Diary of a GP (hope I can keep this up)

22/01/2025

Dear Diary

Today I woke up early at 0530, did some house chores and then did some yoga for and breathwork for 45 minutes and then meditated for half an hour. I never imagined I would write those words- it’s funny where life takes you. But it’s the only way I get my fill of juice in the tank to brace me for the NHS madness. If I don’t top it up, I can end up on the brim of overwhelm.

I cycled in- 15 minutes on the bike in the cold; the perfect commute to work. A bit of movement in the cold means I’m fresh for the morning. Get my cuppa tea and then start working on some admin- blood results/tasks from reception/medication requests/scripts. Then start my clinic at 0830.  

I think the job has become harder as I am getting older. Probably because the patients are more unwell, the system is more under strain, the job is busier and there is more admin. I am also in one of the more deprived areas of the city so the patients need more.

I think I probably give more of myself then I used to. I feel patients’ suffering more now. Bit annoying to be honest. It’s a blessing and a curse. It means I connect more deeply, get a richer experience which nourishes the soul. But it’s an energy exchange… and when you have back-to-back unwell patients, it can drain you. Yesterday I came home, ate some left over cheese toast and lay on the sofa, before going to sleep at 2030. Felt better today.

Some of my patients today:

A 7 month old boy with a cough. He was the son of parents who were under the Safeguarding team because of parental concerns over drug use, possible neglect and there was an investigation into potential Non-Accidental injury. With these patients, even though they’re coming in with just a cough, one has to have one’s antenna up and do a more thorough check. I looked in-depth for signs of neglect or abuse, fully exposing him and checking all over the body and in the mouth. He was a well boy- but the parents seemed a bit out of their depth. Handling was a bit clumsy. When he became upset, they struggled to know what to do and were superficially trying to calm him with contrived soothing noises. The baby was evidently hyperactive. My experience and intuition tells me this is a baby who struggles to get the love necessary for emotional development- when babies are young, as Gabor Mate outlines, they are unable to self-soothe when they get scared and this is what parents need to give their children until they are old enough to learn to self-soothe. It’s not their fault though, because they probably never had parents who gave them adequate care and so a vicious cycle develops.

An 82 year old who was struggling with getting old. One of life’s certainties- we will get old, we will get ill, we will experience pain and we will die. And yet we rarely talk about it or accept it. We deny it. We don’t want to think about it. I mention to her an interesting documentary on Netflix about a man Ram Dass who suffered a stroke that sent him from touring the World on stages giving talks to a wheelchair, relying on others to care for him. He finds life richer and more satisfying then ever… because he has delved deeper in the internal World- a world we never learn to explore but the Eastern philosophies shed light on a whole other universe that means we can learn to be happy without relying on external sources for joy.

Then I saw Jake. What a character. Born with a neonatal brain condition needing an operation that’s left him with a scar on his face that means he’s been bullied his whole life. He has a limp and speech impediment because he is an alcoholic and passed out and gave himself a brain injury that left him with physical disabilities. Most recently, he’s been accused of being a rapist and paedophile based on his looks. He can’t go back to the library anymore. He’s been seeing me to manage anxiety about being attacked as he’s had verbal abuse. We’ve had long chats and I’ve referred him for social support as he’s socially isolated. He is a bit of a genius too, he does wood work, makes watches, terraniums and he’s studied law, anatomy and psychology. He hates technology and he doesn’t own a TV. ‘Your own mind is a TV.’

He came today for a check-in with his mental health. Sadly his fears were realised as he was beaten up on his way out of the supermarket a couple of weeks ago. He had a nasty head injury and after 2 days of vomiting, he took himself to A&E. Luckily it was just a concussion and he’s just been left with mild headaches now. After chatting with him, I looked through his notes to help him get some Personal Independence Payment allowance for his disabilities (benefits). I noticed at Christmas, he had a safeguarding investigation because he was found with knives and some chemicals and he called up the police threatening to attack members of the public. Different beast to the man I know. I asked him what happened. He was drinking. He cooperated fully with investigations and went to court recently and has a fine, a suspended sentence and some community work to do… I said to him ‘Sounds like we need to get you off the booze soon.’  With a wry smile he said ‘it was worse on the drugs before.’ Made me chuckle. He has his demons no doubt. Naturally, he’s had a tough life. But what a mind he has, so much talent and no-one knows about it. Feels like he just needs a bit of good luck. Plugged him in with the a local Creative Arts Project which boosts health and wellbeing with creativity. Will see him again soon.

Right time to go see Bob Dylan’s new movie.