A GP In Despair: We've Got Some Medicine, Where's The Care?

I have recommended Dr. Crippens's NHS Blog Doc on several occasions. It is, by turns, a funny, provocative, gut-wrenching insight into what it is like for GPs who are attempting to provide decent medical care within the NHS. The recent entries are gut-wrenching, plain and simple (hint, you will need to look at the comments and read about what happened on Friday morning to grasp even an iota of the anger and despair underlying this post).

Dr. Crippen has written about the lack of availability of basic nursing care (such as the debridement and care of bedsores) on many occasions. He has painfully detailed times when his own judgment and knowledge of his patients was over-ruled by the application of a protocol by someone who does not know his patient (most notably: the incident of the aneurysm and the paramedics; and the difficulty in admitting a patient whom he had assessed as suicidally depressed - Friday's entry). Dr. Crippen has the medical knowledge and (very obviously) a sense of care that is only found in those who are dedicated to their vocation. It seems as if, very regularly, he is frustrated from exercising both of those qualities.

All of my recent reading about allostasis has emphasised that medical innovations have had an extraordinary impact on our quality of life, well-being and longevity. However, in his essay in Allostasis, Homeostasis, and the Costs of Physiological Adaptation, Sterling argues that these extraordinary, high-level medical interventions are being delivered in a low-level, mechanistic way. He argues that these interventions are most successful when they are delivered in the rounded context of care that address all a person's needs - which probably encompass basic nursing needs, and the comfort of human contact.