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Knowing our limitations

GPs may often be clueless but at least, unlike electricians, we will admit it, Phil reckons

I've just had a week off. It was productive. I've known for a long time that the human venous system, stretched end to end, would extend from Sunderland to Portsmouth. But it was nice to be able to prove it.

It hasn't been all fun. On the negative side, we've had electrical problems here at Pev Towers and we've had the electricians in. I have been dealing with the 'experts'. And it has not been an edifying experience.

The subject of expertise is a tricky one with GPs. We all know we've got it. We're just not entirely sure what we're experts in. This can be disconcerting. Perchance we're expert generalists, and we know that knowing almost nothing about a great number of subjects is an impressive skill.

We take pride in the fact that the number of specialties about which we know next to nowt is expanding all the time, and we revel in the fact that we know diddly-squat about an ever-enlarging, bewildering sum of knowledge.

Patients are no better off. But if a patient wants a companion to wander with them, hand in hand, though the ever-enlarging multiverse of human experience, then the GP is the obvious choice. Just don't expect us to talk any sense.

But at least we are honest. We will admit to our patients, if we have any nous, that they know as much as we do about ankyloblepharon or Sinding-Larsen-Johansson Syndrome – and possibly more.

Other 'experts' aren't so honest. Try getting a new shower put in your house, as I did recently. Try talking to an electrician.

'What you need here,' said electrician number one, 'is a three-quarter-inch co-axial cable laid from the main junction box to this secondary terminal. That's if you don't want cosanguinant waves to be set up during peak demand periods. And I'm thinking you don't want that.'

'I had been hoping to avoid that, if I'm honest,' I conceded.

Electrician number two, when looking at the same problem, told me: 'Your basic mixer boiler can't cope with that sort of demand, gov. You need a gravity-led, tertiary hot-water tank up here, with an immersion element and a quaternary rear-pressure back-lagged ball-cock di-lithium crystal generator. It'll cost you, mind.'

'I had not expected it to be cheap,' I said, after a somewhat baffled pause.

Eventually, I decided to go with electrician number three, who said: 'Hmm, tough one. Leave it all to me. Five hundred quid, or three hundred in cash and half an hour with your missus.'

Thirty-one minutes later he started work. 'Where's your emergency shut-out switch?'

'How the hell should I know?' I said.

'Well it's your house.'

'And that's your body,' I replied, prodding his ample abdomen. 'So where's your thymus gland? You find the bloody shut-out switch, and I'll make the tea. Four sugars, was it?'

Maybe we should use this approach more often with our patients. 'Ooh, you don't want hyperglycaemia, I wouldn't if I was you. Now, do you want your Islets of Langerhans stimulating, or would you rather have reduced insulin resistance? Either way it's going to cost you, but think of your renal tubules.'

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