GP Work is Hard

One week of some GP locums and I am exhausted.

7b609ee5184afeee3a442d25e5549028I can spend 10 minutes per consultation if people have straight-forward tonsillitis or gastroenteritis.

But what about the parents who are hesitant about vaccinating? I need more than ten minutes to make an impact.

What about the woman whose pregnancy test was unexpectedly positive, and needs to discuss options? She might not have anyone else to discuss options with.

What about the myriad people with psychiatric illness? I need more than ten minutes to figure out if it’s depression, or if there is a history of hypomanic spells. Is it substance induced? Is there another general medical condition? Who can start someone on antidepressants after a ten minute consult?

And what about the worried well? The old people with children abroad, with a bag full of chronic medication, and stories of challenges as numerous as the stars.
My dad has a favourite piece of advice for new graduates. It goes something like this:

Remember that when you come into contact with a patient, you may be the only person that touches them that day. The only person that hears their voice, that looks into their eyes. Make sure your touch is a kind one.

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“Expressive hand studies using various media”, Savannah7963, Conway High School.

General Practitioners are pushed for time (and push their locums for time) because it’s the only way they can make any kind of profit, really. I understand that. But that is not the family medicine that I was taught, and I’m having trouble finding the balance.

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The Nicest Interns: Part 2

I just recently finished a four-month Family Medicine rotation. Our after-hours duties on Family  Medicine are as casualty officers at the Accident and Emergency Departments of two different hospitals. Because A&E has high-intensity decision making, our shifts were not allowed to be longer than twelve hours (compare: 24 hour shifts in any other department).

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Continue reading “The Nicest Interns: Part 2”

On Poverty and Health: The Obesity-Conundrum

rich man poor man slimmer man fatEver since I started running (and enjoying it), I have been intrigued by the sociology and economics of health and fitness. It coincided with my “coming of age” in medicine, so to speak, so it has been in interesting and ongoing thought-experiment.

I want to address some pertinent falsehoods about health and fitness, and why the disenfranchised have such a hard time of it. Right now I intend to write a two-part series, but who knows.

Quick disclaimer: I would never suggest that being a student-on-a-budget is comparable in hardship to living in poverty. All the same, being a student on a partial scholarship and a heavy student loan certainly did teach me a little about struggling financially and its effects on health. Continue reading “On Poverty and Health: The Obesity-Conundrum”

Open Letter to South African Private GPs*

Dear South African Private GPs,

Colleagues.

I want to tell you today that I am tired.

I’m sure you are tired too, but I want to tell you that, at least in part, you are contributing to my exhaustion – and that of my fellow interns. Continue reading “Open Letter to South African Private GPs*”

On Call During A Riot

Last night while on call I treated rubber bullet injuries.

I treated MANY rubber bullet injuries.

If you thought rubber bullets only cause bruising – well, you’d be wrong. They can penetrate. During my fourth year forensic pathology rotation, we did an autopsy on a man who died due to a rubber bullet embolism.  Continue reading “On Call During A Riot”

Something Only Family Physicians Experience

I had such a lovely experience last week. I was working Accident and Emergency overnight, as I have finally completed my surgical posting and moved on to Family Medicine.

A mother brought her nine-month old baby in with a chronic cough. Now, it was probably the happiest baby I had seen all night and probably could have just waited to go to the clinic the next day, but whatever: she was there, so I saw her.

In among the questions of TB, smoking relatives, and pets, I asked if Baby was born term, and how. Her response, “Yes, he was a big baby! You did my Caesarian Section!”

pediatrician-and-baby

Continue reading “Something Only Family Physicians Experience”

Implanon in the Bible. Apparently.

ME: I’m sorry to tell you that you’ve had a complete miscarriage.

HER: Oh. Okay.

ME: Was this a planned pregnancy?

HER: No! It was an accident.

ME: Are you planning a pregnancy in the near future?

HER: Not really. I have one already. I can’t afford another baby.

ME: Then I think we should discuss family planning.

HER: *blank*

ME: Prevention.

HER: Oh. Yes.

ME: Even though you don’t want any future children, we don’t recommend tying your tubes at such a young age. The Copper T is always a good idea, but have you heard of Implanon?

HER: I don’t know.

ME: Implanon is a little stick, like a matchstick, that we put in your arm-

HER: Oh yes. I’ve heard of that.

ME: Good. It lasts for three years. It’s not too long but it gives you enough time-

HER: No. No I don’t want that.

ME: Is there a reason? It won’t hurt you and the side-effects are a lot fewer than the injections you’ve been getting.

HER: Implanon is not for me.

ME: You’re absolutely allowed your choice but can you share why you think it’s not for you?

HER: You know.

ME: I don’t.

HER: It’s like they say in the Bible.

ME: *blank*

HER: It’s the mark. The one at the end of days.

ME: Implanon is the mark of the beast?!

HER: YES!

The worst is that after some prodding, she said that a nurse at her local clinic was telling women this. I wish I could say she was the only patient who told us that, but no… it was quite a common belief.