varying backgrounds and personalities, stoically adherent to their own specialty aspirations.

I was looking for a career with team work, communication, investigative variety

And then there was me. Looking the part for sure, warm hands clutching stethoscope and textbook, badge swinging proudly from my waist, but clueless.  I relished my education of course, but floundered time and time again as clinician after clinician asked me what it was that I was looking to dedicate the next half a century to.

As a curious young man, I remember writing my personal statement to apply to medical school. I remember what was then a contrived, but in hindsight an honest, admission that I was looking for a career with team work, with communication, with investigative variety; and I had thus far savoured all the heart murmurs I’d hear one week, lung crackles the next, the cry of a brand new baby beyond that and the long detailed medical history of a well weathered war hero thereafter.

But the more time I spent trailing at the back of specialised ward rounds, eyeballing patients for mere seconds at a time, hunched notes trollies, and watching patients come and go without really feeling like I’ve connected with them, the teamwork became fragmented, the investigating routine and the storytelling disappeared altogether. I didn’t want to listen to wheezes forever. I didn’t just want to listen to murmurs either. I wanted to be greedy. I wanted the lot.

My first rotation in general practice was like wearing glasses for the first time. It’s what I’d signed up for in the first place.  Sat in my own small room with my own small desk, I ran my own small clinic and with each polite knock at the door, the game was on. A fresh new puzzle, calling on a myriad of medical knowledge from a wide plethora of specialties and a dedicated window to speak and be spoken to, to engage holistically and to nurture a relationship.

The politics and bureaucracy are long forgotten and a simple cathartic conversation takes place

From the recently widowed Mrs Johnson, who lives alone and simply wants someone to talk to, to Mr Ali who wants help stopping smoking, from Little Sarah who’s too scared for me to look in her ear and beams with pride at the sticker I pop on her jacket, to Michael who is struggling to get out of bed every morning. From coughs and colds, lumps and bumps, to suspect rashes and frighteningly ill children, the variety keeps me excited and the responsibility as gatekeeper, keeps me engaged.

Despite thus far sounding somewhat naïve and idealistic, I know all too well the painful abundance of paperwork that haunts GPs, the endless complaints regarding waiting times and the scarcity of appointments, the murky future of the health service and how frequently the keys to the money safe keep being passed about. But all that aside, for 10 minutes at a time, six times an hour, for four hours each morning and four hours each afternoon, the politics and bureaucracy are long forgotten and a simple cathartic conversation takes place and yet another opportunity to make a difference is waiting to be seized.

  • Kush is a student at Leeds University

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