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Taking the patient’s perspective

Dear Prime Minister, 

Dr Nishma Manek 330x170

Dr Nishma Manek 330×170

I was 15. I had the typical teenage troubles: low confidence, bad acne, and I was bullied. I had started having sex, and I didn’t know how to stay safe. It got too much.

Things became more bleak. I started to cut myself. I know it seems stupid, but the controlled bursts of pain numbed the blackness that threatened to tear me open inside.

To my GP, I wasn’t just a patient with a problem. I was a whole person with cracks beneath the surface

I went to the sexual health clinic one day for condoms. The nurse was nice; I saw her glance at my wrists and I almost told her. But then a black wave of sadness welled up inside, and the words got stuck. The moment passed. It was the next person’s turn, and I knew I’d never see her again.

I was sinking. I started planning other ways to hurt myself. It was as though I was on fire, but no one else could see the flames.

Finally, a friend suggested I see my GP. I was terrified. But slowly, I started to recall the childhood memories of the kind face with her reels of Superman stickers. Somehow, it felt safe.

The first time I went she gave me acne cream, which helped my confidence. I went back for more, and asked for contraception. There was silence. Something made her ask me what was going on.

It all came tumbling out. She just listened.

It wasn’t that hard. I felt like I knew her. I don’t have a dad. My mum has a drinking problem and my brother has ADHD. She knew that too.

My acne wasn’t bad enough to see a dermatologist. I didn’t want to see the mental health team; it would take months. I didn’t need these pieces of me to be boxed and examined in isolation.

The GP asked to see me regularly for my contraceptive pill. But I knew it was more than that. She told me about a youth group too, where I met other teenagers. I can’t put into words what it meant. But somehow, slowly, I climbed out of that hole.

Ms May, I watch the news. You care about mental health. You care about the ambulances, the trolleys in A&E, the patients who are stuck in hospital. But do you hear much about people like my GP?

To her, I wasn’t just a patient with a problem. I was a whole person with cracks beneath the surface, feeding into a widening hole.

Her job isn’t glamorous. She’s not always diagnosing rare conditions, cutting people open or curing diseases. But my GP manages uncertainty, carries risk, and helps people like me to shape their life stories. In 10-minute snapshots, day after day.

In my stories gone by, she’s played my counsellor, my navigator, my advocate, my source of knowledge and my friend. That can’t be measured. But it’s led to a new chapter in my life.

I’m now 23. I have a stable job and a partner. Life seems more hopeful. And while I still see glimpses of that blackness, I know my GP is there.

My story isn’t dramatic. It won’t make the news headlines. But without my GP, the ending would have been very different.

And, Ms May, she taught me the most important lesson of all: you don’t know what you’ve got until it’s gone.

Yours sincerely,


Dr Nishma Manek is a GP trainee in London

*This story is based on a real patient, but details have been changed to protect their identity