First Blog. The day after my 64th birthday

I opened my blog account on my 64^th birthday. You see, I am a medical doctor – a general practitioner - at the tail end of my career, and due, fairly imminently, to “hang up the stethoscope” for good.

          30 years working full time in a “challenging” location in south east London has left me with amassed memories. Of people, situations, elation, sadness, success and failure. It may be that these pages will act as a host to some of these, and my reflections upon them.

          I find myself thinking again why it is that people become doctors in the first place. And it is in this context that I believe medicine may find the reason for some of its disappointments and dilemmas. The criterion – often the sole criterion – through which applicants get admitted to medical school is that of academic achievement. OK – so it must be of a sufficient level to enable the medical student to survive the four to five years of demanding application and study, and the years of postgraduate training in the chosen specialist field thereafter. But much is said about the idealism and philanthropic motives that cause young men and women to want to become doctors. Yet this is too often an Achilles heel, a source of ultimately frustrated ambition and disappointment. A “caring” soul is often keenly sensitive, too sensitive, perhaps, to survive the harsh reality and realisation that the power of doctors to make a real difference in peoples’ lives can be very limited indeed.

          Looking back on what my patients said and wrote about me when I left my London practice, it seemed that what most of them valued in their doctor was the ability to listen to them, and to treat them with courtesy. This is something quite different from the concept of the “caring” doctor. I have seen too many young doctors traumatised through simply “caring” too much. Some had their careers effectively destroyed by the tendency. A few broke down under the strain. Some even took their own lives.

          For me, courtesy was the backbone of my mode of practice. I made a point of being rather formally dressed, of greeting my patients – unless they were much younger than I – by their title and surname. Standing up, opening doors. That some construed that as “caring” did not matter in most instances. I may have been pretty consistently polite, but I lost no sleep over any of them.

          My reasons for going in to medicine, then? Job security (less guaranteed these days), adequate remuneration, and a certain status. Mind – I never admitted as much to those I “cared” for, but my own view is that they made me a safe and reliable doctor.