Notes from a GP

Reflections on Life, Medicine and Everything In Between

  • What medical school didn’t teach me.

    What medical school didn’t teach me.

    Photo by Orhan Pergel on Pexels.com

    Despite my dream of becoming a doctor, I managed to fail my final exams.

    Medical school itself is a bit of a blur when I look back now. The first two years were spent on the King’s campus on the Strand. Like many students experiencing independence for the first time, I discovered the bar, late nights, socialising and a busy social life. I made wonderful friends and thoroughly enjoyed myself.

    The move to King’s College Hospital in Camberwell brought another adventure. Living away from home, being close enough to pop back when I needed to and having a car gave me a freedom I had never really experienced before. I attended lectures when I could, enjoyed student life and generally had a wonderful time.

    The truth is that I wasn’t a particularly academic medical student.

    I had lots of friends, but very few of them were medics. Looking back, I think I was always drawn to people doing completely different things from me. When I moved to Camberwell, I lived in a large shared house at 95 Coldharbour Lane. It wasn’t just students living there. There were artists, engineers, people already working and all sorts of interesting characters passing through. It felt a million miles away from lecture theatres, anatomy textbooks and medical exams.

    There was something wonderfully bohemian about it all. Conversations around the kitchen table were just as likely to be about art, politics, relationships, music or somebody’s latest adventure as they were about work. Whilst many of my medical school colleagues seemed to spend every waking hour studying, I found myself surrounded by people who viewed the world through a completely different lens.

    Looking back now, I sometimes wonder whether that was part of the reason I struggled with medical school. Whilst everyone else appeared to be studying one syllabus, I seemed to be studying two. One was medicine and the other was life.

    Perhaps that sounds like an excuse, and it certainly wasn’t one at the time, but I can see now that I was learning things that would eventually matter enormously to me as a doctor. I was fascinated by people, by their stories, by the different ways they approached life and the very different paths they had taken to get there. Maybe that is why I always found it easier to learn from people than from books.

    The couple of friends I did have on the course and I would usually sit together in the back row of the lecture theatre, which looked more like a cinema than a place of learning, complete with comfortable red seats. If the lecturing became too much, there was always the second-floor bar. I spent more time there than I probably should have done.

    At lunchtime I would sometimes sneak back into the lecture theatre, put my coat over my head and have a quick snooze. On one occasion, what was meant to be a ten-minute nap turned into something rather longer. I woke up a couple of hours later surrounded by faces I didn’t recognise and listening to a lecture I definitely didn’t understand.

    It turned out I was sitting in the middle of an engineering lecture.

    Trying to remain composed, I gathered my things and quietly left, hoping nobody had noticed that I had slept through the changeover and remained there for the best part of two hours.

    Needless to say, I was never destined to be top of the class.

    Some subjects I took to naturally whilst others I struggled with enormously. Anatomy, for example, was a constant challenge. Spending a year dissecting a cadaver was not something I enjoyed and I found learning from textbooks difficult. Much of what we were being taught felt abstract and disconnected from real life.

    What I found hardest was that medicine seemed to be taught almost entirely in theory. We didn’t meet a real patient until our third year and much of what was discussed in lectures simply didn’t make sense to me because I had no context for it.

    Everything changed once I started spending time on the wards and meeting patients. Suddenly the conditions we had spent years reading about had faces, stories and families attached to them. The medicine started to make sense because it became real.

    Unfortunately, by then I was carrying the consequences of not having engaged with the earlier years as seriously as I should have done.

    When the final exam results were published, they were pinned to a board for everyone to see. I can still remember the crowd of anxious students gathered around it, all trying to find their names on the pass list. I searched once, then again and then a third time. At first I was convinced I must have missed it. I checked every line repeatedly, certain that if I looked hard enough my name would somehow appear.

    It didn’t.

    The feeling was awful. Not only had I failed, but everybody else could see that I had failed too. I remember feeling embarrassed, disappointed and frightened. For someone who had wanted to be a doctor for as long as I could remember, it felt as though the future I had always imagined was slipping away.

    More than anything, I worried about how my parents would react. I felt I had let them down.

    In reality, they were incredibly supportive. Perhaps part of the reason was that they understood exactly how I felt. Dad had failed his finals too, for many of the same reasons. He knew first-hand that a setback at the end of medical school did not define the doctor you would eventually become.

    Those were also the days when university education was free. Repeating a few months was disappointing, but it wasn’t financially devastating. Looking back, I can see that whilst it felt like the end of the world to me at the time, it really wasn’t.

    Six months later, whilst many of my peers had already started their first jobs, I found myself standing in front of the same board once again.

    This time I only had to look once.

    My name was there.

    I had passed.

    It was the most incredible feeling. Seeing “Dr” in front of my name felt surreal. I changed my bank card and cheque book almost immediately, not because I wanted to boast, but because I was proud. I had wanted this for as long as I could remember. I practised my new signature endlessly and threw myself into my first job with all the enthusiasm and confidence that only a newly qualified doctor can possess.

    That confidence lasted until my first on-call shift.

    I remember my first night on call as clearly as if it were yesterday, even though much of those early years has now merged into one long blur of wards, bleeps, sleepless nights and exhaustion.

    In those days the junior house officer was very much at the bottom of the pile. We carried a bleep and were the first port of call for all sorts of things. Rewriting fluid charts, replacing lines, reviewing admissions and trying to stay one step ahead of whatever happened next.

    I quickly learned that one of the secrets to surviving hospital life was understanding that nurses were your friends. The young doctors who arrived believing they knew everything and that nurses were somehow beneath them often had a difficult time. I genuinely enjoyed talking to the nurses and learned a huge amount from them. They had knowledge, experience and common sense in abundance and they made many an on-call shift far more bearable.

    Despite that, it was terrifying at times. I was twenty-four years old and seeing things most people my age had never encountered. Illness, trauma, suffering and death became part of everyday life.

    I still remember the first time I was called to verify a death. Like every junior doctor of the time, I carried my Oxford Handbook of Clinical Medicine in the pocket of my white coat. It was our bible. I looked up what I needed to do before walking onto the ward.

    The lights were dimmed. The curtains were drawn around one bed.

    I remember pulling the curtain back and seeing a woman lying there looking as though she was asleep. My heart was racing. Three minutes is a very long time when you are listening for heart sounds.

    I am also an avid horror fan and a small irrational part of my brain was convinced she might suddenly open her eyes.

    Looking back now, I think about my eldest daughter, who is twenty-four, and I struggle to imagine her being expected to deal with something like that alone. We were so young and yet somehow we simply got on with it.

    Medical school had definitely not prepared me for working as a doctor. Nothing had prepared me for the fear of being called to see a patient on my own, the fear of feeling out of my depth or the responsibility of being the first person expected to make decisions.

    In those days the saying was “see one, do one, teach one”. Procedures such as inserting a line were often learned exactly that way. Looking back, it seems extraordinary. At the time it felt perfectly normal.

    Christmas on call was probably the hardest of all. Whilst family and friends were gathered together, we were often in hospital missing Christmas lunch and family celebrations. The hospitals were very different then too. If you missed the canteen opening times, that was often it. More than once I survived an entire shift on toast, coffee and tea from the doctors’ mess.

    I remember one night being on the cardiac arrest team. I had finally made it back to the on-call room at some ridiculous hour of the morning. I was fully dressed and had just lain down on the bed. I wasn’t just tired. I was exhausted beyond anything I had experienced before.

    Then the bleep went off.

    I hate admitting this, but I simply couldn’t get up.

    A whole group of us carried arrest bleeps and I knew others would be responding. As the most junior member of the team, I convinced myself they would manage perfectly well without me. The truth was that for that one moment I had absolutely nothing left to give.

    There were certainly times when I questioned what I was doing. Many of my friends worked regular hours, had weekends free and earned far more money than I did. Meanwhile I was spending nights in hospital, carrying a bleep, surviving on very little sleep and earning surprisingly little for the responsibility involved.

    Medicine certainly wasn’t a route to wealth.

    For me, and for many of my colleagues, it really was a vocation.

    And yet, despite everything, I loved it. I loved the buzz, the unpredictability and the fact that no two days were ever the same. We worked hard and we played hard. We went out, danced, drank, smoked and enjoyed ourselves. The friendships formed during those years were unlike any others because they were forged through experiences that few people outside medicine could fully understand.

    And then there was home.

    After long shifts, sleepless weekends and endless on-calls, I would return to the sanctuary of family. There I could sleep, be looked after and simply switch off for a while.

    Looking back now, I realise that the things which eventually made me a good doctor were not necessarily the things I learned in medical school. Medical school gave me the knowledge I needed and eventually, after a second attempt, the qualification I had dreamed of for so long. What it couldn’t teach me was how to sit with somebody who was frightened, how to make decisions when I wasn’t entirely sure of the answer, how to work as part of a team or how to cope when I felt completely out of my depth.

    Those lessons came later. They came from patients, nurses, colleagues, sleepless nights on call, Christmas shifts, difficult conversations and countless mistakes. They came from being exhausted, occasionally frightened and constantly challenged. They came from life.

    When I failed my finals, I thought I had failed at becoming a doctor.

    What I couldn’t see at the time was that becoming a doctor was only just beginning.

    The real education came afterwards.

  • Where it all started for me.

    Where it all started for me.

    When I ask medical students and younger doctors why they want to do general practice these days, the answers are usually practical ones. They want a portfolio career, flexibility, the opportunity to move abroad, time for a family or the chance to pursue other interests alongside medicine.

    They’re all perfectly reasonable answers, but I rarely hear someone say, “Because I love it.” Or, “Because it’s in my blood.”

    For me, it really was that I wanted to be a doctor from as early as I can remember. Not because anyone pushed me into it, and not because it was expected of me. It simply felt like the most natural thing in the world.

    My parents came to the UK in 1971. Dad had previously come to Newcastle as a teenager to study medicine before returning home, and like so many people of their generation, they came here to build a life through hard work and opportunity.

    In those days, single-handed GP practices were the norm. Dad started with no patients at all and, by the time he retired in 1996, had built a practice of well over 3,000 patients. He worked tirelessly. General practice was very different then. GPs were on call around the clock, carried bleeps, did home visits, visited patients in hospital and often cared for generations of the same families.

    We lived just up the road from the surgery, so work and home often blended into one. When Mum started working there too, as receptionist, practice manager and everything in between, the surgery became a huge part of our family life.

    School holidays were often spent there. My brother and I would sit in the back, watch television, wander around and simply be part of the life of the surgery. At lunchtime we would often all eat together before the afternoon began. Mum would usually head home, while Dad got on with the rest of his day. That might mean visits, paperwork, casualty shifts or any number of other responsibilities. We often wouldn’t see him again until much later that evening.

    The surgery never felt separate from family life. It was simply part of it.

    Money was tight in those early years. We all slept in one room for a long time because every penny went towards creating a better future for the family. Yet I never felt deprived. Quite the opposite.

    Home felt safe, secure, happy and simple.

    Mum was an incredible cook and somehow managed to make wonderful meals out of very little. She was loyal, resilient, creative and endlessly supportive. Dad shared many of the same qualities. He was kind, thoughtful and wise. He hardly ever got angry. He listened intently, spoke carefully and always seemed to know exactly what needed to be said.

    One of my earliest memories is being allowed to stay up one evening waiting for him to come home. When he finally walked through the door, I ran towards him and he scooped me up so high that I felt I could touch the ceiling. He was as happy to see me as I was to see him. It is a memory that has stayed with me all my life.

    As I got older, Dad made every effort to be there for school plays and important moments. If work occasionally got in the way, I never felt angry or upset. I simply understood that he was needed elsewhere and that he would have been there if he could.

    I was always incredibly proud of my parents. Wherever we went, people seemed to know them. They would stop to chat in the street, wave from across the road or come over to say hello.

    As a child, I loved it. In fact, there were times when I genuinely thought Mum and Dad were famous. The amount of attention they received certainly made it feel that way.

    I loved tagging along with Dad. We would pop into the local newsagent and somehow leave with free sweets because he was the owner’s GP. Easter often seemed to bring a mountain of Easter eggs from grateful patients. At the time, I simply thought it was wonderful.

    As I grew older and understood what being proud of someone really meant, I realised just how proud I was of both of them and how lucky I was to be their daughter. Looking back, those small gestures weren’t really about the sweets or the Easter eggs. They reflected the affection, trust and respect people had for my parents.

    More than anything, I loved seeing the way people warmed to them. They were kind, approachable and genuinely interested in others. Even as a child, I could see the trust people placed in them, and I think that left a lasting impression on me.

    Both of my parents were incredibly generous. They helped family, friends and complete strangers. Sometimes that meant advice, sometimes practical help and sometimes opening doors for others. They were a team in every sense of the word.

    I followed Dad everywhere he would let me. I accompanied him on visits, watched how he interacted with people and absorbed everything around me. At sixteen, I was allowed to sit in during consultations. I loved it.

    What struck me most wasn’t the medicine itself. It was the relationships.

    Patients knew him and he knew them. He knew their families, their histories and often their worries before they had even spoken. People trusted him. They respected him. He was clinically excellent, direct when he needed to be and never particularly tolerant of excuses or self-pity.

    Having experienced hardship himself and spent his life working tirelessly to build a future for his family, he believed people were often capable of more than they realised. It wasn’t a lack of compassion. Quite the opposite. He simply believed in personal responsibility and making the most of the opportunities you were given.

    Yet people knew he cared.

    For our family, he was the person everyone turned to. Even into my fifties, I would speak to him about major decisions. He remained my sounding board, my adviser and my guide long after I had become a doctor myself.

    Mum was every bit as special. She was loyal, resilient, creative and completely devoted to her family. In many ways she was very similar to Dad. The difference was that she had a more sheltered upbringing and perhaps hadn’t seen as much of life as he had. Maybe that was why I found it easier to open up to Dad about certain things, but there was never any doubt that Mum was there for us.

    She created a home that felt warm, welcoming and full of love and, as I got older, became one of my closest friends.

    Both of them are missed every day.

    Looking back now, part of me undoubtedly wanted to be like Dad. Single-handed general practice felt normal because it was all I had ever known. In many ways, I went on to build exactly the kind of practice I had grown up watching.

    But the truth is that becoming a doctor was about more than following in Dad’s footsteps.

    Medicine wasn’t really a career choice for me. It was simply part of life. It was in the conversations around the dinner table, in the surgery, in the patients who stopped Dad in the street and in the example my parents set every day.

    I had seen what being a good doctor looked like.

    More importantly, I had seen what it meant to serve a community, to work hard for something bigger than yourself and to earn people’s trust over a lifetime.

    So when people ask me why I became a doctor, the answer is simple.

    Part of me wanted to be like Dad.

    But more than that, it was already part of who I was. It was in my blood, in my upbringing and in my being. I had seen first-hand the privilege of helping people and the difference one person could make to so many lives.

    That is where it all started for me.

  • The journey that led me here.

    The journey that led me here.

    “I would never have chosen the events that brought me here. But they shaped not only the doctor I am, but the person I have become.”

    A Different Way of Practising Medicine

    For many years, I worked as a single-handed GP, supported by a small and dedicated team. Together, we cared for around 4,000 patients and built something that felt personal in an increasingly impersonal healthcare world.

    One of the greatest privileges of working in this way was the opportunity to truly know my patients and their families. I cared for multiple generations, shared in life’s milestones, supported people through illness and loss, and built relationships based on trust and continuity.

    Those years taught me that good medicine is about far more than diagnosis and treatment. Clinical expertise matters, but so do listening, reassurance and understanding the wider context of a person’s life.

    Patients do not always come to see their doctor because they are seriously ill. Sometimes they come with worries, fears or uncertainties that have been weighing on their minds. Often, what they need most is someone who will listen, take them seriously and help them make sense of what they are experiencing.

    Knowing my patients, their families and their stories reinforced my belief that medicine is at its best when it combines clinical expertise with genuine human connection.

    I loved working that way and imagined I would continue for many years to come.

    When Life Changes Direction

    Life, however, had other plans.

    The last few years have been some of the most challenging of my life.

    In October 2023, my father died at the age of 92. For several years beforehand, I had played a central role in his care. My involvement extended far beyond simply offering support. I was part of every aspect of his care, from personal care and day-to-day practicalities to navigating healthcare decisions, advocating on his behalf and helping him remain at home for as long as possible.

    My parents had been married for 65 years.

    My father’s death devastated me.

    I was incredibly close to both of my parents, particularly my father. Throughout my life, there was rarely a day when I did not see them and, if I couldn’t see them, I would speak to them.

    They were a constant presence in my life.

    Losing my father left a space that can never truly be filled. At the same time, I was watching my mother navigate life without the man she had shared more than six decades with.

    It was heartbreaking for all of us.

    Just four weeks later, my father-in-law also passed away.

    Whilst our family was still processing those losses, another unexpected challenge arrived. In January 2024, I was informed that I would need to leave the surgery premises from which I had worked for many years, with very little notice.

    Despite exploring every possible option to keep the practice going independently, it became increasingly clear that the landscape of primary care had changed. Eventually, I made the difficult decision to join a larger partnership, and the merger took place in July 2024.

    Although I understood the practical reasons behind the move, I found the transition challenging. After so many years of working independently, I was adapting to a very different environment.

    Caring for Those Who Cared for Me

    My caring responsibilities did not end with my father’s death.

    My focus then shifted to my mother.

    As I had with my father, I became deeply involved in her care, helping her remain at home and supporting her through the final chapter of her life.

    At the same time, family life continued. I was supporting three young adult children still living at home, maintaining family life, and trying to meet the needs of everyone around me.

    Life did not pause because I was grieving.

    There were still meals to cook, responsibilities to manage, people to support and countless practical tasks demanding attention.

    In August 2025, my mother died peacefully at home at the age of 93.

    Caring for both of my parents through the final years of their lives was one of the most important experiences of my life.

    I have no regrets.

    My parents gave me everything. Their love, support, guidance and sacrifices helped shape the person I am today. Without them, I would not be who I am.

    Being there for them at the end of their lives was never a duty.

    It was a privilege.

    I am deeply grateful that both of my parents were able to remain at home and die peacefully in familiar surroundings, with the people who loved them around them.

    Seeing Things From the Other Side

    Throughout my career, I had always tried to practise medicine with an appreciation of what illness, loss and bereavement mean for patients and those who love them.

    End-of-life care was an important part of my role. It required compassion, honesty, difficult conversations and a willingness to support families through some of life’s hardest moments.

    Caring for my own parents gave me an additional perspective.

    For the first time, I was not only the clinician who understood what families were experiencing.

    I was the daughter living through it myself.

    It reinforced values that had guided me throughout my career: listening, being present, having honest conversations and recognising that some of the most meaningful care we provide has little to do with prescriptions or investigations.

    Understanding Burnout

    Following my mother’s death, I reached a point where I knew I could not continue as I had before.

    For the first time in many years, I made an appointment to see my own GP.

    For the first time in my professional career, I took time away from work and was signed off sick.

    As a single-handed GP, I simply could not have done that before.

    For many years, the responsibility rested with me alone. Patients still needed care, staff still needed support, decisions still needed to be made and the practice still needed to function. Stepping away for an extended period was not something I felt able to do, either professionally or financially.

    What began as time away from work became eight months of healing, reflection and processing everything that had happened over the previous few years.

    For the first time, I truly understood what burnout meant.

    Not simply feeling tired or stressed, but reaching a point where the emotional and physical reserves that had sustained me for so long had finally been exhausted.

    Looking back, taking that time was one of the most important decisions I have ever made.

    A New Chapter

    The months away from work gave me time to think about what I wanted for the future.

    For many years, I had carried the responsibilities that come with being a single-handed GP. Alongside the rewards came the knowledge that the responsibility ultimately rested with me.

    After everything I had experienced, particularly caring for my own parents through the end of their lives, I began to reflect on whether I wanted to continue carrying that responsibility alone.

    One of the reasons I started to consider different options was the realisation that I no longer wanted to be solely responsible for some of the most difficult decisions and situations that family doctors inevitably encounter.

    That reflection did not diminish my commitment to patient care. It simply helped me recognise that the way I wanted to practise medicine was evolving.

    The experiences of caring, grieving, rebuilding and recovering reinforced my belief that patients need time, continuity, compassion and the opportunity to be truly heard.

    Healthcare is not always about fixing people.

    Sometimes it is about being present.

    Sometimes it is about listening.

    Sometimes it is about helping someone feel less alone.

    Sometimes it is simply about being there when a patient is worried, uncertain or frightened.

    Those moments can be just as important as any diagnosis or treatment plan.

    When the time came to decide what I wanted the next stage of my professional life to look like, I became one of the founders of a private practice built around the values that matter most to me.

    I wanted to create a service where patients are given time. Where continuity, trust and meaningful relationships remain central to healthcare. Where people feel heard, understood and supported, not simply treated.

    But my decision was not based solely on clinical philosophy.

    The events of the previous few years had also forced me to think differently about my own future.

    Founding a private practice offered an opportunity to build something meaningful and sustainable. It gave me the chance to create a different model of care for patients, whilst also creating something that I hope will give me greater flexibility in the future and allow me to shape the later years of my career in a way that is both fulfilling and sustainable.

    After everything that had happened, I realised that looking after my own future was not selfish.

    It was necessary.

    Looking Back

    I would never have chosen the events that brought me here.

    But they reminded me why I entered healthcare in the first place.

    Today, I bring not only my years of clinical experience to my patients, but also the perspective gained through caring, loss, recovery and rebuilding.

    Standing where I am today, I know those experiences have shaped not only the doctor I am, but the person I have become.

    Thank you for taking the time to read my story.