Andrew Papanikitas is Deputy Editor of the BJGP. He is on X: @gentlemedic
There is an idea that strikes terror (or more usually, cynicism) into the hearts of many doctors. Reflective practice is an embedded feature of both medical education and the overt appraisal of medical practice that is mandatory in the UK. It is, broadly, the idea that we can think about our experiences, critique and learn from them, and use the learning to enhance our own and others’ practice. Twin dangers lie in reflection: it can be so bland that it is pointless or so soul-searching and demanding that its outcomes are unattainable or unsustainable. The art of overt written reflection can be at the core of both a good story or an engaging article in BJGP Life. As both an editor and an educator I have often relied on John Driscroll’s three ‘Whats’ when giving feedback on BJGP Life submissions and undergraduate coursework: What happened? So what? What now?1 I invite you to keep these questions in your head as you survey our articles. How will this story change mine? Where is the Goldilocks connection? Read on to find out!
“Language and stories are the quintessential trait of humanity. They can also be a GP’s superpower.”
Storied creatures
All parties to a consultation are the heroes of their own story. Ben Hoban argues that how we understand our story makes a difference to how effectively we do the job and how it leaves us feeling when we go home.2 Tim Senior laments the way in which our healthcare records and policies often strip the stories and consequently the meaning from patient’s health experiences.3 A major illness event can be a savage disruption to a patient’s biography. Occasionally the patient is a professional storyteller. Maryam Naeem reviews Shattered by Hanif Kureishi — a humbling, funny, graphic, lewd, and humane account of the enduring will to live and to thrive.4 Richard Lehman reviews Rebalancing Medicine by Neal Maskrey, and finds health care to be an epic quest with actual heroes and villains.5 Jeremy Howick and Amber Bennett-Weston discuss language, meaning, and the story of empathy research.6 They expose a hero idea and a villain idea: on the one hand, shared language and overlapping ideas reveal a usable meaning of empathy for health care; on the other, the drive to claim uniqueness and status in academia generates a narcissism of small differences that ultimately delays human benefit.
Old wives’ tales
In our Yonder column, Alex Burrell travels into the yonder of healthcare research and brings back stories and wisdom to entertain and inform us. This month we learn about antidepressant follow-up, NHS app use, sore throats in community pharmacy, and the link between anticholinergics and dementia.7 Shared stories can also contain much that is inaccurate or at the least context dependent. Tara George and colleagues explore the wisdom of popular cautionary advice we give to children — does watching too much television make your eyes go square?8
“All parties to a consultation are the heroes of their own story.”
Death comes for us all
Death is the end of most human stories; sometimes a feared adversary, sometimes a gateway into an undiscovered country, and sometimes a void. Lily Lamb discusses the role of doctors in delivering the new UK assisted dying policy, arguing that policymakers have not really considered the impact on those doctors.9 Paul McNamara and Craig MacKay reflect on a family story of near death experience.10 What happens when we die? This is a question that human beings have been pondering since time immemorial. Peter McCartney reads a 19th century gravestone to unpack a tragic tale of medical misadventure, with impact on the wider story of vaccination in London.11
Lyrical offerings
Historically, stories were shared as songs and poems. In the past I have relied on lyrical authors to explore professionalism.12 Sophy Wollaston takes in the London skyline on her journey from doctor to patient, and back again.13 Callum Leese challenges us to reflect on the nature of our quest.14 Have we lost sight of our mission in servitude to tasks and process?
Stories and the Goldilocks principle
By now I hope that you, like me, are fizzing with ‘Whats’ of every kind! You may be wondering, however, ‘Where is Goldilocks, and what does she have to do with anything?’ In the infamous nursery story, Goldilocks goes into the house of three bears and tries each bear’s breakfast, chair, and bed. She finds each time that the baby bear’s porridge, chair, and bed are ‘just right’. This is the challenge for all of us in primary health care. We are often working by trial and error to get things ‘just right’ for our patients, our colleagues, and our society. The Goldilocks principle (getting things ‘Just right’) is explicitly referred to by Joanne Reeve in her work on advanced primary care generalism.15 The Goldilocks approach requires us to practice in a personalised, holistic manner. Language and stories are the quintessential trait of humanity. They can also be a GP’s superpower.
References
1. Papanikitas A. Self-awareness and professionalism. InnovAiT 2017; 10(8): 452–457.
2. Hoban B. Overcoming the monster. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740625.
3. Senior T. Stories and medical records. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740721.
4. Naeem M. Books: Shattered: a Memoir. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740685.
5. Lehman R. Books: Rebalancing Medicine. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740697.
6. Howick J, Bennett-Weston A. An empathy definition at last: exposing the narcissism of small differences. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740613.
7. Burrell A. Yonder: Antidepressant follow-up, NHS app use, sore throats in community pharmacy, and dementia and anticholinergics. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740709.
8. George T, Hall D, Davis T, O’Shea N. Seven cautionary tales we tell our children: a brief literature review. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740601.
9. Lamb L. Crossing the Rubicon: assisted dying in general practice. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740649.
10. McNamara P, MacKay C. Memento mori — remember that you must die: but then what? Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740301.
11. McCartney P. Written on a gravestone: a story of medical misadventure from 1869. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740589.
12. Papanikitas A, McKenzie-Edwards E, Starer R, et al. Storytime as a vehicle for reflective practice. Br J Gen Pract 2022; DOI: https://doi.org/10.3399/bjgp22X719165.
13. Wollaston S. Poem: A Room with a View to Die For. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740673.
14. Leese C. Poem: For Whom Do You Serve? Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X740661.
15. Reeve J. Goldilocks medicine. In: Medical generalism, now! Reclaiming the knowledge work of modern practice. Boca Raton, FL: CRC Press, 2024; 59–67.
Featured photo by Thomas Lefebvre on Unsplash.
