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BMJ. 1999 February 27; 318(7183): 613.
PMCID: PMC1115060
Soundings
Smug
Liam Farrell, general practitioner
Crossmaglen, County Armagh
 
“OK, OK, send her in and we’ll take a look at her,” said the senior house officer, his tone pregnant with studied insolence, as if he was talking to a mentally defective child of 2. “Don’t patronise me, you smug little shit,” I felt like saying, “I was looking after sick kids before you were masturbating.”

But I didn’t, because I was that soldier, and neither would you, because we’ve all been there, haven’t we; brainwashed, either overtly or insidiously, all through medical school, that GPs are lazy and stupid.

So instead I lay on the sarcasm: “Perhaps you could check her mother’s blood pressure while she’s in, as we don’t have the equipment out here, and by the way she’s had a sore throat and I keep giving her antibiotic after antibiotic and it isn’t getting any better; perhaps you could give her a strong one, what do you think might be causing it?”

At his age he won’t understand. He is young, and to him so much is occult and mysterious. Why are we here? What was Woodstock and was there really a band called Country Joe and the Fish? What do health visitors do? What is the meaning of life? Why do small bald men always want to become surgeons? Can Darth Vader really be Luke Skywalker’s father? No, honestly, what do health visitors actually do?

But if I could I would kiss his lips and take his hand and sit him down among long dappled grass and explain the recherché perversity of general practice; how it is not a specialty, but rather a generality, with all the burdens and privileges that this role confers, demanding skills that reach across the divide, not just of a dissonant phalanx of fragmented medical specialties, but of that deep romantic chasm between science and art, haunted by woman wailing for her demon lover.

If we truly have any special interest or skill it is in understanding the individual, surely the most Daedaelian subject of all. As Voltaire said, “It is easier to understand Mankind than to understand one man.” We are the Corinthians, the Renaissance Men, the profession of Chekhov and Turgenev, emphatic students and observers of the human condition and the whole human gestalt, so close your eyes in holy dread, lad, for we on honeydew have fed and drunk the drink of paradise.