In desperate need of idleness

Andrew Papanikitas is Deputy Editor of the BJGP.

Once upon a time, a group of GPs went on an away day. The team-building exercises came thick and fast. Finally they divided into two groups with the task of building a bridge out of wastepaper and Sellotape. The goal was to be first and the race was on! Both teams initially divided up their tasks into the building of the platform and the pillars and the final assembly. One team, however, slowed down and looked at the bridge as whole, despite protests from its leader. They came second, but only their bridge was subsequently able to support the weight of the facilitator’s smartphone. The lesson was not lost. They had taken a day out from ‘work’ to get to know each other and reflect on their broader mission. Even there, a dysfunctional focus on tangible outputs and task-completion surfaced.

In this issue Jonathan Sunkersing describes a ‘pathophysiology of purpose’. We can see the ‘what’ overwhelming the ‘why’ all too frequently.¹ Our articles showcase the importance of taking the time to read and reflect, practice holistically, to take a global view, and to embrace the humanities. The value of reading is just one strand in philosopher Bertrand Russell’s 1935 essay, In Praise of Idleness. Russell argues that seeing hard work as a virtue in and of itself is a relic of aristocracy, intended to keep workers subservient. He argues that all elites (including communist ones) have an unjust interest in giving some people too much work while denying employment to others. Technology and abundance should mean that we should not have to work every hour in order to subsist. He goes on to propose the available work should be divided evenly, with everyone working a 4-hour day to maximise both productivity and leisure. At the same time, however, he shows us that leisure is essential to civilisation — the arts and the sciences alike emerged from people with time on their hands, who were not labouring from dawn till dusk in the fields. He suggests that those who work too hard might favour passive recreation, citing the cinema. More rested people would use their free time for active pursuits (for example) involving creativity, education, and science. In a prophetic streak he links the obsession with productivity to a failure to enjoy and use goods well. Russell makes the case that reduction in work hours would ultimately lead to a happier, wiser, and more peaceful society.² For the time being we have to somehow make our own time …

… to reflect and practice holistically

Alex Burrell expands our horizons this issue. He looks at pattern disruption as a way of challenging biases and preserving cognitive flexibility in a profession that relies on pattern recognition. He examines an article on how health inequalities are conceded in general practice training. He also considers an initiative to use the time waiting for mental health treatment more fruitfully, and a tool for improving shared decision making for older patients.³ Saul Miller embodies a new sense of freedom to invest time in patients as  he dives into work as a GP locum and reflects on the difference between this and his previous practice. While challenging in all sorts of ways, locum work feels less ‘oxygen depleting’.⁴ Perhaps Russell has a point?

… to adjust one’s focus

Rhiannon Day-Thompson takes the time to consider the connection between poverty, ultraprocessed food, the microbiome, and persistent gut symptoms.⁵ Dipesh Gopal asks whether certifying long-term sickness absence should be a role for general practice, and (if it should) do we have the resources to do this well enough?⁶ Certainly announcements that begin ‘GPs are best placed to’ rarely explore whether additional time will be allocated to do whatever task is to be added. Indeed, the system does not value rehabilitation enough in terms of financial currency to meaningfully resource it.

… to embrace the humanities

Rhodri Evans reviews The Morbid Age by Richard Overy, a history of society and health in the interwar years between 1919 and 1939. This is the period when planned parenthood and eugenics were equally respectable, and politicians became interested in the health of the UK population in connection to national prosperity. This morbid age influences where we find ourselves now.⁷

John Launer also does some time travelling of his own to consider a morally ambiguous spaghetti Western movie, Once Upon a Time in the West. It is a magnificent movie, but more magnificent for not making virtue look easy or straightforward. It speaks to the perennial tensions between idealism and realism that we must sometimes learn to manage.⁸

Poetry is an underappreciated form of creative writing for professionalism in its ability to connect experience to feeling and share this with the reader. Kayleigh Oliver deploys poetry in the defence of the GP in training. Giles Dawnay is lyrical about pathological samples in the shared narrative of patient and clinician. Both poems reattach humanity to their subjects, stripped away by productivity.^9,10

Of course, the idleness proposed by Russell is multifaceted, nuanced, and dependent on how we define both work and idleness itself. Idleness encompasses all the things that enable us to flourish as individuals and as a society but get shunted into our own time (what’s left of it). Healthcare workers need time to think, to read, to recover. Our patients and colleagues deserve no less.

References

1. Sunkersing J. A pathophysiology of purpose: when the ‘What’ kills the ‘Why’. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746001.
2. Russell B. In praise of idleness and other essays. London: George Allen and Unwin Ltd, 1935.
3. Burrell A. Yonder: Pattern disruption, health inequalities in GP training, waiting for mental health treatment, and shared decision making. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746013.
4. Miller S. Diving back in. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746097.
5. Day-Thompson R. Follow the microbes: a new perspective on health inequalities. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746025.
6. Gopal DP. Should general practice certify long-term sickness? Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746037.
7. Evans R. Books: The Morbid Age: Britain Between the Wars. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746061.
8. Launer J. Sex, violence, and moral ambiguity in Once Upon a Time in the West. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746049.
9. Oliver K. Poems: Personal Protective Equipment. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746073.
10. Dawnay G. Poems: Samples. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/bjgp26X746085.

Featured photo by Bere Del Valle on Unsplash.