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At the heart of general practice since 1960

Haslam's view: Our view of lives from the cradle to the grave

Have you looked at the remarkable Street View program on the internet?

A development of Google Maps, it lets you look at a huge number of roads in major cities in panoramic views, giving a remarkable – if incomplete – view of these areas.

It is incomplete for a simple reason – there is so much more to any street than bricks and mortar, trees and pavements. Almost all GPs have a very different and very personal street view of their practices. As I drive around my practice area, after a lifetime working there, almost every house brings back a medical memory. Some are happy. Some are sad. And some are almost unbelievable.

As I drive past number 27, I always think of the baby who was born there, and the old man who died there - the perfect symmetry of family practice.

The birth was far from planned, but the delivery was very rapid. It had been years since I had seen a baby born – indeed I rather suspect that the last time I had been present at a birth was the arrival of my own son. But there was no choice – the patient had phoned in a panic, the midwife was miles away, the ambulance was held up by atrocious weather and road conditions, and her waters had broken. I guess all those deliveries I had carried out as a junior hospital doctor had somehow had an impact, and as the contractions kicked in with full power, I somehow remembered just what it was that I needed to do. It was a wonderfully happy occasion – and one of the high points of my career, even if the proud new mother didn't realise that I was as much in need of gas and air as she was.

A few years earlier, in the room upstairs, I had held the hand of George as he quietly passed away. My arrival was equally as unplanned as it had been for the birth. I had known he was terminal, and I was just doing a routine supportive visit when it became apparent that the end had arrived. To have been present was a real privilege. On both these occasions I had been present at the ‘dark and tender places' in these people's lives, to use Don Berwick's memorable phrase.

And over the road is the house where a young cancer sufferer locked himself in his bedroom and refused to go to his outpatient appointment. When I was called by his frantic parents to try and persuade him, and tapped on his bedroom door, he told me in no uncertain terms where to go. Eventually persuading him that if he absolutely refused to go to hospital, then I would give his iv chemotherapy at home took all my negotiation skills – and left me puzzling over whether this had been the right thing to do. When, 20 years later, I saw him happy and healthy then I knew that particularly stressful day's work had really been worthwhile.

And three houses down are the flats where the young drug addict tragically died of an overdose, where the poor asylum-seeking couple made their first home together, and where the baby survived what had appeared to be a cot death.

And, as every GP knows, while the stories from this street may seem dramatic, I could tell similar stories from almost every road on the patch. Soap operas are nothing compared with the things we see, hear, and witness. The GP's street view over a career is an extraordinary mix of pleasure and pain, tears of joy and tears of sadness. The Google version might be clever – but it's not half as interesting.

Author

Professor David Haslam CBE
FRCGP
GP, Ramsey, Cambridgeshire, President, Royal College of General Practitioners, national clinical adviser to the Healthcare Commission and Visiting Professor at de Montfort University Leicestershire

Haslam's view

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