Liam Farrell: Sometimes what you don't say is more important than what you do

Writing isn't just about the words, it's about the spaces between words as well, like a piece of silence dropping in. And it's the same in medicine; sometimes what you don't say is more important than what you do.

He obviously hadn’t wasted his time at medical school.

‘OK, OK, send her in and we'll take a look at her,’ said the junior hospital doctor, his tone clipped, pregnant with studied insolence; just for me, gotta admit it did make me feel kind of special.

‘Don't patronise me, you smug little shit,’ I could have said, but I didn't, because I was that soldier, and neither would you, because we've all been there; brainwashed, either overtly or insidiously, all through medical school, that GPs are second division stuff.

At his age he won't understand. He needs certainty, and certainty is not a flower that thrives in the complicated jungle of family practice. I felt like Jean Valjean, he is young, and in his heart he is afraid; to him so much is occult and mysterious. Why are we here? What was Woodstock and was there really a band called Country Joe and the Fish? What do health visitors do? What is the meaning of life? Why do small bald men always want to become surgeons?

But if I could I would kiss his lips and take his hand and sit him down among long dappled grass and explain the recherché perversity of general practice; how it is not a specialty, but rather a generality, with all the burdens and privileges that this role confers, demanding skills that reach across the divide, not just of a dissonant phalanx of increasingly fragmented medical sub-specialties, but of that deep romantic chasm between science and art.

If family doctors truly have any special skill it is in understanding the individual, the most Daedaelian subject of all. As Voltaire said, ‘It is easier to understand Mankind than to understand one man.’ We are the Corinthians, the Renaissance Men, the profession of Chekhov and Turgenev, students of the whole complicated human gestalt.

So close your eyes in holy dread, lad, for we on honeydew have fed and drunk the drink of paradise.

  • Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell

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