The tiniest kindnesses were vital during my headache emergency
One GP recounts how a killer migraine has made her consider cutting her hours to make her a kinder, slower doctor
I was woken at 4 am by a crashing, screaming, sickening headache the likes of which I have never experienced before. I took two paracetamol, phoned work and settled down with wheatbag and two ibuprofen. After 2 hours it eases. Immediately feel guilty for missing work - was I just being feeble? But on hearing my tale my GP immediately sends me to hospital.
The pre-admission acute GP checks my blood pressure – it was 180/100 at the GP’s but has come down to 166/92. Says I look fine but phones the neurologist and comes off the phone cursing. I am to have CT and lumbar puncture.
The CT is uneventful but the neurologist has sent an SHO to do the lumbar puncture, a strapping lass - think East German shot-putter circa 1970, think Grant Mitchell in a dress. She is extremely sweet and probably more nervous than me, so I of course start apologising and try to put her at her ease.
‘Ivanka, that’s a lovely accent, where are you from?’
‘Oh wow - so sorry about this, can I do anything? Oh, OK, I will just keep still. So, Ivanka, did you study…Er, did you..er, study here?’
‘No, in Azerbaijan, is beautiful country… But I never do one of these ‘til I come here, in my country the consultant does them.’
‘Ah… I see… I see… And how many… I mean… How long have you been here?’
‘I come for 6 months.’
She proves to be superb, total star, and I hardly feel a thing. I lie flat for two hours, have a cup of tea and leave – they don’t know what it was, it should pass, I’m referred back to my GP. I thank them profusely, apologise a bit more, and drive home (I know, I know).
All well. Or not. By 8pm it is building again and I pass a frightening night with appalling pain, even worse than the initial presentation. I phone my GP first thing - he prescribes opiates.
A similar pattern of pain and sickness continues throughout the day and night. I phone my GP again the following morning – he suggests I add in ibuprofen, wishes me luck. The following morning (Saturday) I am terrified of facing another night like the last three.
I call the out of hours service and give succinct history. She seems to listen, then asks:
‘Do you have a headache? Do you have MRSA? Can you speak? Are you conscious? How did you hear about us? Would you recommend us to your friends?’
She concludes I am safe to wait to see my GP on Monday but she will ask a doctor to call back. When he calls back I cannot hear him. Now my hearing is affected! But the doc shouts back that they are having technical problems. He calls back and advises me to go to a clinic imminently. (I apologise again).
My husband attempts to drive me 10 minutes down the road, but we need to turn back. My husband half carries me back into the house. He phones on-call service as I now cannot speak. He asks them to cancel my slot, and asks for visit. They are very busy, waiting for a visit could take up to six hours. The call handler offers him an appointment in three hours at the clinic. We ask for a call back. The next caller blames the medication and says a doctor will give a second call back.
Finally - he agrees I need a visit. I apologise again. Visiting doc is wonderful, wonderful, wonderful bloke.
He apologises for checking my fundi/power/reflexes yet again - I tell him he is the first to do so (this is day four). Gets fed up with me saying ‘I’m fine now, really’ and makes me laugh by saying I sound like the Black Knight from the Monty Python film (YouTube it). Although it hurts to laugh I could hug him for being so sensible, compassionate and competent. I am now on more drugs than Ozzie Osborne on a bender. The new meds help
I have appointment with neurologist first thing Monday. In the waiting room I try to twist awkwardly across two chairs while I wait for my appointment, trying to stay as flat as possible. I am crying quietly, sore and afraid. I am the only person in the waiting area apart from two reception staff. They do not ask me if I am OK.
The consultant, who I know quite well, does not recognise me. He does a double take then tries to cover it up. I perk up when I lie down, apologise again, and he writes me a treatment plan. A tip to raise CSF pressure: caffeine. He recommends we buy Red Bull. He also recommends lying flat on back seat on way home, (‘horizontal evacuation’).
Things begin to come together and I am now recuperating at home. I am lucky; it has made me think though.
I am a GP of 25 years standing, I know the system, but still I was scared and felt very vulnerable at times. The tiniest kindnesses have stayed with me: the radiographer in the CT department (I only spent minutes with her but her manner was so gentle); the consultant neurologist (not a close friend) who offered to see me immediately; the visiting doctor (whose name I knew but whom I had never met before) offering to give me his mobile number in case I had another terrifying night; my colleagues from work (who have been supportive despite being overstretched).
The casual cruelties also jar: receptionists chatting, oblivious to my predicament; the neurology consultant with whom I have exchanged letters for 20 years, not taking 10 minutes to see me on the day; health care workers who hear but don’t actually listen.
I am resolved to change my practice - I will try to recapture some of the bright eyed open-heartedness of my younger self.
I am still kind, I think, but 30 years of giving have taken their toll and I am a bit jaded. If needs be I will reduce my days and do less, better – and stop battling with the clock. I know now that a single ill-chosen phrase or glance at my watch will wound.
The author is a GP in south west England.