View from the ground, by Dr Jessica Garner
I make no apologies for the fact that I love Christmas. There are surely worse vices than getting over-excited at the sight of twinkling lights, and teary eyed on hearing the strains of the Salvation Army. I even tolerate work around the Christmas season; from tepid Christmas dinners in hospital canteens as a junior doctor to trudging round home visits in the frost. If holly and fake snow are involved, I’m happy. However despite all the Christmas cheer, on many levels the last 12 months have been particularly challenging ones.
It certainly feels like each week brings a new maelstrom of bad news. International politics lurch from the perplexing to the alarming, tales of misdemeanours and sordid behaviour keep coming thick and fast, wars continue to rage, terrorism threats persist, and environmental tragedies are ever present. More pertinently it sometimes feels that our own press exists solely to publish stories about the NHS and its innumerable woes. Cuts, scandals, waiting lists, inefficiencies, and the perpetual undermining of our clinical capabilities. Highly emotive or ethical cases become fodder for the newsmakers and doctors seem repeatedly tarred with the ‘don’t care’ brush.
The pressures on general practice have continued to heighten this past year and many regard the profession as having hit rock bottom. The headlines have been relentless: more GPs retiring or fleeing to sunnier climes, more work, more pressure, more funding restrictions, and morale at its lowest ebb. However I am an eternal optimist and think December always brings with it a degree of reflection and introspection. Despite all the doom and gloom there are good stories out there. Most of them never make the pages of the papers or the internet. Most of them don’t even make it to the coffee room (if such places exist any more?); however, each of us has many affirmative anecdotes to tell—not newsworthy nor dramatic, but of real consequence and significance to our patients.
Think back over the past 12 months and remember the countless patients who have recovered, improved, or just changed their outlook due to your involvement. The patient with depression you now rarely see because she is back at work, the patient with debilitating arthritis whose pain control is currently manageable, the person with diabetes who has lost weight, feels infinitely better for it, and has the HbA1c to match. The countless occasions clinical skills have picked up treatable illness and disease. The times you have just listened. The mums you have supported during the first difficult months of parenthood. The patients you helped to die a comfortable and dignified death. The cradle-to-grave philosophy lives on in general practice despite what the politicians and journalists may claim.
So when you get your next Christmas card from a patient, before stuffing it in a folder ready for the new year’s appraisal, remember that amidst the despondency there are still many things to be proud of. Who knows what 2018 will bring? There will be problems and continuing difficulties, no doubt. But hopefully also a few welcome surprises and maybe even a glint of positivity. Sure, the moaners will continue to moan and the complainers continue to complain, but the vast majority of patients will be grateful we are there. Happy Christmas.