Confessions of a GP

Uzma is still crying her eyes out and is refusing to go home. What the hell am I going to do now? I need some help with this one. I’m rubbish at comforting crying teenagers. Why on earth has this girl come to see me about all this. Surely there must be far better qualified people to deal with this than me. Someone trained in understanding the emotional turmoil of adolescence, someone who finds it rewarding to address teenage angst on a regular basis. Someone with endless patience and empathy and someone who wasn’t supposed to be in the pub 20 minutes ago! As she sobs, I do a quick Google search for teenage counsellors in the town. I get a few numbers and phone them but just reach answerphones. They’re all in the bloody pub, lucky buggers.

Just as I’m wondering how I’ll ever get home, Uzma’s phone rings. It is one of those annoying ringtones that is extra loud and the start of an R&B track that I don’t recognise because I’m over 20. The tears stop almost instantaneously and she answers the phone, ‘’Old on a minute, Doc. Wassup, Letisha… Is it?… Is it?… Oh my days!… Are you chattin’ for real!… I’m just with the doctor and that… I’ll be right there.’

The anguish suddenly vanishes. ‘Sorry, Doc, I’ve got to go. My friend Letisha just got dumped. I’ve got to go round and find out what’s going on.’

Before I can say a word, Uzma is gone. Speechless, I sit in silence pondering the mysterious world of the 16-year-old.

Africa

During a holiday in East Africa, I visited some old friends from medical school who were working in a small rural hospital in Kenya. Rob and Sally had been GPs in the Midlands until they decided to sell their house, quit their jobs and commit to three years in Kenya setting up and running a rural hospital.

Rob proudly showed us round. They had been in Kenya for two years and had achieved an enormous amount for the local community. Thanks to their tireless work, there is now an organised maternity unit and a well-equipped medical ward. Rob has also set up an AIDS clinic with free testing and, most importantly free, access to AIDS medication. It is the only one of its kind in the whole region. Rob and Sally have also pushed hard for education and disease prevention and have spearheaded a campaign to encourage mosquito nets. As a result, they have significantly reduced malaria deaths.

Not only had Rob and Sally been working hard treating patients, they have also been single-handedly planning and managing the changes and improvements to the hospital mostly with funds they have raised themselves. My targets in England for the year might be to get a few patients to lose some weight or cut my diazepam prescribing. Rob and Sally’s targets were to build a maternity ward and prevent 100 local children from dying of malaria.

Rob asked me to help out with the HIV clinic for the day. There was no appointment system. The patients arrived en masse in the morning and sat patiently outside my room all day until the last one was seen at about 6 p.m. Not a single person complained about waiting and each one thanked me with genuine gratitude and warmth when the consultation finished. It truly was a humbling experience.

My most memorable patient was Cynthia. She had set off from a neighbouring village the night before and, despite being weak with advanced AIDS and TB, she walked the entire 12 miles and spent the night sleeping in the doorway of the hospital along with many other of the morning’s patients. She didn’t speak any English so a nurse was translating for me. Cynthia was 24 but looked much older. Her two children had both died aged around 18 months and, although never given a diagnosis, they almost certainly died from AIDS-related illnesses. Cynthia’s husband, from whom she contracted HIV, left her once she could no longer work and he realised that she wouldn’t be able to produce any healthy children for him. Cynthia was alone and her only means of income was digging in the fields. She was still getting up each day and attempting to work, but her AIDS was advanced and she was too weak to dig. The medications for her AIDS and TB were free and were helping, but what she really needed was something decent to eat. ‘Where are you going to get your next meal?’ I asked via the interpreter. She shrugged her shoulders and then after a long silence looked me in the eye and asked me a question in her native tongue. Waiting for the translation, I assumed that Cynthia would be asking for some money or food. To my surprise, what she actually asked me for was a job. Even in her weak state, Cynthia clearly still felt that she should earn her way and hadn’t even considered a hand-out. One of the previous patients had given me six eggs to say thank you for the mosquito net I gave him, so I gave them to Cynthia and she left with at least some basic sustenance to help her muster the energy for her long walk home.