Confessions of a GP

As an idealistic sixth-former applying for medical school, I imagined spending many long years working in the poorest and neediest parts of the world. The reality is that apart from my brief experience in Kenya, my only other time practising medicine abroad was three short months in a hospital in Mozambique soon after I qualified. The reality of working in an African hospital was really hard. The facilities were limited, the bureaucracy made me want to tear out my hair and the extent of the corruption was terrifying. The experience was incredible and although it was some years ago, I think of that time often and it helps put both my work and life back in the UK into perspective. I’m a more experienced doctor now and could potentially be much more help back in that hospital in Mozambique, but the question is: do I have the motivation to go back?

Rob is a GP with a similar amount of experience to me. The week before we arrived in Mozambique, a woman came to the hospital in the middle of the night in labour with an arm presentation. This means that the baby’s arm had been born but the rest of the baby was still inside the womb and basically stuck. Rob, like me, had spent a few weeks on an obstetrics attachment as a medical student but that was pretty much the sum of his experience of delivering babies. Suddenly, as the only doctor around and ten hours from the next nearest hospital, Rob had to do something. The woman needed a Caesarean section, but there simply weren’t the facilities at hand. He tried desperately to push the arm back in and deliver the baby but to no avail and the baby died. The mum was extremely weak from loss of blood and exhaustion. The baby needed to be taken out or the mum would die too. Rob cut off the baby’s arm and managed to deliver the remainder of the dead baby.

Rob saved that woman’s life and I have the utmost respect for him. If he had decided to stay in England, that woman would have undoubtedly died. Throughout this book I’ve moaned a bit about the fact that I went to medical school to save lives and make a difference but instead I keep lonely old ladies company and dish out sick notes to the work shy. I haven’t ruled out the possibility of returning to Africa to practise some genuine ‘life-saving’ medicine, but right now I’m not sure that I have the emotional strength to hack the arm off a dead baby at three in the morning.

Evidence

I was being dragged round town on a Sunday morning and, despite the fact that I really fancied a coffee and some cake, my wife wanted us to try out one of the new trendy juice bars that had sprung up. The man behind the counter had a silly pointy goatee and a ponytail. I asked him what a acai berry was given that it was going to make up one-fifth of my five berry smoothie. ‘It’s hand picked from the shores of the Amazon, man.’ (I doubted this.) ‘It’s got 100 times the vitamin C of an orange so a real natural high. You’ll be feeling great all morning and it’ll keep those colds at bay.’ He looked really pleased with himself as he handed me my smoothie and I wondered what other nonsensical medical advice he gave out to his customers. ‘Eat a papaya and cure your verruca.’ ‘Eat some raspberries and your friends will like you more.’ I was desperate to tell Mr Goatee Man that there was no evidence to suggest that eating excess vitamin C was of any benefit in keeping colds away and that it wouldn’t give me a ‘boost’, why would it? Added to this was the fact that if I received any more than 200mg of vitamin C, I’d simply shit and piss out the excess so might as well stick to an orange, which was much tastier and cheaper. My wife knows me too well and gave me a look that meant stay quiet and don’t embarrass her in public. I took my smoothie and sat down. Irritatingly, it was really nice and made me feel quite revitalised.

Mr Goatee Man and his smoothie are part of a growing trend of advertising and marketing of ‘healthy products’ with huge claims about medical benefits without any evidence to back them up. This might seem like a typical rant from a closed-minded doctor, but I genuinely have nothing against my patients taking many herbal remedies and dietary supplements. Many of our medicines originate from plants so perhaps some of them may have genuine medical properties. Saint John’s wort, for example, is shown in clinical trials to be effective in the treatment of depression. What I object to is health food companies playing on people’s fears and anxieties with regard to their health by making unproven medical claims to sell their excessively expensive products.