Tuesday, 23 June 2015

Life in the GP trenches

"If I take too long to think about the impossibility of what I'm trying to do, I'll be defeated by it" Tim Cahill on the challenge of being a writer.

So according to my BBC radio 4 listen on my way to work, there is yet more advice on how to be a GP. Apparently in the UK we have 1000 more deaths from cancer than we should have relative to our European partners. So NICE has come up with the answer, refer more more people more quickly for 'tests'. Oh deary me, has anyone who comes up with these pronouncements ever worked full time for many years in general practice?

One thing that make GP the challenge that it is, is managing an ever increasing tendency to medicalise all of life, with concurrent absence of family support and 'common' sense. By which I mean that our newspapers and medial generally are full of 'conditions' waiting to deprive us of healthy life. No part of life is free. Holiday ailments, stress in the workplace, cholesterol, obesity, GM foods, shyness, ageing, pregnancy, every part of life is out to get us. And since we all live miles away from parents and grandparents (especially the latter who were used to dealing with problems themselves, since a phone call to the GP at night may have meant a 400 year walk to the nearest phone box-well it did for my granny, I remember walking with her!), no sensible advice is on hand.

So as a GP still remain a gatekeeper of the NHS, desperately holding  my finger in the dyke of spiralling costs, trying to reassure that not every symptom needs close attention and 'tests', and that when a patient has consulted me they have 'seen someone' (as in the patient who requests to 'see someone', ie  a specialist, who by definition has a limited view of things, after I have spent 20 minutes reassuring the patient about their problem). And yet on the other hand the advice to refer more and more patients into a system that is already clogged.

Ah well, retirement looms!

Monday, 22 June 2015

Holiday reads-Shackleton!

I really love the chance to get stuck into some good books whilst on holiday. I recently managed five, all rather different, whilst lounging in the sun and shade. First up, one of my heroes.

Shackleton By Endurance we Conquer by Michael Wilson.

I'm a big fan of all things Shackleton and have enjoyed reading previous accounts of the remarkable Endurance expedition and especially the rescue of the guys left at Elephant Island. Leadership insights from Shackleton in the book Shackleton's way has been a previous favourite.

This relatively new biography (2014) is a great read. It provides a rounded picture of the man who was able to overcome truly hopeless odds in the extremis of polar exploration, but he was plainly just never able to settle into 'normal life' away from the pole. His rather casual approach to family and marriage, his many business ventures and failures, his chaotic approach to money and fundraising and his rushed planning of expeditions are all well described. However although hopeless with money, Shackleton was not greedy and was frequently generous with money he could ill afford to part with. He nonetheless had a charismatic personality that lead many wealthy donors to support his various exploits.

The retelling of the Endurance journey and especially the stunning improvisation and courage shown by Shackleton and his men is brilliantly described.  To read again of the journey of the James Caird, a mere 7m long and 2m across, with 6 men on board needing to sail 800 miles across the mountainous swells of the Southern Ocean-and all in the hope that they could locate rescue ships to go back for the 22 men remaining on Elephant Island-was both exhilarating and humbling. And then the need for Shackleton, with Worsley and Crean to hike across South Georgia, with just 3 days food supply. Its stirring stuff.

Yes Shackleton was a great leader, and there are many aspects of his leadership that provide a great model for any contemporary aspiring leaders, but perhaps his ability to inspire hope rises to the surface of all his talents. Towards the end of the book Wilson reflects on the remarkable feat of saving all the men from the Endurance adventure,

If there were touches of genius about his leadership, they could be found in the way that Shackleton held together a disparate group of men in appalling conditions, making sure that disruptive cliques were not formed, and that everyone was treated equally. He never took unnecessary risk, was able to adapt to the constantly  changing circumstances, and never asked a man to do something he would not do himself. But Shackleton's supreme achievement was that he instilled hope, and the belief that they would all service.

Magnificent  book. Ok its over 400 pages, but superbly written.



A light touch

Just pebbles Its great to be back in the Hebrides. Although lots of rain is forecast this week, yesterday was a pleasant surprise. So we...