Tuesday, 22 May 2007

Oi! Grandad!

There are some pictures on my surgery wall which were drawn by my children a few years ago. Some twelve years in fact, but I've never got around to taking them down. Today a young man in his mid-teens came to see me. “Did your grandchildren do those?” he asked. Of course I am old enough to be a grandfather, but none of my children are yet married or in relationships where they might have children. I had not thought of myself as a Grandad, despite my spreading wrinkles and male-pattern baldness.

A small piece of insight occurred today during my first consultation, with a chronically anxious chap who has half a dozen different problems or sets of symptoms. For many years these have proved impossible to sort out, control or cure, and he has been referred to the hospital for most of them at least once. Every time I see him I worry about whether I ought to refer him back again, or do something else, or try a different treatment, or think of a different investigation. For each of half a dozen problems! Today he complained that his blood pressure tablets were making his face burn (and no, he wasn't taking amlodipine!) In a moment of exasperation as I felt the consultation once again slipping out of control I said “no, it's just your anxiety”. To my surprise he accepted this without demur, and even looked relieved. I can see that I have been on the receiving end of the transference of a vast amount of anxiety over the years, which has done neither of us any good. I resolve to stay cool in future (and will then promptly miss his early presentation of cancer, knowing my luck).

I think I shall have to watch my mood again for a bit. Recently the days have again started to feel interminable, the consultations less enjoyable, and I'm having to push myself to concentrate and to do tasks that I used to enjoy. I don't just want to get through each day, I want to enjoy life. (Selfish old me!)

I've been watching the political furore over the grave failure of MMC/MTAS which has put the future careers of young doctors in serious jeopardy. Although I realise that this is not a fair analysis (and one of my best friends plays a significant role in the BMA), it does look as though the BMA have been weak at resisting the Government's incompetent plans. I get the impression that since the Labour Government came to power they have taken the view that they cannot oppose them in any serious way, and the best they can do is to negotiate and try to influence their ideas a little. The cynics say that the leaders of the BMA are all waiting for their gongs and don't want to spoil their chances of knighthoods and seats in the Lords. I prefer the explanation mentioned by Michelle Tempest in her blog, that they (and we) are suffering from learned helplessness and sit like rabbits transfixed by the headlights of the oncoming Governmental limousine.

On the other hand, the junior doctors have rather less to lose than we older doctors (in the way of gongs, pleasant incomes and decent pensions). They are only a few years out of medical school, still with large debts to be repaid after five years of study, on low salaries and with their prospects of a career in this country looking extremely shaky. They are furious and have nothing to lose. I am not surprised that they have taken the actions they have, and I think that the BMA would do well to learn from their example.

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