The flicker: one more day

Highly commended in ‘The patient that taught me’ category, Dr NNV writes about the patients that make it worth going to work each day

The NHS is crashing, or it has crashed, or will crash – or whatever. I still go to work. I arrive an hour before my first patient is booked. I log in, clear the tasks, meds, and labs… all so I can hit the ground running. 

The computer won’t load. The receptionist I ask for help gives me a bored, exacerbated look. The practice manager says we need new computers. But NHSE won’t fund new computers. So, as I call the computer fix-it guy, I wonder who funds him. He says he will have to send his IT guy out again. I calculate how many trips it would take before we could justify a new computer. 

Nevermind, I’m on now. Morning session, 20 patient contacts, here we go.

There’s the ‘I’ve googled my symptoms’ starter. Also known as the ‘worried well’. It is good to warm up with I guess before my patience runs too thin. Then the viral babies, worried parents, safety net, self-care and pray no proper sick kids please.

Next we have the frequent attenders, the non-reassurables, the non-specific and the ‘all over body pain’ back again. ‘You’re not taking me seriously doc’. ‘The NHS has failed me, why aren’t you doing anything doc?’ Sighing, I wonder who will look after my mental health? 

Chase my referral; chase my results; prescribe it; I don’t want to buy it; don’t you GPs just push paper around anyway? AI will help! The ‘extreme pain from blood collection around my elbow’ turned out to be in real life: a bruise, sustained from venepuncture yesterday. It’s quite fun really, like a game of guess what the diagnosis is really going to be.

And then there’s that one patient. The history clicked, rapport was established, a sixth sense prickled up and a call was made. Transfer of care was accepted without argument. Treatment was given in a timely manner and the treatment worked – true shared care was actually achieved. He even came back to say: ‘Thanks, that made a difference. You might have saved my life.’ I smile and feel a flicker of content. That flicker is quickly extinguished as I call the next patient in. 

Then, 10 hours pass and I’m driving home. The blur of people and problems – disappointments, anger, regret, frustration, indifference, sadness – hurriedly flip through my mind like the pages of a book. 

Why do I do this job? The flicker reignites and moves forward, like a small flame burning slowly but brightly. I remember that one patient; the connection, the feeling that someone else’s life might in some, even very small way, be better because I was at work today. 

That one patient who made me feel like it is worth it. It was not all for nothing. It meant something that I was there. I should come back tomorrow. One more day.

Dr NNV is a salaried GP in Buckinghamshire