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When everything starts to unravel

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As we’re all likely to do at some point, I have just mentally unravelled. I don’t know how many neuronal threads there are in the GP brain, but the story of how it happened to me has two.

Thread one: the local nursing home calls me to see an old geezer with a cough.

Thread two: for weeks, I’ve been trying to jump through the right hoops to access help for a 13-year-old school refuser and his increasingly frazzled family. It’s unclear whether he’s phobic, depressed, suffering family dysfunction or just being a screwed-up adolescent. It’s complicated, escalating and the education authorities are putting the frighteners on his parents.

Gawd knows I’ve tried to sort it, but we really need the child and family to consult with the experts.

Let’s see. Child, family, consultation... that would be the Child and Family Consultation Service, right? Yet despite various letters, CAF forms and phone calls, nothing’s happening, not even the statutory triage before the pre-assessment before the assessment before the treatment. In evolutionary terms, this kid’s management is still in the primordial soup. The parents aren’t happy, and nor am I. So I phone the ‘service’ and leave a curt message asking the Man With No Discernible Child Psychology Plan to phone me back. 

So here I am at the nursing home, seeing the old geezer with cough, only to discover that he was sorted out by the community matron yesterday, which they forgot to tell me. Before I can find the right expletive to sum up the situation, my mobile rings.

It’s the child psychology gateway person. The conversation is difficult because a) a demented lady in the next room is screaming ‘For f***s sake let me out of here!’ every 30 seconds and b) I’m expected to endure from him 20 minutes of obfuscation, evasion, excuses and wiggling.

Thanks to screaming bonkers lady, I’m having trouble hearing what I don’t really want to hear anyway. As far as I can tell, the referral stumbling block is that I’m supposed to come up with a diagnosis and specify the treatment needed. In other words, CFCS will only help if I can solve it myself, and if I can’t, they won’t. Nice.

Weeks of suppressed rage erupt. I hear myself shouting down the phone that he’s not devising a treatment ‘pathway’ but an obstacle course, that his team needs to get off its big fat stupid multidisciplinary arse and do something and that, if I don’t see some action, I’ll personally send my dog round to gnaw off one of his testicles. Ridiculous. I don’t even have a dog.

I look up slightly shell-shocked and realise that the carer who guided me to coughing old geezer’s room has long gone.

The doors partitioning the corridor are locked and I don’t know the combination. I’m trapped, incarcerated in an old people’s home. 

I swear and then I hammer on the door, shouting: ‘For f***s sake let me out of here!’ 

Bonkers woman peers at me. And I realise, with a chill, that some years ago she could well have been a GP asked to visit an old geezer with a cough.

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder