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The Working Life of Dr Nobody


ICSs


6:40

I wake up and if, in that momentary waking moment, I realise that I am seeing patients all day I let out a load and primal groan, followed by an unspecified expletive.

I stumble out of bed, and put on my clothes that are on the floor next to me from the previous day, and try and avoid the kids who are already watching Netflix downstairs as I hurriedly get ready.

7:00

I drink three double expressos quickly in succession

‘GET ME SOME TOAST…!’ I hear one of them shout to me as I try and find my keys and coat; I pretend not to hear. At the moment I’ve got spasmodic torticollis, and can’t turn my head in any direction without pain, so after five minutes I give up on my walk to the bus stop and order an Uber to the surgery, sitting in it in silence with my black unwashed face-mask on, as I pretend to be asleep in the back of a Toyota Prius. 

8:00

I arrive outside the surgery, and I painfully extract myself from the Uber and make my way into the surgery

Nowadays during Covid, there isn’t the usual ‘queue of dread’ of people snaking around the outside of the surgery, and there is a sign saying not to enter unless they have an appointment. There are a few patients with facemasks on milling around outside the surgery; even with the masks on they look angry. One of them recognises me, and starts walking towards me, at which I speed up in the opposite direction into the surgery entrance.  

I walk past reception and say a muffled ‘good morning’ to reception as I make my way to my allocated consulting room for the morning. As I log in, I can’t help but feel a sense of impending doom as Systemone cranks into gear and my morning list appears before me. I sit on my chair which sinks low as I recline into it. I can’t find a pen. The room has a funny smell, the raindrops run as if in slow motion down the windowpane, and the damp patch on the wall outside seems to have got bigger. Someone with a facemask on walks past my room. I can’t recognise who it is, but as least it isn’t Brian, one of the other GPs,  (God, he’s annoying), and I offer a brief prayer of thanks that I now haven’t had to speak to him for the last 53 days…

9:00

 I scan the names on my morning list and the pit in my stomach grows tighter.

‘Nooooooooo!’ I silently exclaim as the first of many familiar names comes into focus. The full horror of the list appears before me as I lackadaisically pick up the phone. After 35 phones calls comprising of a smorgasbord of international misery, alcohol and drug addiction, unspecified pains, antibiotics and anti-depressant prescriptions, sick notes and various Covid queries I gently place my head in my hands and silently, despairingly, think that I can’t take another 20 years of this.

14:00

I’m down for the hot clinic in the afternoon, which means lots of appointments of seeing people who have colds, after which many prescriptions of amoxicillin later I’ve nearly finished; the PPE really is annoying. I then file 40 blood results mainly consisting of mildly low vitamin D levels.

18:30

The day is nearly over, the drizzle has started again, and it’s getting dark and cold. I venture outside, think about taking the bus, but then realise my neck is still in agony, and order another Uber. This time is a grey Vauxhall Zafira. Masked up in the back of the Uber is the most peaceful and restful part of the day; I give the driver five stars on the rating.

19:00

I get home, and then realise the kids might still be up, so I walk around the block in the rain wasting a bit of time. I get another takeaway coffee. The coffee shop owner looks at me as I damply walk into the cafe; ‘double macchiato?’ he says to me knowingly

20:00

I get home and don’t feel like speaking to anyone having been bombarded with verbal GBH all day from the punters. I then sneak upstairs and lie on the bed in the dark and put the radio on;  Magic FM for the old stuff, as I enter into a hypnagogic state with ‘Nothing’s Gonna Stop Us’ by Starship on as a musical backdrop.

21:00

I feel exhausted and myalgic, and can hardly summon up the energy to go downstairs. I’m not hungry having snacked on a Twix, some wine gums and packet of salt and vinegar crisps while waiting for the Uber.

My wife is out.

One of the kids comes up screaming, saying that the iPad won’t work. I roll over and pretend to be asleep; as I mutter: ‘I’ve got to have an early night as I’m seeing patients again all day tomorrow and my neck hurts…’

Dr Nobody is a GP in London

READERS' COMMENTS [16]

kathryn Moore 3 December, 2020 11:13 am

I felt desperately sad for you as I read this, it doesn’t sound as if you are very well at the moment – please get some help and speak to someone – the BMA have support for doctors.https://www.bma.org.uk/advice-and-support/your-wellbeing/wellbeing-support-services/counselling-and-peer-support-for-doctors-and-medical-students

Decorum Est 3 December, 2020 12:41 pm

Maybe Dr Nobody Is using his poetic licence in an admirable cathartic fashion to resolve familiar and prevalent distress?

Kevlar Cardie 3 December, 2020 1:10 pm

Cheer up.
Soon be Climate Armageddon.
😉

Hello My name is 3 December, 2020 2:01 pm

That does sound unbearable. Time to take back control, consider a more flexible salaried role, locum work or retainer? The job is grim, but working under these circumstances it sounds intolerable. But I do see people at many practices that lead lives like this. I get up and put on dirty scrubs and face masks too. I can’t face all the washing, and on work days my motivation for even basic self-care like changing socks is low.

Patrufini Duffy 3 December, 2020 3:28 pm

UK society is a grey, lonely, miserable, fragmented, empty, inert, lost and unappreciated consumerist place.
Family is non existent, and self-care too hard, but self-absorbed and self-righteousness is easy. Other industries closed their doors, others fuel the misery. But, yours glimmers the only hope. Still unappreciated and with no societal or likeable value. The 2020 Christmas tree will be devoid of cards and presents. And none of us are not getting a medal at the end of this. And so, I suggest a you-first, patient-second approach. It holds value and merit. No one will suffer. But, in fact you may be a “somebody” again.

A non 3 December, 2020 6:13 pm

This is the basic reality of a lot of GPs lives. Thank you for sharing

Scottish GP 3 December, 2020 8:36 pm

Hmm
Don’t like your family, job or colleagues, is there a common factor here?

Julian Procter 4 December, 2020 5:24 am

I agree with Kathryn. Please seek help.

James Cuthbertson 4 December, 2020 8:44 pm

I am planning on leaving general practice entirely. Prior to making this decision I kept looking at adverts designed to tempt me back in some way. The unifying feature was the way that the jobs were sold by how much non GP work they included, essentially acknowledging the crapness of the job, The problem is that society values GPs as worthless, barriers to the clever doctors of secondary care. Whilst the lovely relationships you can make with patients is a positive, the new way of working of online triage> F2F if needed will erode this. This is made worse by the ethos of the powers that be that seem obsessed with stopping ED attendances and “managing referrals” like GP time is worthless but secondary care must be protected at all costs. I can tell you that although some specialists work exceedingly hard, there are plenty who take the p*@s and their workload is nothing like the intensity of a busy duty doctor day in general practice. I think a large pushback against this is long overdue.

DJ Marlow 4 December, 2020 10:56 pm

This isn’t a therapeutic cathartic rant, this is depressing. There’s no humour or irony in this, just a pile of unwashed red flags. The last straw is surely avoiding your children. Perhaps the editor wanted to demonstrate an example of despair, I hope the author has already been counselled. Get some help, urgently.

Mark Semmens 5 December, 2020 11:02 am

Hope you eventually find some happiness and fulfilment in life my friend. It sound like you need to move on…

IDGAF . 5 December, 2020 3:29 pm

It is fascinating to see the replies. Is it a bona fide diary, or a fiction presented by someone who is ground down? There are innumerable ways of looking at this, each of which is just a perspective, and this number of ways could be cut if some context was provided.
Kids up at 6.40 watching Netflix? OK…..
Going to work with spasmodic torticollis, that rare neurological disorder which falls under the cervical dystonias? Or is it GP talk for a stiff neck? If it is truly spasmodic torticollis, is it secondary to a degenerative brain disorder with affective symptoms?
Whichever way one looks at it, the picture presented is not a happy one. Perhaps the commenters should look at the reaction it evoked in them, as this is more “real” than anything one can firmly conclude about what is presented.

I for one will grab a couple of pans, and bang them together appreciatively. Good stark writing.

Victoria Cleak 7 December, 2020 4:33 pm

I also feel sorry for your wife and children.
No wife would walk around the block until the kids are asleep unless they were almost catatonic. Mothers have to carry on regardless.
Nothing will change until you change you or your situation. Get some help.

John Ashcroft 7 December, 2020 7:28 pm

I usually advice my patients to write down what is troubling them, on paper, and sleep on it. pick up what they wrote and review it. Hopefully the author will find it helpful.
There is a bigger issue and it is this,
The way NHS GP is funded does not adequately fund workload that comes with deprivation.
Worse partners in practice make more money by doing less; try to deliver more by employing more staff you take home less.
Doctors who try to deliver more become burnt out; doctors who are more protective of their time survive.
We need a new contract that rewards when we deliver more, and doesnt reward partners and partnerships that deliver less.
Uncomfortable, but true.

Kevlar Cardie 8 December, 2020 11:03 am

Sound F*****G AWESOME.
Where do I sign up ?

David Jarvis 14 December, 2020 4:42 pm

Get out of London. There is a world ouside the M25. Live up north your money goes further and plenty is not deprived. It seems the only reason people move to London is for opportunities to make money. But even with London weighting the maths don’t add up for GP’s. 30 mins in a Taxi and I would be 25miles away not walking distance.