Georgia Avon is the ‘Nomme de plume’ of a London GP.*
Wendi and Peter both texted Niva, Rula and Hana the same text at 9am as they hadn’t seen them for a few days with the long shifts and irregular hours.
“How are you three doing ?” it said in the text “How’s things going at the ICAC?”
Rula, Hana and Niva had all arrived at the ICAC for their morning shift, but both felt the atmosphere at the ICAC had been really weird since the incident with Peter, Wendi and Gareth.
No-one had really said anything about it, and Niva wasn’t even sure how many of the IHPs were aware of it, but the feeling at the ICAC felt almost mutinous to her.
Some more “handler” IHPs had arrived, despatched form the ICG and were patrolling up and down the ICAC management areas, and Gareth wasn’t to be seen anywhere, although someone had said he had been assigned some “backroom” office work for the time-being. The new handlers were called Elon , Al and Siri and they were already making themselves visible in the ICAC atrium, checking the IHPs in as they started their shifts and authorising several AIADS assessments and sign-offs for some of the IHPs working there.
“It’s weird” Hana WhatsApped back to Seamus, Peter and Wendi. “Everyone’s really tense and on edge”. “I don’t know what you two, Peter and Wendi have started off here, but it’s got the feeling that somethings gonna happen! ” Hana WhatsApped, concluding with two sad emojis.
“Wow” messaged Peter. “Lets us know what happens”. “By the way…” Peter continued with his message, “would you, Rula and Niva be interested in starting up a new GP surgery with me and Wendi, based at Endeavour Mansions, which will be called ‘Endeavour Medical Centre’ .Seamus has been in touch with Patrick our landlord, and he’s really keen for us to do it, using the bottom two floors of the Mansions, and Patrick has even said he will meet all the costs and pay us a salary for the time being!”
Niva saw the message and just put a happy emoji in the chat, as did Rula.
Hana also replied with a happy emoji.
“That would be so amazing, working with friends in a friendly GP surgery – I’ve always dreamt of that” messaged Hana. Hana then checked the old RCGP/ICS agreements from the mid-2020s, and found the (very short) clause, tucked away on page 254 that said that GPs could still set up their own surgeries if they could find the premises. “Yes!” Hana exclaimed to herself as she read the clause in the 2026 agreements. She messaged the others “I’ve double checked the original contracts – we can do it!”
“Endeavour Medical centre’ [Happy emoji]” came back from Niva. Niva, as well as being a GP, loved art, books, and literature, and already had come up with a stylish “art-deco”, style logo for their new project.
Rula also thought it sounded fantastic, and loved the Art-Deco idea. “Amazing!” she WhatsApped back.
Hana, Rula and Niva had started their shift, trying to keep up to speed with their morning shift. Niva was running late however; she really cared about the clients, but because of that took a bit longer with them, and so ran behind. Today, however she was really running late, which had alerted the handler IHPs.
Al walked up behind Niva’s cubicle, and said quietly “Niva, can I have a quick word in my office?”Niva got up and followed Al to the handlers office area, which as it was in the centre of the atrium, was still in full view of most of the ICAC workers, although Al possibly did not realise this, considering what happened next.
Al went into the office area followed by Niva
“Why do you always run so late Niva?” Al asked with a distinctly angry and petulant tone. Siri and Elon were also there, and turned around nodding. They were monitoring the ICAC dashboards and time-logs, and could see that Niva always ran late, and was also running behind on her CIHCPs which meant loss of revenue for the ICAC.
“I try my best said Niva, but some clients are more complicated and take more time…I’m sorry” said Niva, starting feel upset. She felt a tear start rolling down her left cheek.
Siri and Elon moved up closer to Niva.
The three handlers now surrounded Niva, and started letting rip.
“Do you know how much money you’re losing us Niva?” spat out Siri, starting to raise her voice and shouting. “This will come out your wages you know.”
“Yeah, and why do spend so long with clients, are you that inefficient?” Elon sarcastically sneered.
“And why don’t you use the AI and digital tools and symptom sorters, and chatbots that I’ve created and installed on the ICAC systems?” Al hissed in to Niva’s left ear. Niva was briefly tempted to say “because they are crap,” but refrained.
Niva physically recoiled backwards from this verbal attack, instinctively. She did not feel safe.
Hana, Rula and most of the other ICAC workers, had been watching every moment of this encounter, and from the rest of the atrium, and when Niva recoiled it looked to them that she had been struck by Al, as Niva was now clutching her head and weeping in the handler offices.
Hana and Rula were the first to act.
Hana lifted up her chair, and suddenly smashed it into the monitor in front of her: the monitor screen cracked and the holo-prompts became distorted. There was an enormous bang and crash from this, followed by complete silence. Rula had simultaneously picked up one of the monitors and toppled it off the stand.
They one by one, all the other IHPs, all 55 of them in the ICAC picked up their chairs and similarly smashed the monitors with them.
Hana walked into the handler offices, grabbed Niva by the hand, Rula took her other hand, and all of them marched out of the atrium doors and out of the ICAC. Following them, all the other IHPs in the ICAC did the same, at the same time shouting “shame on you!” to the IHP handlers in the ICAC offices, who by now were cowering behind their desks.
A few minutes when they were outside, they started hearing the sounds of police cars and sirens and a loud deep droning noise, like a distant thunder, with the police obviously making their way to the ICAC, having been called by the handlers.
But it was too late for the handlers… the revolt was over and the ICAC workers were free.
Suggested soundtrack: Revolt by Muse
September 2032 (Aftermath)
Suggested soundtrack: Aftermath by Muse
Peter had been reading a lot of WH Auden since Seamus had mentioned him, and had now moved on to TS Eliot. He like Eliot’s quote about human beings; “humankind is not able to bear very much reality”, Eliot had said. Peter thought how true that was in the aftermath of the ICAC revolt
“Endeavour Medical Centre” had officially opened up in the bottom two floors of Endeavour Mansions on 24th April 2032 , and already over ten thousand patients had registered there
The GPs working there included Hana, Rula, Niva and Wendi as well as several others from the old ICAC. It was mostly face to face appointments at the surgery, which the patients much preferred, but obviously there were still a lot of phone calls and some video consultations. In general though, the very fact that so many patients had registered there indicated that the human touch, empathy and a face to face approach was needed and desired by the majority of the patients.
After the revolt, the ICAC had been shut down by the ICG: the ICG claimed that they were going to close it down and merge it with the North London ICAC anyway, and tried to save face by trying to bury the news of the revolt, which wasn’t even mentioned in the ICG newspeak. Everyone knew what had happened though: but there were no prosecutions, as the ICG did not want to publicise what had happened.
Patrick the landlord had been absolutely fantastic and had funded the transformation of the lower two floors of Endeavour Mansions into the medical centre: it was still underway, but was making good progress and hadn’t delayed the opening of the centre, and there was also going to be a new entrance to the new medical centre on St John’s Street. Patrick was also helping with paying the GPs, but Seamus had secured a deal with the ICG and RCPCP about payment, as it was still contractually binding for them to be paid. Hana had also checked this and had meetings with the ICG and RCPCP about the contracts and payment. Hana knew about these things and was brilliant at negotiating. Seamus was tasked with overseeing the transformation, and had loved being involved and meeting up with Wendi, Rula, Niva , Hana and Peter to discuss the formation of “EMC” as it was beginning to be known. Seamus sat in the medical centre coffee room on the ground floor with a view out to bustling Endeavour Avenue, and sat back into his chair, sipping his cappuccino
“Absolutely amazing”, Seamus grinned as he reclined back, cross-legged in the chair and beamed at Peter, Wendi, Rula, Niva and Hana who were also sitting in the coffee room, before their morning clinics. The patients were already gathering in the waiting rooms since the clinic had opened the doors at 8am.
“I know Seamus, we couldn’t of done it without you, we are so grateful” said Wendi
“Not at all Wendi”, said Seamus, “it’s been an absolutely joy and a pleasure to be involved”
“This is what I call real General Practice! The profession of General Practice strikes back against the managerial classes!” laughed Seamus. Peter looked at Seamus and asked him something that had been on his mind
“Seamus would you come back and do some GP sessions with us?!” Asked Peter. “We would love it if you did!”
“Oh, I think I’m too long in the tooth for that Peter”, said Seamus, “but thanks so much for asking, I’m really touched by that”
“Well keep it in mind” said Hana , “We’d love it if you did!” Niva continued
“Yes please Seamus” said Rula “You can come back and help chair the new Endeavour Balint group that we’ve just stated” Rula continued, excitedly
“Well….maybe, but I’d better let you lot get on with your morning surgeries hadn’t I ?” said Seamus, looking at the already long queues at reception, and patients gathering outside the medical centre
Seamus eased himself out of the chair and made for the door looking around him.
“I love this place,” he said. “It’s got great architecture and morality, and most importantly great GPs, with honesty and integrity, who want the best for their patients”
As he got to the door he noticed Peter was wearing a metal tag on a string around his arm
“What’s that on your wrist Peter – looks interesting!”
“Oh it’s my old ICAC metal number tag” said Peter, “that says ‘ Peter Lamb IHP code number 56 ’that I put on a bit of string. It’s to remind me that I escaped and how lucky I am now to work here at EMC and to have escaped the soul-destroying, mechanised digital pseudo-medicine of the ICAC. It’s a sort of souvenir I suppose!”
Seamus laughed, as did the others and made his way through the door, outside into the street.
“I’m so proud of you lot and what you’ve done, carry on strong and I’ll leave you with what a wise old poet once said: noli timere ” and with that he walked out into the street waving and smiling at them through the window.
Wendi, Peter, Rula, Hana and Niva waved back at Seamus, smiling and laughing “we’ll look up what that means Seamus !” Hana shouted out of the window, laughing.
At that moment the clock struck nine and the five of them bounded upstairs, coffees in hand, to the second floor to start their morning clinics, calling the first patients into their rooms on the way with huge smiles on their faces, welcoming the patients into the Endeavour Medical Centre consulting rooms.
Suggested soundtrack: Souvenir by OMD
It was November 2032 and the nights in London were closing in and getting colder. Seamus had been visiting having just done a locum shift at Endeavour medical centre. It was getting seriously busy now that the practice list size had grown to over 35,000 patients within the space of a few months.
Seamus sat with Wendi and Peter in the basement at Endeavor mansions, all of them sipping on a coffee after work and reflecting on the day.
Suddenly all the lights in the building all went off and there was a complete blackout, which they could see was extending down the road affecting all the adjacent houses. Alarms started going off; the local dogs started barking.
“Oh my God”, exclaimed Seamus, looking at Wendi and Peter “You know what this means don’t you?”
Wendi and Peter both nodded. The cyberattacks had started again. The ceasefire had lasted nineteen months. It was now over.
Suggested soundtrack: Blackout by Muse
2035 (Kill or be killed)
Endeavour medical centre had gone from strength to strength even as the national and global situation was rapidly deteriorating: all the GPs practised brilliant General Practice, and Seamus had stayed on long-term even though he was now nearing seventy but he had no desire to go back into retirement. The country though had slipped into a sinister dictatorship, the average summer temperature was 44 degrees and the water and food shortages were reaching a tipping point. Morningbird was getting increasingly paranoid and ruthless and the third year of summer riots had been swiftly, devastatingly and violently dealt with by Morningbird and the new paramilitary forces that patrolled all of E&W major cities. They were called he MPF (Morningbird Paramilitary Forces), wore silver visors that obscured their faces and they were feared and reviled throughout the land. London’s MPFs were the most cruel: dissenters to Morningbird went missing and disappeared regularly, and Wendi and Peter were on their “hit list” due to their total and continued opposition to the dictatorship.
Wendi and Peter were in the Endeavour Medical Centre basement again, sharing their daily cup of coffee (rationing was down again to one cup a day) after another long day of seeing patients. It was getting dark.
“I’m exhausted” said Wendi as she leaned back into her chair.
“Same here” said Peter as he glanced through the basement window. As he looked out he saw an elderly lady being stopped by two of the HPFs and it looked like she was being interrogated. Suddenly one of them struck her viciously over the head and she was then hand-tasered, as the two HPFs walked off: even though they had their visors on Peter could tell that they were laughing.
She lay on the floor groaning in agony. People continued walking past on Endeavour Avenue and no-one stopped to help her.
Wendi rushed out of the door to the lady, helped her to her feet and spent ages dressing her lacerations and checking her over. She took some antiseptics and with her, as the last remaining antibiotic had now recently become useless due to mass antibiotics resistance, and then Wendi managed to contact her family who came to collect her. Wendi had however been spotted by the HPFs who had turned around and were now walking straight towards her.
Wendi rushed back into the medical centre, but had not given the HPFs the slip.
Peter then put his arms around Wendi and kissed her gently “ I think the universe of you” he whispered into Wendi’s ear. “And I think the world of you”, Wendi whispered back.
Suddenly there was a ferocious banging at the door.
“Oh God it’s the MPFs” said Wendi fearfully “They are going to kick the door down!”
“We’re cornered” said Peter, “and I’m also scared, but I’m not going to be taken: we might have to kill or be killed”
Suggested soundtrack: Kill or be killed, by Muse
Suggested Soundtrack: Absolution, by Muse
Closing Soundtrack: 1984, by Eurythmics
Nineteen Eighty-Four, published 8th June 1949 by Secker and Warburg
*Name and address supplied to the BJGP team