Editor’s Letter 2015 No. 11

[box] Our Editor-in-Chief changes trains at Clapham Junction on his way to GP Land [/box]

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Eventually we all reach a Clapham Junction. We don’t all reach it in the flesh, the seventeen platform behemoth, but I can assure you that all of us disembark there every once in a while. It’s that sense of being distanced from everything else yet also at the heart of it. It’s that sense of paying more for a smaller coffee. It’s that feeling of going with the tide and yet everyone else is swimming the other way.

On this particular visit, coffee in hand, I was going the opposite way to everyone else as usual. I was off into GP Land, a realm not often discussed or visited, nor is it a realm that as medical students we often set our sails for. I’ve spoken about general practice before; how we’re not exposed to enough of it and how we’re never going to fall in love with a career that is bashed repeatedly by hospital doctors. It is, and always has been, a shame that such a rewarding career is derided so.

As I waited under my umbrella, treading water in the puddles, I turned to see the rest of the swimmers cramming themselves like sardines into a train bound for Waterloo. I, on the other hand, was the one with a table to myself all the way to Guildford.

As I took the tour around GP Land I met the entire staff, every single cog that keeps the surgery ticking, something that happens so rarely on hospital firms that I often wonder if some of workforce ever make conversation.

“This is where we keep the emergency bags, the oxygen and such like,” I was told during a thorough tour of the building, “although hopefully you’ll not have to use them”. Famous last words of course, as within two hours I was part of a small troop trying to help a homeless man who had started vomiting blood. He was cool, clammy, confused. We lay him down. We called 999. He was brought in by the staff of a local charity that runs services for homeless people living in the town. We made conversation. They made me smile.

A little later at lunch I found out that one of the GP partners does a clinic once a week in the same homeless shelter that brought that patient in. This interested me as, perhaps out of ignorance, I had never fathomed the idea that such a service could be provided.

A few days and a few Clapham Junctions later, I was there in the shelter, meeting the residents and the wider community at the clinic. We talked to some about the drugs and the drink and the dangers of living on the streets. We talked to some about chest infections, their repeat prescriptions and their sorrow at the deaths of loved ones. They’re people just like us and, even if sometimes we are guilty of turning our noses up and walking on by, they still need healthcare. They live forever in a Clapham Junction — always there but never noticed, so far removed from those sardines on the train to Waterloo. I realised at that moment that whatever career I choose, I wanted to help these people to be the best versions of themselves that they can be.

As a wee pup striving to be a psychiatrist, I feel that I can be a part of the machine which helps. So many homeless men and women encounter psychiatric services every day that my future career is going to depend upon charities and shelters like the one I encountered last week, rehabilitating and providing a roof for my homeless patients once they’re well enough to be discharged. At the same time, my alternative vote for general practice is looking like an ever more attractive career. If my life were to take me down that path, through Clapham Junction and off out to GP Land, I would have no complaints, no wars with the world, and no sardines with which to make unwilling, rush-hour bedfellows.

Rob

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