Dr Max Skittle - The Secret Doctor: What Really Goes On Inside Your Doctors Surgery

Contents

For my family

And to everyone sitting in a waiting room:

Sorry, were probably running late ...

What Exactly is a GP?

A General Practitioner (GP) is a medical doctor who treats acute and chronic illness, and provides preventative care and health education to patients.

A bit on the dry side, Wikipedia, but yeah, alright. Still, lets add a little more sauce to the job, shall we? Heres what I think ...

Being a GP is about compressing life into ten minutes. Six hundred seconds. Youve got to be prepared to manage the physical, mental, social, and spiritual health of the person sitting in front of you in all its glorious, confusing, and terrifying totality. Cradle to grave. No room for error. Its about looking through the window of that persons life and trying to make it better somehow. To make it healthier. Happier. Longer. Embedded within a community, the job asks you to be detective, mediator, doctor, and counsellor, unearthing why that person feels the way they do. Yet the surprising thing about such a life my life as a GP is that the hardest part is everything in-between the medicine. Its the anger, the sadness, the frustration, the love, the joy, the tragedy, the fear, the compassion, the hate, and the loss. You go on a journey with that patient. Life in ten minutes. Tick. Tock. And yet, strange as it may sound, sometimes they dont even realise youre there, like some tacit travelling companion. Hidden away in a pathology result processed. A phone call to a specialist. A clinical letter read and filed. Names without faces. And then, at the end of every day, you go home, having collected up the emotions and concerns of society, and try to live your own life. Unencumbered.

Unsurprisingly, this means learning to compartmentalise the job from your own life is a mandatory requirement. One that is, in reality, always out of reach. You have the privilege to see the light and dark of life. And all those endless shades in-between. Which is where life really happens. Where the stories are told. Like a chameleon, its about always adapting to that person in front of you. Working out how to meet their needs. Their wants. Their expectations. And when they leave, you then have to work to digest the truth that its you who has ultimate responsibility. You manage their risk: your diagnosis, your decision, your treatment. Get it wrong, and they suffer. Not you. Plus, youll probably get sued. Yet with all this omnipotent worry and stress for company, my life as a GP is fundamentally, truly, and resoundingly, fucking brilliant. Its why I chose to be a GP. For the people. To help. And I wouldnt dream of doing any other job.

This book is about why. This is my story.

Monday, 4th June 2018

My name is Max Skittle and Im a 32-year-old GP. Its 7:45am on a Monday morning in June 2018 and this, as it so happens, is the perfect day to start the story of my life as a GP. Right now, Im sitting at my desk in the inner-city GP surgery where Ive worked since qualifying as a GP three years ago, so youre joining me at what is the relatively fresh and exciting early stage of my career. Yet right now thats by the by as all I can do is stare. Stare down at my violated crotch, not quite believing my appalling luck.

Stained crusted white this morning, courtesy of what at the time seemed like an innocent spoonful of whole-fat Greek yoghurt. With five woefully insufficient minutes before my clinics due to start, I make a tragic decision to pat down the area with tap water. Four minutes until clinic starts ... Now I look like Ive got something wholly incriminating on my trousers and tried to hide the evidence or Ive simply pissed myself. Lifes pendulum swings. Deliberating, I try to refocus. It will be a good day today. It must be a good day Im definitely due one after all. A rational thought until my eyes absorb this mornings clinic list. Between the unrecognised names are some well-known regulars. A few of them Im looking forward to seeing. Others ... well, less so. I stare into nothing.

Three minutes until clinic starts ... My trousers still arent dry. Sadly, like some uninvited yin to its yang, I notice the pot plant my wife, Alice, got me for my clinic room is though. Not an altogether positive message to my punters: heres your doctor, he cant keep a 5.99 supermarket pot plant alive, but hell have a crack at you. Leaning back in my broken three-and-a-half-wheeled chair, I swivel unevenly around, taking in three deep breaths before bringing myself level again. I straighten the keyboard and align my pen parallel to it. One minute before clinic starts ... I hover the mouse arrow over the bell icon, ready to call in my first patient.

Still damp, I smile. My heart beats a little faster. I love it, I really do. I love this job and wouldnt, despite my daily moans, want to do anything else. Which is precisely why Ive written this book.

Think of it as an angry and confused extension of that love.

So, yes, welcome. This is my book about life. To be precise, Ill be throwing out a clinical dragnet to compile some of the messiest, most bewildering, most humbling, and funniest stories of the lives that cross the threshold of my GP consulting room over the next year or so. All the patients, and the stories that come from my encounters with them, will be genuine. And, Id be surprised if any Hollywood effects will be needed to sex them up. The rich texture of life of our lives assures me this wont be necessary. Naturally, all the names, dates, ages, ethnicities, even genders, will be changed. That way you can only giggle, cry, jaw-drop or frown at them as you read this book rather than in person. The latter, we can all agree, would be more than just a little playground cruelty. Oh, and if you think Ive written about you, respectfully, youre mistaken. If the facts do happen to align with you, its merely coincidence. Trust me on that. Any and all identifying features have been changed or removed. I say that confidently as, despite writing this book, patient confidentiality is a principle that I dont fuck around with. Plus, I dont want to get fired. Or struck off by the General Medical Council (GMC). My wife would unquestionably kill me (very slowly, I expect). Especially as weve a baby on the way.

*

The first thing to know about me as a GP is that Im human too. I dont mean that on some New Age, hemp-loving, hessian-wearing, sentimental level. I simply mean that Im not some giant absorbable sponge, sitting in clinic day after day, here simply to soak up all the spectral outpourings of emotion that patients unload. Instead, just like you, I judge, I dislike, I disapprove, and I anger. And yes, on the flip side, I laugh, I cry, I smile, and I like. And because Im human like you, there are times when its bloody hard (impossible even) as a GP to stay being a nice person. Because being a GP is difficult. Being anything in the NHS is difficult, tiredness and overworking bringing out any humans worst side. Myself very much included. Which is why Im dropping an early spoiler alert: There is absolutely no doubt that this job has changed me as a person. Its pushed what was a moderately dark sense of humour even darker. Pitch black at times. And its pushed what was a reservedly crude sense of humour into being now overtly crude. All of which I suspect after three years in the job are competing coping mechanisms and collateral damage in equal measure, as I try to do the best job I can for the person in front of me while staying sane. And I really am trying to achieve both.