I knew her husband before he died – all the doctors and nurses in the surgery did. He had been unwell for a long time, and his care needs had been immense. Year upon year he got the best care from her that anyone could have wished for. His family became nursing experts, and it was a job they did with complete love until he died.
She’s come in to see me fairly regularly since his death, ostensibly about her own health problems, but we usually end up talking about him. We talk about all the people she has to tell about what’s happened; about the rest of her family and how they are dealing with things completely differently; about the funeral, about her perpetual struggles with the monstrously complex benefits system. She tells me of her anger and bitterness too. But most of all, she tells me about him – about what made him smile.
She tells me that when she is ready, she’s considering going into care work because she’s been told by so many people (including me) how very good she was at it. I say I think that sounds like a wonderful idea, and the people she would care for would be lucky to have her. As has happened so many times since starting out in medicine, as well as seeing the darker side of human nature, I am struck by people’s generosity too.
She gets up, and before I know it I am enveloped in a hug. She kisses my cheek. ‘Thank you so much.’ She gathers her things and leaves, leaving me wondering what I did, and wishing desperately I could do more. Which is something I wish for so many of the people I see. When in hospitals, especially my years in O&G and acute medicine, I found such satisfaction in the quick results I saw; seeing people improve during their stay, and the feeling that I was making a tangible difference. But I have found GP land so different, a different sort of satisfaction completely. I am told sometimes that I am not going into general practice at a good time; I hear all the time about the depressingly Kafkaesque bureaucracy, and QOF and CCGs and the relentless pressure on GPs to do ever more with ever less. Only recently I have read about a survey that said how many GPs are considering quitting over the next 5 years – on the order of 10% - and I hear about how many are retiring early and going part time. And I can see the problems and frustrations. But I am finding even so, just beginning this road into what I believe to be a bloody difficult but hugely valuable profession, that there is still so much joy and satisfaction to be found. People come in to their GPs with their loneliness, their grief. Perhaps sometimes all we can do is listen, to bear witness and be present for their suffering and pain, be with them in their journey - and I am slowly learning that this can be a gift, in itself – to both patient and doctor. And I feel so grateful to my patients for what they have taught me so far.
So I feel lucky to be starting out in this job, and have loved it up till now – and hope it’ll be a little while before I become too cynical! Anyway, better get back to clinic – those QOF points don’t accrue themselves you know.
Dr Georgia Belam is a GP in Devon
