Woke up and smell the coffee!

Andrew Papanikitas is Deputy Editor of the BJGP.

It has been pointed out to me that BJGP Life is a little bit ‘woke’ of late. I wondered what this could mean, and it seemed like an excellent opportunity to craft a headline that would trigger some cognitive dissonance (over grammar at the very least), because I am using ‘woke’ as an adjective or (worse!)  as a verb in the present tense. Woke is defined as being ‘aware of and actively attentive to important facts and issues (especially issues of racial and social justice)’, and is identified as US slang. It originated in African American English in the first half of the 20th century and gained more widespread use beginning in 2014 as part of the Black Lives Matter movement. By the end of the decade it was also being applied as a general insult for anyone appearing to be politically left-leaning, or as a perjorative adjective describing people who are ‘too politically correct’.^1,2 I am fairly certain that being aware of and attentive to important facts and issues is certainly something we should be striving for at BJGP Life. In this issue our authors embody this by reflecting on their physical relationship to dance and coffee, how understanding with patients on their own terms can result in better healthcare, and the healthcare ecosystem in which they practice — in its threadbare glory.

Smell the coffee and dance the tango

Anuj Sean Chathley reviews his relationship with coffee. Caffeine is a psychoactive substance and potential dependence to it is a well-established phenomenon. Workplace cultures are built around it. Coffee rounds are viewed almost as team-building exercises rather than pharmacological rituals. If we need caffeine simply to function, perhaps the real issue isn’t what’s in the mug.³

Rachna Chowla muses on how dancing the tango teaches us about the importance of trust and presence, ‘If we don’t see each other, we cannot deeply see one another — and we cannot see that we are beings trying to find meaning and understanding in what’s happening.’⁴

Talking cures and desire paths

So Sakamoto, an emergency physician in Japan, points out that (after screening for significant pathology) talking can be an effective treatment for hyperventilation. He demonstrates how this can be safer and less distressing than coaching breathing. His approach requires awareness and attentiveness to the physical state of the patient.⁵ Maiedha Raza applies this attentiveness to patient movement through a health system, and introduces us to desire paths in primary care, those informal, patient-driven routes through services that emerge outside of prescribed systems.⁶ They highlight the importance of communication skills in shaping access and experience. Importantly they highlight barriers to care but perhaps they might simultaneously hint at better design of care pathways.

Attend and respond to the primary care ecosystem!

Alex Burrell offers a selection of insights from other medical journals: if GPs are lacking the resources to host medical students in person, might offer live-streamed medical education? Do complaint patterns suggest that the poorest patients get the worst care? How is mental health affected by the weather? What are the social and cultural barriers to effective screening for cervical cancer?⁷

Simon Smail picks up on an article written in the BJGP in 1985 by his uncle and finds its message compelling and current after over 40 years — we must be aware of and actively attend to what the media are saying.⁸ More than this, primary care must be proactive.

Saul Miller invites us to consider the threadbare aspects of general practice in the UK in an imagined practice meeting. How should we respond to an inadequately resourced system? Should we signal dissatisfaction through mild disobedience (collective action as a profession) or exit the system? Miller reminds us that the social solidarity model of health care (the NHS), threadbare as it is, remains a significant benefit of living and working in the UK.⁹ Does this, however, mean that those who work in the NHS can be subject to moral exploitation,¹⁰ endlessly being forced to do more with less, while taking the burden of and the blame for systemic shortcomings?

While this issue’s Life and Times articles are not especially about race or gender, they are broadly ‘woke’. Mindfulness about the aroma of coffee or the immediacy and intimacy of a dance extends into practical empathy as talking cures hyperventilation or we prepare patients to access healthcare services. This develops into professional and political awareness. To say that we should not be aware and attentive, or only be interested in the welfare of those closest to us culturally or socially, does not seem like a recipe for a healthy society or good primary health care.

References

1. Merriam–Webster. Stay woke: tracing the history of ‘woke’. https://www.merriam-webster.com/wordplay/woke-meaning-origin (accessed 22 Sep 2026).
2. Tang T. How ‘woke’ went from an expression in Black culture to a conservative criticism. Associated Press 2025; 30 Sep: https://apnews.com/article/woke-wokeness-trump-dei-94ccabbc0af185b494c273238d3bb50c (accessed 22 Sep 2026).
3. Chathley AS. The acceptable stimulant. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp25X742917.
4. Chowla R. What tango can help us rediscover in medicine. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746649.
5. Sakamoto S. Stop coaching breathing: treat hyperventilation by talking patients back to normal ventilation. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746673.
6. Maiedha R. Desire paths in patient care. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746685.
7. Burrell A. Yonder: Livestreaming clinical education, complaints, weather and mental health, and HPV and cervical cancer screening. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746661.
8. Smail S. Medicine and the media: why my uncle’s 1985 message matters now more than ever. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746721.
9. Miller S. Threadbare. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746709.
10. Parker J. Junior doctors and moral exploitation. J Med Ethics 2019; 45(9): 571-574.

Featured Photo by Nolan Issac on Unsplash.