View from the ground, by Dr Sarah Merrifield
After 15 years of training, I was delighted to finally qualify as a GP in October 2019. What was once my dream as a 16-year-old GP receptionist, was now a reality. Relieved to finally have control over my career, I took a few months off to get married and travel, before accepting a salaried role in a small practice in January 2020.
I approached my first day with a mixture of trepidation and excitement. As with any new job, there was much to be learned about the workings of the practice. After a few weeks settling in, I felt content and that I had finally achieved my career and life of choice.
My contentment was short lived. There were whisperings of a virus that was capable of causing an unknown disease, with the potential to affect millions. I watched the news with a morbid fascination as it crept progressively closer to the UK. When the first case was found in my area, the sense of foreboding increased.
Around 6 weeks into my career as a GP, lockdown commenced. The surgery doors were locked and all consultations were undertaken remotely, unless face-to-face was deemed absolutely necessary.
Initially, this seemed a bit of a novelty. I felt a guilty sense of enjoyment about the time I had to get to know my new colleagues. For a few weeks clinics were only half filled, with patients scared to leave the house or contact the practice. The surgery felt almost eerie—warning tape covered the normally full waiting room chairs. There was also an odd sense of excitement, whisperings of redeployment to Nightingale hospitals. After years of paper-shuffling and form-filling, was this the chance to do ‘real’ medicine for once?
I was surprised when people clapped for the NHS weekly. Could this be the change I had hoped for? Would people finally respect and value the nation’s healthcare workers?
But then, there was also the fear. I had little experience of remote consultations, in fact no more than around 4 hours from my GP training. What if I missed something? Should I see the patient in person? What if I brought them into the surgery and they caught the virus? Should I visit them at home, or would that be even worse? Were angiotensin-converting enzyme (ACE) inhibitors and steroids dangerous? Was it COVID-19, or something else? So many questions that no one really knew the answers to.
And perhaps a deeper fear, would I die if I got the virus?
I saw my first patient with COVID-19 on a home visit. He was unwell and slumped forward on to me as I listened to his chest. After admitting him to hospital, I felt a different fear when I read his positive result. Stories of healthcare professionals sadly losing their lives filled the news.
After seeing more and more patients and staff become unwell from the virus, I felt sadness and anger. Angry that this unknown villain had taken so many lives, but also a selfish sadness that it had also taken away my life as a knew it. Previously, stressful days at work were balanced out with fun weekends and holidays; now, there was only work and staring at the TV.
A fleeting lull over the summer brought hope. But also, the side effects of a national lockdown. I saw people depressed after losing their jobs, new mums feeling increasingly isolated, and many people frustrated that their treatment had been delayed. Powerless over many of these problems, I tried to help them as best I could.
I am now 1 year into my GP career and we are in the midst of a second wave. Gone is the excitement, novelty, and praise, replaced instead with frustration, anger, and discontent. Despite some media representation, I am finding the workload tougher and more complex than it has ever been. The cognitive load of trying to work out how to safely complete usually straightforward tasks is huge. By the end of the week I feel exhausted.
The last year has been a rollercoaster that feels like it isn’t going to end anytime soon. I just hope there are some highs coming soon!
Dr Sarah Merrifield