Clinical courage is a term that has emerged in the field of rural general practice, particularly in Canada and Australia. Caroline McCarthy reflects on how it manifested for her.
...I sensed that they also lived in a different dimension of time. The soft chattering of the patients waiting and sitting on the grass outside the clinic had an unhurried acceptance of just waiting. Storied reflection from rural general practice in South
But this self-indulgent reflection on my potential physio appointment has led me to reflect on the patients I saw today. Was I curious? Was I attentive? Did I help them navigate their own story or was I quick to jump in with
There is still so much stigma and invisibility around pregnancy loss. Patients are often encouraged to “move on.” Clinicians are often too afraid of saying the wrong thing—so they say nothing at all.
Dave Mummery offers a dystopian vision of integrated neighbourhood teams two years from now (let's avoid this version). Soundtrack included.
‘Trauma is patient, doc, if it's one thing I've learnt.’ His pale green eyes fix on mine dark pupils with an infinity of space. A poem by Giles Dawnay
Taking a look at her consultation model feels like the least painful of her goals to try and get done, and so she takes hold of the flaking metal handrail, slowly breathes in and out to centre herself, and walks down the
"I am struck by how Eder pursued three passions – socialism, Zionism and psychoanalysis – that were all cutting edge causes for most progressive people in his time but have largely diverged from each other since then and become contested or marginalised."
The door is barely opened. ‘I’ve a bone to pick with you’, wheezes Mick through the widening gap ...
Something shifted in my head, and I heard the sound of a penny dropping in a bank vault deep underground. I rummaged around in my desk for the Campbell-Frank Analyser and applied the scalp electrodes and mask with trembling hands.
"Edward Jenner remains the most famous GP in the UK and is still very relevant today. He had multiple talents; here, I focus on three: GP, scientist, and writer."
This challenges the notion that clinical interactions should be structured according to a strict division between diagnosing disease and understanding the patient’s broader illness experience.
A means by which participants can make some sense of their threads... And nurse the ends of their unravelled stories. The healing ...Is in the weaving.
Kez has an embarrassing problem. He has tried a cream that maybe worked in the past but not now. He needs the doctor, he thinks. He rings the surgery...
"On their memorial it was recorded by the sculptor Mr Mills, that William died from 'erysipelas coming on after vaccination'. I have walked past this grave many times over the years: as a GP and occasional vaccinator it made me ponder. Those
How we understand our story makes a difference to how we go about the job, how effectively we do it, and how it leaves us feeling when we go home... One of these proto-narratives is especially relevant to us as doctors: Overcoming
Giles Dawnay captures the transition of autumn to winter in a poem about cancer.
The idea was simple: a short walk in the park to clear our heads, engage in light-hearted conversation, and bond with colleagues. Over the years, this practice has not only endured but flourished...
"For the first time for many years I felt that I had lost control. Suddenly my comfortable Western privilege wasn’t working. I felt stranded, helpless, a powerless fragment of a distressed and angry crowd."
...none of this stuff is difficult if you keep in shape and know what you’re doing ... Bosco felt like she had been running her whole life, one way or another, and you might just as well have asked her to stop
Identifying the mind as a source of the body's pain can help a patient make great strides towards taking control of their health and reducing the impact chronic illness has on their day to day lives. Paul McNamara and Ella Butterworth explore
What (if anything) happens when we die? This is a question that human beings have been pondering since time immemorial. Paul McNamara and Craig MacKay reflect on a family story of near death experience.
My first go at introducing stories into my own teaching was through the work of Rita Charon. But when I tried to introduce some of these concepts to my teaching, I was less successful. Family therapist and GP John Launer offers an
When does a GP attend a patient’s funeral? Emma Ladds writes about how it is such a privilege to be a family doctor, and about grief when losing a patient.
Appeals to tradition represent a desire to preserve the evanescent, to build a clear narrative that tells us who we are and how we should go about things, even if its historical basis is shaky. We project our thinking onto ... general
The Wild West of medicine - a history for doctors’ feels like a more honest title for a book that makes interesting and informative reading.
Sophy Wollaston offers a lyrical journey from doctor to patient and from community to hospital... and back again
"Health is whatever helps me to travel hopefully within and between my story-strands." Paul Thomas describes this as Community-Oriented Integrated Practice (COIP) – a way of thinking & acting that facilitates local collaboration for health and care.
In Japan, there is a saying that deities disguise themselves as difficulties and offer trials to those who have true courage and strength. My supervisors taught me that when we are overwhelmed and troubled by complex problems, we should respond with sincerity
The practice of silencing is unjust and unfair, but probably universal in medicine. Trisha Greenhalgh reflects on a 'powerful' new book that is packed with compelling patient stories and accessible summaries of the academic literature. And for the teachers and trainers among
Can't sleep unless I've had a skinful... his ruddy face flickers. Oscillating fast... between the big man not allowed to cry... and the little boy who chose to survive.
In a time of unprecedented pressure on health professionals, especially on GPs, how do we hang onto the magic ingredients that make those brief consultations count? A poem in answer.
So my big reveal was that I was a doctor. That is to say a human being who'd been to medical school and was employed in delivering healthcare, not someone who'd been born with supernatural skills to look into other people's souls
Establishing general practice first as an independent subject or specialism, and then as a university discipline has been a major challenge over many decades. Where we are at present doesn’t appear to be working. Howie, Freeman, and heath reflect on what we
General Practice or Primary Care. What is the difference? Howie, Freeman and Heath discuss the development of primary care research and education and the the rise of SAPC in 2000.
...At last GPs could receive direct reimbursement from the NHS for time taken for teaching, allowing accelerating expansion of clinical placements in General Practice. At the same time there was NHS support for additional clinical academic staff in the Departments allowing research
John Howie, George Freeman and Heather Heath introduce an archive that traces the development of General Practice as a university-based academic discipline in the UK
There’s much to be said for novellas – short novels you can read in a couple of evenings, without the commitment needed for a blockbuster. If you’re looking for a great example, I’d recommend The Shooting Party by the Russian dramatist Anton
'It has been a hard week.' Poetry by Terese Tubman
The greatest challenge was a general practice one: not making a definitive diagnosis but to triage, having to decide what was safe to watch and wait, what could be managed with resources onboard the ship, what needed to be seen on land,