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Gold, incentives and meh

I can’t be the fall guy any more

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I have in front of me a letter from the A&E department. This is what it says:

‘This 15-year-old lad was playing football on Saturday, and lost his ball up a tree. He climbed the tree to recover it, but fell out from about eight feet and landed on his back. He did this four times. On the final occasion he fractured his clavicle.’

These letters give me the material for these articles. Human stories. The utter absurdity of the behaviour of homo sapiens. The basic material for 500-odd magazine columns, since I first started writing them 20 years ago.

The fascinating thing is the ambiguity. The obvious conclusion is that we are dealing with an utter moron, the type of dude Darwin predicted would be weeded out of the gene pool. But there is another interpretation worthy of serious contemplation.

Perhaps we are witnessing one aspect of the indomitable human spirit. The triumph of hope over experience. He kept climbing and he kept falling. It’s almost heroic. By definition, we only see the failures. Who knows how many teenagers keep climbing and get their ball back at the fifth or sixth attempt? There are probably many.

As I read the letter, I’m laughing and crying in equal measure. Because I now know this experience is nearly over for me. Because I can’t go on.

This article may be unique in the annals of Pulse because a decent proportion of it was written in a hospital bed, with 15 electrodes attached to my body and an IV drip limiting the use of my right arm.

The oxygen mask was hampering my vision and the pulse oximeter had to be transferred to a pinky, because I don’t type with those. But hey, a deadline is a deadline.

The fact that I was back in rapid AF and heart failure within an hour of getting back to work after a short holiday is not, I think, coincidental. The escalating workload, the tumbling income, the futility of trying to keep up with demand, the frustration of being the last port of call for so many problems that really are nothing to do with us; the sheer lack of time to practise medicine as it should be practised. It is insupportable that we are dumped on, taken for granted and held responsible for the failings of others. Above all, the total absence of interest in the vacancies at my practice makes the future as a GP partner unbearable to me.

My love affair with my profession is over. I hate this bloody job. I can’t stand going into work any more. It makes me depressed, unhappy and, latterly, literally sick.

I believe there is some currency in the Government’s ‘5,000 GPs’ idea, but I think they’ve got it the wrong way round. I predict 5,000 fewer GPs over the next five years, as people like me reach the end of their tether. I know of literally no one around my own age who is not thoroughly disillusioned. None of us will still be practising at retirement age. And there is no way we can be replaced, let alone the overall numbers of GPs be increased.

I have climbed my tree and fallen out too many times now. If I was stupid, I would get back up and start climbing again. But I realise that next time, I’m going to fall out and break something. In fact, I may already have done so.

Dr Phil Peverley is a GP in Sunderland.

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Readers' comments (156)

  • I've found that it isn't usually the outside forces that cause the physical and mental harm, it's how we react to those influences. A full course of CBT might be a great help and comfort. It really does help if you engage fully.

    Get well soon and look after yourself, Phil, and thanks for your brilliant articles over the years.

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  • I am so very sorry for you Phil and for all the amazing GPs that do a job most wouldn't. I am grateful every day of my life for the amazing doctors I have met and been treated by. I can't believe what has happened to you all because I met so many idealistic and lovely people and I owe them my life. (I have severe asthma and I have been ventilated 10 times - I read this journal because I've seen all you talk about but from the other side and I need an outlet like this too!) I thank you and wish I could help make the world a better place.for you all. You should look after yourselves because it sounds like nobody else well. Thank you

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  • Farah Jameel

    I am sorry to see a fellow colleague in this way and feel awful for how the profession has left you feeling.

    Look after yourself, a big hug and lots of good wishes.

    Get well soon.

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  • Hussain Gandhi

    Pev as many comments state look after yourself.
    Most important thing in life is you and yours. Everything else is just gravy.
    To anonymous 29.5 7.35pm- your comments are disgraceful and offensive. You clearly do not have the courage or responsibility to comment as yourself and hide behind anonymity as a troll. I am assuming your belief is that GPs should not simply work for the health of our patients but give so much as to risk our own sanity, health and possibly lives in the process?

    Your comments are both insensitive and offensive and I call on the moderators to be responsible and act appropriately.

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  • Deepest sympathy - get well soon - you've served your time (I've been enjoying your column for a very long time!).
    Like others, I can only deplore the effects successive governments have had on general practice and GPs.
    In 1990 there was an outcry when Kenneth Clarke forced GPs to retire at 70: what has been done to general practice since to make even 60 a late retirement age for GPs?

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  • Vinci Ho

    Phil, sincerely dedicate this song to you
    "Let It Be"

    When I find myself in times of trouble
    Mother Mary comes to me
    Speaking words of wisdom, let it be
    And in my hour of darkness
    She is standing right in front of me
    Speaking words of wisdom, let it be

    Let it be, let it be
    Let it be, let it be
    Whisper words of wisdom, let it be

    And when the broken-hearted people
    Living in the world agree
    There will be an answer, let it be
    For though they may be parted
    There is still a chance that they will see
    There will be an answer, let it be

    Let it be, let it be
    Let it be, let it be
    Yeah, there will be an answer, let it be
    Let it be, let it be
    Let it be, let it be
    Whisper words of wisdom, let it be

    Let it be, let it be
    Ah, let it be, yeah, let it be
    Whisper words of wisdom, let it be

    And when the night is cloudy
    There is still a light that shines on me
    Shine on until tomorrow, let it be
    I wake up to the sound of music,
    Mother Mary comes to me
    Speaking words of wisdom, let it be

    Let it be, let it be
    Let it be, yeah, let it be
    Oh, there will be an answer, let it be
    Let it be, let it be
    Let it be, yeah, let it be
    Whisper words of wisdom, let it be

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  • Vinci Ho

    I was going through a really difficult time around the autumn of 1968. It was late in the Beatles’ career and we had begun making a new album, a follow-up to the “White Album.” As a group we were starting to have problems. I think I was sensing the Beatles were breaking up, so I was staying up late at night, drinking, doing drugs, clubbing, the way a lot of people were at the time. I was really living and playing hard.

    The other guys were all living out in the country with their partners, but I was still a bachelor in London with my own house in St. John’s Wood. And that was kind of at the back of my mind also, that maybe it was about time I found someone, because it was before I got together with Linda.

    So, I was exhausted! Some nights I’d go to bed and my head would just flop on the pillow; and when I’d wake up I’d have difficulty pulling it off, thinking, “Good job I woke up just then or I might have suffocated.”

    Then one night, somewhere between deep sleep and insomnia, I had the most comforting dream about my mother, who died when I was only 14. She had been a nurse, my mum, and very hardworking, because she wanted the best for us. We weren’t a well-off family- we didn’t have a car, we just about had a television – so both of my parents went out to work, and Mum contributed a good half to the family income. At night when she came home, she would cook, so we didn’t have a lot of time with each other. But she was just a very comforting presence in my life. And when she died, one of the difficulties I had, as the years went by, was that I couldn’t recall her face so easily. That’s how it is for everyone, I think. As each day goes by, you just can’t bring their face into your mind, you have to use photographs and reminders like that.

    So in this dream twelve years later, my mother appeared, and there was her face, completely clear, particularly her eyes, and she said to me very gently, very reassuringly: “Let it be.”

    It was lovely. I woke up with a great feeling. It was really like she had visited me at this very difficult point in my life and gave me this message: Be gentle, don’t fight things, just try and go with the flow and it will all work out.

    So, being a musician, I went right over to the piano and started writing a song: “When I find myself in times of trouble, Mother Mary comes to me”… Mary was my mother’s name… “Speaking words of wisdom, let it be.” There will be an answer, let it be.” It didn’t take long. I wrote the main body of it in one go, and then the subsequent verses developed from there: “When all the broken-hearted people living in the world agree, there will be an answer, let it be.”

    I thought it was special, so I played it to the guys and ’round a lot of people, and later it also became the title of the album, because it had so much value to me, and because it just seemed definitive, those three little syllables. Plus, when something happens like that, as if by magic, I think it has a resonance that other people notice too.

    Not very long after the dream, I got together with Linda, which was the saving of me. And it was as if my mum had sent her, you could say.

    The song is also one of the first things Linda and I ever did together musically. We went over to Abbey Road Studios one day, where the recording sessions were in place. I lived nearby and often used to just drop in when I knew an engineer would be there and do little bits on my own. And I just thought, “Oh it would be good to try harmony in mind, and although Linda wasn’t a professional singer, I’d heard her sing around the house, and knew she could hold a note and sing that high.

    So she tried it, and it worked and it stayed on the record. You can hear it to this day.

    These days, the song has become almost like a hymn. We sang it at Linda’s memorial service. And after September 11 the radio played it a lot, which made it the obvious choice for me to sing when I did the benefit concert in New York City. Even before September 11th, people used to lean out of cars and trucks and say, “Yo, Paul, let it be.”

    So those words are really very special to me, because not only did my mum come to me in a dream and reassure me with them at a very difficult time in my life – and sure enough, things did get better after that – but also, in putting them into a song, and recording it with the Beatles, it became a comforting, healing statement for other people too.

    – Paul McCartney

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  • T Roscoe

    Time to go Phil, you know you have to.. Make it NHSE's problem and get your pension fully paid up as you are retiring through ill health.

    Tref

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  • Legend

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  • Hope you are soon feeling better Phil but don't forget - many of our patients are feeling exactly the same.

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