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At the heart of general practice since 1960

GMC to send back complaints to PCOs

It is hard enough to be a GP, without being asked by patients to usurp the role of the church

‘What's the point of it all? And is there a pill for it?

‘What will happen to my mother after she dies, doctor?'

Thankfully, I was prepared for this. It is always a dodgy consultation, delivering bad news to the relatives. The elderly lady in question had just been diagnosed with metastatic bowel cancer, and the advanced nature of the disease and her dire mental state made aggressive intervention an unrealistic option.

I adopted my most empathetic posture; face on, leaning forward a bit, direct eye contact and grim but somehow slightly sympathetic pursed lips. Christ, I sometimes hate myself for my mendacity.

‘Rest assured, we will make her comfortable. After she passes on, you need to talk to the funeral director. They will take her to the chapel of rest, and look after her there. If you're worried about a post mortem, we don't need to put her through that because we know what her illness is....'

At this point I was interrupted. ‘Yes, I know all about that doctor. We had all that after my Dad died. What I mean is, she was a good person. Will she go to Heaven?'

It is not often I am reduced to speechlessness, but this was one of those occasions. I took a deep breath, and rehearsed the only possible honest response; ‘How the hell would I know? I'm your family doctor. I look after you when you're ill, and do my best to ease your passing from the world of the living to whatever it is, if anything, that comes afterwards. My responsibility for your welfare ends when you die. Leave me out of it!'

What I actually said was: ‘I'm sure she will be at peace.' And when the daughter left, smiling and wiping her eyes, I smacked myself soundly between the eyes with the palm of my hand.

We live in a Godless society. No-one goes to church. Religion, of the Church of England-type, has died a death over the past 50 years. There is a spiritual void in our society. Our patients may have a passing acquaintance with Holy Water when it is briefly dabbed on their foreheads in the first few weeks of life, but for many, they don't meet their spiritual advisers again until dry earth rattles down on their coffin lid.

But the eternal questions of human existence remain unanswered. Why are we here? What's the point of it all? And is there a pill for it? Maybe the GP will know. In the absence of any other authority figure in their lives, we sometimes seem the only option.

A man came to see me recently in some distress. ‘I've been married 20 years, doctor, and I thought I had a good marriage, but she's just left me and moved in with a bloke who works in Homebase.'

‘I'm sorry to hear that' I told him. ‘What can I do to help you?'

‘Well nothing really. But I needed to talk to someone, and I thought of you.' I gave him a tight-lipped smile, clasped his hand, and offered him our version of tea and sympathy; a sick note and half a dozen sleeping pills. Much good may they do him.

peverley@supanet.com

Dr Phil Peverley is a GP in Sunderland

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