That’s me at the end of my morning surgery today.
I just don’t seem to know a thing. Twenty-odd patients have passed through my door and I haven’t made a single new definitive diagnosis in any of them. Sherlock Holmes has left the building and pre-senile dementia has popped in to keep his seat warm. What on earth made me think I could be a doctor in the first place?
The thing that’s brought on this attack of the colly-wobbles, this acute-on-chronic Imposter Syndrome, is that I’m thinking of becoming a trainer, and I’m honestly starting to wonder if that isn’t the most insane bit of hubris since Icarus started eying up that large pile of feathers. How could I possibly be a trainer? I know nothing! I am the original Manuel!
They talk about the management of uncertainty in general practice, but the only uncertainty I’m trying to manage right now is how utterly uncertain I am about why I’m here in the first place.
The average Daily Mail reader could make more confident pronouncements about half the patients I’ve seen today. If I hear myself say ‘it’s probably a virus’ one more time, I swear, I’ll send myself home on indefinite gardening leave.
If only I could have had just one molluscum contagiosum. Or a nice, straight-forward meralgia paraesthetica. But no, it’s just been one long stream of rashes the like of which I have never seen before, punctuated by chest pains which could be anything or nothing, and you’d think I’d know the difference by now, with the odd chronic fatigue wanting a blood test I’ve frankly never heard of thrown in for good measure.
So when it comes to trying to remember the third-line antibiotic for a burgeoning cellulitis in a patient with multiple allergies, I just draw a complete blank and run out of my room screaming.
And now I sit contemplating my chances of being the kindly sage gently guiding my young registrar protege through the murky gloom of front-line acute family medicine, and wondering what the hell I was thinking. When they gaze up at me with their eager trusting hopeful young eyes waiting for the answer to life, the universe, and whatever latest medical conundrum sits before us, I can hardly say ‘Search me, mate, I’ve literally not the foggiest.’
Felicitas Woodhouse is a GP in Warwickshire and was the winner of the 2016 BMA writing competition. She writes under a pseudonym
I thought it was only me...
Yep and me!!
Refreshingly honest and very familiar !
Ah this is so reassuring. I thought she was describing me to a tee !
I often say "I haven't the foggiest". It has two positive results. It means I don't have to feel guilty in the way Felicitas clearly does. And secondly, next time they attend they will see one of my partners instead.
beautifully articulated, very entertaining, well done. Please keep writing!
we all have our moments of doubt - I read recently in a learned medical journal - the only thing certain in medicine is uncertainty!
It needs patients to come in with recognisable pathology,
I drown in generalised unhappiness, moles that have non-specifically "changed" (without getting bigger or darker or changing shape) and patients with inexplicable fatigue and/or pain.
Do I do some good- probably. Is it what I was trained to do- probably not.
Completely agree with everyone’s comments. And here I am in my own GP surgery waiting for a blood test when on the radio in reception comes one of those annoying adverts from a local firm of solicitors advertising their services for No win No fee medical negligence claims. Outrageous. The public have no idea what it’s like sitting on our side of the fence.
Well written and so true
I was taught one significant diagnosis per month,
But I would add one significant treatment per week,
One significant piece of management per day,
At least one significant piece of advice/education accepted per hour,
And taking care every minute
Memo to self: Must tell everyone that I write under her pseudonym.
I’m hearing this more and more from my GP friends. It’s not just you and you’re not going mad. It’s just that most patients don’t fit neatly into the medical model you were taught at school. I met one GP a couple of weeks ago who realised that soon after qualifying and quickly retrained in NLP and various other ‘alternative’ forms of treatment. Another GP friend is now joining the ranks of Doctors retraining as Medical Herbalists. In herbal medicine we can normally figure out what’s going on with a patient. If we can’t, a colleague usually can and even if that doesn’t work we can treat them anyway. I really don’t envy you, with that and all the other stuff you have to deal with.