Andrew Papanikitas is Deputy Editor of the BJGP.
It was a bright Sunday morning in the resplendent setting of Oxford’s Sheldonian Theatre. Actor, singer, and now author Alexander Armstrong was constructing a supervillain (with the aid of several young hench-lings in the audience). One idea circulating was a character called Dr Brain, a seemingly mild GP who turned invisible in the sunlight ‘… along with all his appointments’, he quipped to parents’ polite laughter. Dr Brain might well be a good name for a children’s supervillain — maybe not as scary as Dr Insidious. I wondered, however, about the unsung GP superhero, Dr Nemo.
Dr Nemo is the archetypal GP. She (if we’re basing her on demographics) is everywhere and nowhere, the largely unsung hero (‘Nemo’ is Latin for ‘nobody’). I can think of at least three literary heroes bearing the name. The most obvious is Captain Nemo, the revolutionary submariner from Jules Verne’s Twenty Thousand Leagues Under The Seas; but also Mr Nemo, the impoverished and drug-addicted former army officer in Charles Dickens’ Bleak House, who takes a pseudonym out of shame; or the Nemo that Odysseus adopts as a pseudonym to conceal his identity from the Cyclops. All these ‘Nemos’ allow our heroes to enact their virtues of bravery, kindness, and guile. They are both an influential part of the world in which they act upon and yet separate from it. Invisibility allows us to get on with things without interference, but it also means society does not see the value of what we do or the resources we need.
The blessing and curse of invisibility
The Health Foundation has recently identified that the public’s first big priority across the NHS is to make it easier to get an appointment at their GP practice. Nada Khan explores what meaningful access looks like in general practice. Simple metrics bely the range and depth of work connected to appointments.1 Alex Burrell serves up useful illustrations of the organisation, toll, and form of work: extending access to health care, GP retention, wellbeing interventions, and contact post-paediatric admission.2 Richard Vautrey reviews a new history by Chris Locke: GPs, Politics and the Medical Professional Protest in Britain, 1880–1948. He reflects that GPs’ concerns about insufficient pay, workload, not being valued, and fears that independence will be taken from them are not new.3 This only means that we have to constantly remind society of what we do and the resources we need to do it and do it well.
Saving the world
General practice (with the rest of health care) has the power to save or hurt the world. All our professional activities come with cost in carbon lost into our atmosphere, and environmental awareness and sustainability are now established as medical concerns. Terry Kemple takes a critical eye at medical conferences,4 and Emma Radcliffe asks whether clinical guidelines should be more consistently and coherently environmentally friendly.5 NICE take note!
Listen well!
Tim Senior reflects on 20 years at the same clinic. His story intersects with so many others.6 Ben Hoban challenges a transactional model of general practice with a burst of satire — an understanding of illness as part of the patient narrative is the key to many a successful consultation. The devices we use are intellectual, but imagine if narrative analysis came as a piece of hardware?7 Elke Hausmann reviews a new book, The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far by Suzanne O Sullivan, and worries how its story will be heard:
‘What she says is not neutral. She is completely right in saying that mental health conditions should not be stigmatised, but the fact is that they are. Already, the central thesis of her book, overdiagnosis, has appeared in the media as a convenient way to minimise the extent of the problems that long COVID and mental health conditions currently pose for our society … ’ 8
Stories are a GP’s superpower. Recently I had the pleasure of hosting two workshops at the BJGP Research and Publishing Conference, and hearing all the ways in which colleagues would like to discuss, debate, and demystify (or even re-mystify!) general practice for the BJGP.9 I look forward to seeing these and many more in BJGP Life. Perhaps then we’ll be less invisible but more transparent!
References
1. Khan N. Access to general practice. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741465.
2. Burrell A. Yonder: Extended access, GP retention, registrar wellbeing interventions, and contacts post-paediatric admission. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741489.
3. Vautrey R. Books: GPs, Politics and the Medical Professional Protest in Britain, 1880–1948. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741513.
4. Kemple T. What’s the value of annual medical conferences? Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741477.
5. Radcliffe E, von Heimendahl S. Is NICE failing to prioritise environmentally sustainable health care? Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741453.
6. Senior T. How long does general practice take? Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741537.
7. Hoban B. Narrative failure. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741501.
8. Hausmann E. Books: The Age of Diagnosis: Sickness, Health and Why Medicine Has Gone Too Far. Br J Gen Pract 2025; DOI: https://doi.org/10.3399/bjgp25X741525.
9. Papanikitas A. Write for (BJGP) Life. 2025. https://bjgplife.com/write-for-bjgp-life (accessed 8 Apr 2025).
Featured photo by Birmingham Museums Trust on Unsplash.
