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At the heart of general practice since 1960

From the cradle to the grave

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It is almost never a good idea to lie to your patients and it is difficult to imagine a situation when doing so would have a good outcome. As family GPs, we have a duty of honesty.

But I had to tell a lie the other day, and it’s troubling me. I went out on a home visit to see an old gentleman patient of mine, who has been gradually dying of an unknown primary cancer for several months. It’s not been a bad illness, as these things go. He’s been OK on the whole, in the circumstances.

I had got into the habit of visiting every week and, as usual, I parked my car and walked around the corner to his house.Where, to my horror, I found him being loaded into a hearse by six blokes dressed as extras out of Oliver Twist; top hats, black coats, the works. The only things missing were the black-plumed horses. His daughter dashed over. ‘Oh doctor, how good of you to come and pay your respects! Dad would have been so pleased!’

Dilemma! Seconds before I had been expecting my usual chat with my patient about Rommel and Montgomery (he had been a Desert Rat) and now suddenly I’m in deep doo-doo.

Do I tell the truth? (‘Sorry love, I didn’t know he was dead. I wish you’d let us know earlier. I’ve got a lot of paperwork back at the surgery, I could have been doing that.’)

Or do I lie? (‘I couldn’t let him pass without seeing him off. You must all be devastated. How are you? Can I do anything to help?’)

I’ll let you guess which option I chose, on the spur of the moment, but I’m bloody glad she didn’t notice the doctor’s bag I was carrying and ask herself just why I would have brought that to a funeral.

‘Would you come to the crematorium with us doctor? And then back here afterwards? Dad would have been so pleased!’

I politely declined and skedaddled, but the incident set me thinking. Actually, I would have liked to attend his funeral; he was, I think, the last proper World War Two veteran under my care, and his passing was the passing of an era, for me.

And I genuinely liked him and enjoyed his company. Why should I have to forgo an act of genuine respect just because I’ve got a pile of bloody insurance forms to fill in? Which, in the long term, is more important?

In practical terms, we just can’t do three funerals a week (the average in our practice), even though the savings in mini pork pies and sandwiches with the crusts cut off would be significant. Time just does not allow. But I like the idea. Bevan’s vision of cradle-to-grave healthcare would be realised, in very literal terms.

But then again, not all my patients are like the Desert Rat. Some funerals I would be honoured to go to; some would just be a profoundly irritating and hypocritical waste of time.

How would you choose? Would a two-tier ‘deathcare’ system develop, with some patients blessed with their GP’s attendance at their funeral and others not? Would we end up with a bloody funeral rota? 

Maybe some things are best left the way they are.

Dr Phil Peverley is a GP in Sunderland

Readers' comments (4)

  • I've been to several patient funerals in my time and in my current practice we aim to send a representative to as many patient funerals as possible. Whether it's a doctor an HCA or a receptionist doesn't matter - the families are very appreciative and supporting other family members registered with us in the grieving process is often helped by knowing that little bit more about the deceased that can be picked up from the eulogy. I would recommend others to try it.

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  • I've been to several patient funerals in my time and in my current practice we aim to send a representative to as many patient funerals as possible. Whether it's a doctor an HCA or a receptionist doesn't matter - the families are very appreciative and supporting other family members registered with us in the grieving process is often helped by knowing that little bit more about the deceased that can be picked up from the eulogy. I would recommend others to try it.

    xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

    Should we add in Christianings, Bar Mitvahs, weddings and 21 st birthday parties?

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  • Well handled Dr P! The families do appreciate this care, speaking as both a patient and a nurse.

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  • My father died a brutal and untimely death (CA (GBM) last year. The GPs and practice staff involved in his care were just brilliant. The image i glimpsed through a doorway of dad's GP sitting on his bed when he was very ill and just stroking his arm is one that will stay with me forever. The knowledge that everyone did the very best to make his passing as humane as possible is enough for me. You don't need to attend funerals but you do need to be told that once in a while, especially when you are feeling rather world weary about your profession.

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