What I miss and don’t miss about being a GP

The constant worry over potential mistakes is something I am glad to have left behind when I changed career

Three months ago I changed my life. I stopped getting into my car to go to work, travelling across the river and up the hill. I folded my relatively new scrubs and put them in the back of the wardrobe. The cloth bag containing my stethoscope and sphyg was flung under the stairs, to join the tatty sharp-edged leather doctor’s bag that I had abandoned years ago because it bruised my calves as I lugged it up narrow northside staircases. I walked away from the life of a jobbing GP and settled myself into my small home office; slippers on, coffee machine gurgling, laptops humming.

What do I miss? Honestly, the first thoughts that spring to mind are the things that I don’t miss. I don’t miss that very faint yet omnipresent little niggling worry that today will be the day that I make a ‘big mistake’. Every day as a doctor we try our best, or at least we try to try our best. But there have been plenty of days with a seat-of-the-pants feeling to them, where the universe has somehow managed to save our bacon and, more importantly, the patient’s bacon, by subtly nudging us to double-check that INR or feel that thready pulse.

There is a sense of thin-ice skating that some people thrive on, some people ignore, and which gives me low-level gastric ulceration. It is only when that threat has waned that I begin to count the number of sleepless nights over the years, which have been spent going over the day’s clinical scenarios, wondering what tragic mistake I have made, waiting for the hours to pass so that I can rush to work to call yesterday’s heartburn lady and assure myself that she hasn’t ruptured her aorta overnight. (What do patients make of those seemingly innocuous phone calls, I wonder? Do they realise that when we casually say that we’re “just checking in to see how they are doing”, that what we really mean is we are checking that we haven’t killed them with our incompetence?). Then there is the worry of the worry that you didn’t worry about.

The patient that you thought no more about as soon as the door was closed behind them. The universe gave you no hint, no nudge, no metaphorical tap on the shoulder to remind you to check their allergies or feel their tummy. Your brain is devoid of any niggly concern about them until you see their name emblazoned underneath an expensive ivory letterhead from Messrs Gotcha and Fleece Esq, with words like negligent and culpable swimming in front of your eyes.

You still have no idea what was wrong with the patient, but you know for sure what is wrong with you and it is cold dark terror. So I don’t miss that, though I am under no illusion that a thick cream envelope cannot still make its way through my letterbox. But there is an element of relief in knowing that I am not accumulating additional potential sources of litigation as the days pass. What I do miss is the physical energy and warmth that comes from sharing space with another person. Smiling, chatting, observing each other’s movements.

There is a dance to interpersonal interaction that is fluid and serene, while at the same time unpredictable and tense. My body misses that waltz. I miss the worthiness of being useful. My children used to express surprise when they heard that I used to work in a hospital, “like a real doctor.” The cosy confines of a general practice surgery did not fulfil their expectations for the workplace of a life-saving hero. I thought I could stoop no lower in their estimations, until I started to go to work upstairs in the back room. In my slippers. Now I am about as heroic to them as an old sock. I went back to the real world to give some booster jabs over Christmas (a full 10 days of holidays in late December was simply a bridge too far for my psyche to take, after years of simply being grateful to have Christmas Day off).

I got to waltz again for a few hours, and chat and smile behind the FFP2. I also got to lie in bed for hours wondering if the last man I sent out the door was now lying dead behind a skip having had a massive anaphylaxis because I forgot to ask him if he was allergic to Movicol.