Confessions of a GP - Benjamin Daniels [1]
Although I’m now a GP, my training required me to spend many long years working as a hospital doctor. I completed five years at medical school and then spent several years working in various hospital posts gaining the experience needed to become a GP. I was a junior doctor in surgery, psychiatry, A&E, paediatrics, gynaecology, geriatrics and general medicine. I also broke up my training with a three-month stint working in Mozambique. All in all I loved working as a hospital doctor but have absolutely no regrets about leaving it to become a GP.
Introduction
I can still fondly recall the first diagnosis I ever made. As with many others that followed, it was spectacularly incorrect, but it still holds a special place in my heart. In my defence, I was just a mere boy at the time, wet behind the ears and only a few weeks into my first term at medical school. I was sitting in the local Kentucky Fried Chicken and spotted a man slumped unconscious in his plastic seat. A wave of excitement flooded over me. This was what it was all about! This was my vocation! With the limitless enthusiasm of youth and inexperience, I bounded over to undoubtedly save his life with my new-found wealth of medical knowledge.
It didn’t take me long to conclude that this gent had suffered from a spontaneous pneumothorax. This was not based on clinical signs and symptoms but more that this was the condition that we had learnt about that morning in a tutorial and so was the first and only diagnosis that sprung to mind. With an air of self-importance, I explained to the KFC manager my diagnosis and instructed him to call urgently for an ambulance. Looking thoroughly unimpressed, he wandered out from behind the counter and roughly manhandled the unconscious man from his seat and threw him out of his restaurant. My first-ever patient spectacularly regained consciousness, uttered a few obscenities addressed to no one in particular and staggered off down the street. The KFC manager in his far superior wisdom had, in fact, made the correct diagnosis of ‘drunk and asleep’ and prescribed him a swift exit from his premises.
I can see why the professor chose to teach us innocent medical students about a spontaneous pneumothorax that morning. It is, in fact, a wonderful feel-good condition for doctors. An otherwise healthy person collapses with a deflated lung and then the clever doctor diagnoses it with his stethoscope and sticks a needle between their ribs. With a triumphant hissing sound, the lung inflates and the patient feels much better. The professor was trying to help explain the normal functioning of the lung and what could go wrong. He was also trying to encourage us to embrace the wonderful healing abilities we could have as doctors. Back during those early days of medical school I believed that most of medicine would be that straightforward. Someone would be unwell, I would do something fabulous and then they would get better.
Funnily enough, despite a spontaneous pneumothorax being the first medical condition I ever learnt about at medical school, I have, in fact, never actually seen one since. Looking back, I wonder if actually a far more useful and accurate introduction to being a front line NHS doctor would have been a tutorial on how to remove a semiconscious drunk bloke from a waiting room:
‘Would everyone please welcome our guest speaker today. He has a long and celebrated career working in numerous late-night fast food outlets and will be giving you his annual demonstration on how to prepare yourselves for spending