General Practice

An invitation into a patient’s garden

1 September 2024 1 Comment

Lucy O’Hagan

Early in his memoir Native Son: The writer’s memoir, Witi Ihimaera introduced me to the idea that stories have a whakapapa. I had an image of a story travelling through generations of tellers and listeners, told in different places: a dinner table, a classroom, a wharenui, a road trip or perhaps as a whisper in a bed. And I imagine each teller and listener moulds that story into something that makes sense to them in their time and place.

I was recently told a metaphorical sort of story by my friend, the thoughtful and passionate GP, Nigel Thompson. It was a story that had been told to him by Richard Bolstad, who had been given the story by psychotherapist George Sweet. I don’t know Richard Bolstad at all, but if he is someone who passed a story from George to Nigel, I feel I would like him a lot.

Covid cat

1 March 2021 7 Comments

Jill McIlraith

I was eight when I learnt two things: how to tie a reef knot and that I should never sing in public. The right-over-left-and-left-over-right knot sequence had a symmetrical simplicity that stuck with me and was the most useful thing Brownies taught me. Not singing in public was a lesson learnt when another girl and I were persuaded to sing Galway Bay for the end of the year Brownie concert, because “everyone had to do something.” The silence after the first few bars encouraged us, until we realised the audience was too appalled even to snigger. We ploughed on, determined not to stop even as the shuffling got louder. We got polite applause, but were not too young to realise it was less from appreciation of our singing than from gratitude that we were done. But despite the muted response, I felt dogged satisfaction that we had not given up. We had stood side by side supporting each other and had stuck it out to our final flat note.

Ten years later, when I was an exchange student in Arizona, the music teacher insisted I join the school’s a capella choir on the premise that all exchange students did so. I explained why I should be exempt, but he insisted on an audition. Three bars into Edelweiss, he stopped and muttered, “I see what you mean.” I remember telling him not to worry, there were lots of other things I could do and I would concentrate on those.

And 2020, like no other year, has shown us how to rely on our strengths and adaptability, standing side by side, undaunted, while fearsome eddies swirl around. Those of us who work in general practice are used to days not turning out as planned, but none of us foresaw that we’d be spending blustery afternoons wrapped in flapping PPE among the road cones of car park Covid clinics. We looked as alien as we felt in those first few weeks of the Covid response level 4 lockdown, caught in the spotlight and wondering if we were up to it. It seems quaint now to look at the practice’s 2020 diary with its days blocked out for leave and travel. Patients were similarly thrown off track, but often much more seriously, their plans evaporating with job losses, home schooling demands and the seeping anxiety that comes with planet-wide uncertainty.

How to cope with so much uncertainty and change? Could we keep everyone safe and care for our patients? Overnight, we had to change to a completely new way of practising: phone and video consultations, triaging patients into red and green streams, keeping up with who we were supposed to be swabbing that day and who didn’t qualify. How could we meet the expectations of patients, Ministry of Health, DHB, PHO and our families, while not going batty ourselves? And were we going to be financially and emotionally robust enough to still be there for patients by the end of 2020?

We needed to work together with the sort of resilience, togetherness and grace under pressure that I had glimpsed as a hopeless eight-year-old singer.

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On not being Ashley

27 April 2020 26 Comments

Lucy O’Hagan

It’s 5 April, 2020. The country is in lockdown. Waiting. The pandemic hasn’t quite reached our shores but I feel a need to rise to the occasion, offer my services at the front line instead of faffing around as I have been, writing a book about being a doctor while doing little of it, and teaching others how to do it while wondering if I still have that sharpness in me, that quick pattern recognition, that diagnostic edge, that confidence that I know what I don’t know, drug doses at my fingertips, that glorious feeling that I can do all of this and simultaneously manage the unexpected, the macabre, the lost and the uncertain.

I had imagined myself as a pandemic doctor giving unction to the dying in virus-infested houses, but in reality I have spent the week doing telephone consultations at my kitchen table in my socks.

I want to be heroic, as doctors are meant to be, but actually I’m terrified at the idea of exposing myself to a lethal viral load while tending to those coughing and hoiking and drooling. Me, with no mask and no drugs. I have read the grueling stories of doctors in Italy and New York. But this is New Zealand and already some good keen bloke is in his shed making plastic face shields with his 3D printer and attaching these to small helmets and delivering them free to doctors around the country. I have one and I feel safer.

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The invisible cyclist

1 July 2019 1 Comment

Joe Baker

The Invisible Gorilla by Christopher Chabris and Daniel Simons challenges many preconceptions about our certainties of the world. The subtitle, And Other Ways Our Intuitions Deceive Us, describes what the book is all about: how we can be lured into a false sense of believing ourselves correct in many aspects of our lives. The authors describe the fragility of memory; how recall seems to us like an unedited video, but is instead a continuously updated and altered process with errors added all the time. We should never be certain of past events unless there is robust corroboration. Professors admanant they knew exactly where they were when the Twin Towers were attacked were mistaken. Eye-witness testimonies taken very soon after events can differ remarkably. The examples go on.

After reading The Invisible Gorilla I now preface every statement involving memory with a comment along the lines of “As far as I recall”. So when I say that, as far as I recall, the last thing I remember before regaining conciousness in the Emergency Department was seeing a car heading straight towards me and thinking “I’m not certain that car should be there,” I might be mistaken. However this is the image that still wakes and haunts me in the early lonely hours.

Depression: back from the dead and celebrating life

10 September 2018 2 Comments

Today is World Suicide Prevention Day. The following article is an updated version of one originally posted on this day in 2016.

Mark Thomas

Like a shorter, slower version of the great All Black John Kirwan, I have decided to speak up about depression. My life is fantastic and I get immense pleasure from my love of sport, travel and the amazing people around me. But here’s a simple statement of medical fact: I have experienced major episodes of clinical depression since the age of 18. I don’t know how that works, how the same mind that allows me to drink in life like an intoxicating nectar can also turn dog on me and drag me to the depths of emotional hell, but that is the truth of it. I do know that depression can afflict anyone, regardless of how good or seemingly enviable their life is, just as cancer, heart disease or any other illness can strike anybody, regardless of how happy, famous or wealthy they are.

Song for Rosaleen: “the heartbreak that is dementia”

25 June 2018 3 Comments

Sue Wootton

A memoir, by definition, is composed of memories. It is almost unbearably poignant, then, that Song for Rosaleen is a memoir that exists only because of memory loss. Written by Wellington oral historian and editor Pip Desmond, it documents her mother’s slide into vascular dementia and the effects of this on the entire family.

Perhaps this sounds grim – and of course in many ways it is. But Song for Rosaleen is gripping. It is at one level a personal account, at another a meditation on memory itself, and at yet another an erudite critique of how our society treats the frail, dependent and voiceless. For this latter reason alone it should be essential reading for everyone who works in health: management, non-clinical and clinical staff alike.