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It’s a wonderful GP life

It is Christmas Eve 2016 and George Pailey (also known as GP) is standing on Clifton Suspension Bridge. He feels like he is sleepwalking, but he’s there because the voices in his head were urging him to go.

He felt he was too far down this road to turn back

‘George must change’ and ‘Old George must go’ they keep repeating, which is why he is now hovering near the edge. They’ve made him feel utterly worthless, unable to see any value in what he has been doing for the past 25 years. Gazing out through a mist of tears, he reluctantly climbs the wall and looks down, feeling there is no other way forward.

Then, out of the corner of his eye, he notices a white dove circling over his head. He realises he has seen this dove before, but never really paid attention to it. This time, he is transfixed by its hypnotic movements as it fills his head with visions that replace the endless voices.

The first vision he sees is from 1992. George is resuscitating a child with a severe asthma attack. He smiles at his youthful floppy hair, and vaguely recognises the practice nurses, but it is George who is leading the team.

Next, he sees a vision of himself from 2004. He is on the front page of the local rag for setting up an outreach clinic for Asian men, encouraging them to reduce their risks of heart disease. This local initiative meant CVD risks at his practice were the lowest in the area.

The final vision is of Matilda, who irritated staff by calling the practice several times a day. George had a good relationship with Matilda but resisted the urge to request multiple tests and referrals. Then after 18 years of managing Matilda, George found a lump. The lump led to surgery and the surgery led to chemotherapy, but in her final hours, it was only George’s hand Matilda wanted to hold.

In spite of these visions, George remained convinced he should take the plunge. He had internalised the voices’ insistence that he must adapt or die. He had also invested a vast amount of time on ‘working at scale’ and ‘interprofessional working’ and felt he was too far down this road to turn back.

But then the dove revealed a new set of visions – those without the influence of George in people’s lives. The child with asthma collapsed and died at the age of seven. Fatima lost her father to a heart attack when she was 14. And Matilda saw multiple nurses, paramedics and consultants – but in the end, had no one’s hand to hold.

‘Is it too late?’ George wondered. ‘Too late to stop the rot and fight for the old George?’

He climbed down from the wall and, dizzy with possibility, ran back across the bridge. He now knew he had to save himself in order to keep saving others. For the first time in years, he felt exhilarated and ran all the way back towards his practice to spread the news.

He was so intoxicated with joy he didn’t see or hear the government vehicle pull into the sliproad of the M32. He was so lost in thought he didn’t hear the screech of its brakes. But as he lay underneath it, he saw a final vision – of multiple doves flying off into the distance – and he wondered why he hadn’t followed them earlier.

Dr Shaba Nabi is a GP trainer in Bristol