There is magic you can ’ t measure .

Then one night when you are having trouble sleeping , you decide to try paracetamol , and find it can be a powerful aid to insomnia .

Sometimes you can do somersaults

to accommodate a patient ’ s

needs and it is not deemed to be

enough . You may learn that a very

demanding patient was not self-

assertive with a doctor previously ,

going along with the doctor ’ s advice

that led to disastrous consequences ,

the death of their infant .

A patient who is depressed and

Dr Pam Rachootin GP in Adelaide , SA .

has recently had a miscarriage is muddled and comes at the wrong

PICTURE CREDIT

time for her appointment , and I tell her to wait and I will see her after I ’ m finished with the current patient , but she leaves .

The next thing I know I am noti-

cedure , or a previous cancer diagno-

fied of her death from a ruptured

sis , or diabetes , or bipolar disorder .

cerebral aneurysm .

Patients may also reveal the

I am feeling totally guilty and call

most amazing things , like a pillar

the neurosurgeon who saw her in

of society admitting to their youth-

hospital after her collapse at home .

ful dabbling with cocaine , or a sep-

I tell him I was treating her for

tuagenarian , engaged and enjoying

depression from pregnancy loss .

her grandchildren , who confides

He tells me he ’ s sure she had

that she is still grieving the loss of a

depression and informs me that

pregnancy in her 20s .

the aneurysm was inoperable ; had

A patient may present with the

it been detected earlier she would

most trivial complaint , like wanting

still have died from it .

you to squeeze a single , tiny pimple

I hope that he is not just being

on their face .

charitable to me , but I choose to

Or a patient may present with a

your patient over many years .

you make on someone ’ s life .

recall reminders or phone messages

believe him so I can go on .

trivial complaint of a sore , bruised

And other health profession-

Or you may not know the impact

and you are left perplexed , and you

A patient in early pregnancy

finger and a history of a suitcase

als challenge that diagnosis and

you have made on someone until

miss them .

who sadly informs me that she

falling on it from the top of the

agree with you , and the label that

years later . And then they mention

Your patient moves across town

believes she has passed a fetus in

closet .

had been given by the specialist is

that fact — that they won ’ t ever for-

to a new GP and then laments : “ It ’ s

the toilet that morning , later walks

But then you look at that fin-

overturned .

get what you said to them — and you

just not the same when I get my vac-

into the rooms from her ultrasound

ger longer and see hundreds of

One may have the best instincts

can ’ t recall at all what it was and

cinations anymore , without you

that same day smiling , saying :

splinter haemorrhages in her fin-

about a patient and never have an

decide to keep quiet .

singing Twinkle , Twinkle , Little Star

“ Well , two out of three isn ’ t bad .”

gernail , and you realise she has a

inkling that they have been engaging

Your actions may have saved

to distract me .”

A patient smiles while telling you

life-threatening condition , possi-

in heinous acts of criminal behaviour .

your patient ’ s life , and the next

The thoughtfulness and gener-

that their cardiologist said they had

bly bacterial endocarditis , with an

osity of patients may at times be

a big heart , not realising the implica-

ischaemic finger .

She needs to go to hospital immediately , where the doctors tell her : “ Your GP saved your life .”

And that GP is you , and it is just

The thoughtfulness and generosity of patients may at times be overwhelming .

overwhelming . Then again , the thoughtfulness and generosity of your cancer patient may need to be graciously declined , like when they want to

tions that they are in cardiac failure . In passing , a patient shares her love of photography with me and I am inspired to pursue coursework in a multitude of art forms , finding a love

your first week in general prac-

share some of their medical mar-

of ceramics and befriending a whole

tice , and you are totally terrified

You may develop a deep rap-

thing you know you are being con-

ijuana and leave it in your let-

new community of creative folks .

because you know how close you

port with someone who was a total

tacted to transfer their notes to

terbox as a sleeping aid for your

Over the years I have come to

came to sending her home with an

stranger a few minutes before walk-

another practice .

husband who has insomnia from

feel that I have gained more wisdom

anti-inflammatory .

ing into the surgery .

You may have experienced an

dexamethasone .

from my patients and colleagues

One must trust one ’ s instincts ,

It may take decades for you to

excellent professional relationship

You advise a patient to try par-

than I have ever given .

like when a specialist makes a men-

build up trust such that a patient can

with a patient over decades and

acetamol for pain management , and

Life as a GP is full of surprises .

tal health diagnosis after just a few interactions with your patient that is counter to your knowledge of

fully confide in you and share their darkest secrets of the past .

You may never know the impact

they repeatedly voice gratitude for your care .

Then they don ’ t respond to your

they later report back that “ it absolutely wiped me out and I slept like a baby ”. You chuckle to yourself .

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