The average age of a patient in general practice is 75; multiple diagnoses, incredibly complex care, increased expectations and ever-reducing resources, but as Epictetus said: ‘The greater the difficulty, the more glory in surmounting it; skilful pilots earn their reputation from storms and tempests.’
Like Tennyson’s Ulysses, we have drunk the delight of battle and fought the long defeat in the hope that we could make things better for others, if not for ourselves. But there comes a time when we’re no longer that strength which in old days moved earth and heaven, and we must pass on our values of sacrifice and selfless dedication.
‘I don’t like going to see doctors,’ said Joe.
‘And doctors don’t like you going to see doctors either,’ I agreed, glad we had found some common ground, building a relationship, although maybe not quite ready to start dating yet.
‘Look at this,’ he said.
It was scary, but then I had a brainwave; I have a degree, you know (and diplomas, which don’t really count – Diploma of Child Health, Diploma in Obstetrics, just pay the exorbitant fee and they throw the scroll at you).
The registrar should see this, I thought, he needs the experience. ‘Have you examined it?’ he asked me, with puppy-like naivety, clearly wondering if the college had a protocol for this kind of thing.
‘What do you think, my Telemachus?’ I answered – because the open-ended response encourages the registrar to think for himself.
‘We’d better examine it,’ he said, visibly girding his loins.
‘If you want to get that close, be my guest,’ I said. ‘I’ll be observing you from far away, with a telescope.’ I passed him the rubber gloves (it’s good to be needed, no matter how humble the service), but before I could shout a warning, he poked at the unexploded sebaceous cyst, with catastrophic consequences.
‘Smells like something died in here,’ said Joe.
Sometime later, when our registrar had been cleansed, I offered him encouraging words: ‘Be strong in will; to strive, to seek, to find, and not to yield, especially to insalubrious body fluids.’
- Dr Farrell is a GP from County Armagh. Follow him on Twitter @drlfarrell