This site is intended for health professionals only


Take heart. The pain could be so much worse



I can tell you the precise moment that the 17-year-old me resolved to work hard, get my A-levels, go to med school etc etc. I was one week into a summer job which, to a teenager, had sounded wonderful: working in a factory that made record-player pick-up arms. The reality was that this involved me pulling, then releasing, a lever, which put a drill through some metal. Up, down; up, down. The whole day. After an hour I was bored out of my skull; after a day I was bordering on psychotic and after that first week I’d have gladly put my head where the metal was.

I’m glad someone does it and I’m glad it’s not me

That was when I decided that my future career had to involve some challenge and some stress. And I guess that’s why, many years later, I find myself working as a GP.

So, careful what you wish for.

But look, for all its current complete crock-of-shitness, general practice isn’t so bad. After all, it does still involve medicine, and we’d all agree that’s quite fun, even if that mainly means syringing ears or handing out statins.

Besides, even within medicine, there are jobs that are far worse than being a GP. Like working in A&E, for example. Imagine what fun that must be at the moment. Or being an endocrinologist: spending all day doling out skiploads of drugs to increasingly dejected and decreasingly well-controlled diabetics. Or being an anaesthetist. Okay, yes, there are certain patients I would like to render unconscious – just long enough, say, for me to leave the country or change my identity. But still.

Then there’s the worst job of all. The job that has me waking each morning and thinking, even if it’s a Monday and the next 12 hours are going to grind my gonads to dust, at least I don’t do THAT. And THAT, of course, is working in a pain clinic.

I can take heartsinks, TATT, patients who want antibiotics, CQC inspections, appraisal, revalidation, micromanagement, pay cuts, complaints, avoiding unplanned admissions DESs, the recruitment crisis. Even sodding 8am to 8pm, seven-day working. But I could not take one morning of seeing patients whose sole referral criterion is that the GP has not been able to control their pain.

After all, it’s not like we GPs are pain management morons: it’s pretty much our bread and butter. I diagnose and manage the cause, prescribe analgesics if necessary and job done. Trickier cases might need something stronger, a sprinkle of co-prescriptions and a side order of psychological tweaks. So by the time I’m penning the letter to the pain clinic, the implication is I’ve hit one hell of a ‘something must be done’ brick wall. Which means that the person really being treated, as I offload my intractable backs, fibromyalgics and medically unexplained pain, is me.

So good luck to the ‘pain experts’ is all I can say. I’m glad someone does it and I’m glad it’s not me. I presume they must be sadomasochists who enjoy the transference of pain from patient to specialist. If not, I genuinely wonder how they make it to the end of each day. But hey, if it gets too much, there’s this job in a pick-up arm factory.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield