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On kindness

Coalface tales

James Booth

Tuesday, 23 October 2018

AdobeStock_178561902_Kindness.jpgWe’re about to welcome our first medical students to the practice; Chelmsford now has a new medical school and alongside a lot of local practices, we’re going to be welcoming two undergraduates to the surgery on placement next month. We’ve been thinking about what we will be teaching them about primary care, and alongside the skills and knowledge they will need, I think a GP surgery is a place where there’s a real opportunity to learn the other side of medicine. It’s not just about knowing how to work as a doctor, is knowing how to take on that role and embody it. So much of this job isn’t found in the pages of Kumar and Clarke, and instead is learnt from the people we care for, and the attitudes that the team have towards them.

This has led me to think about something that I think is crucially important to medicine, and especially to general practice. It is also something that is exemplified by a story that has been one of the most notable in my career so far. I’m going to be vague on specific details in the telling to keep it anonymous as it involves a safeguarding case, but the truth of it won’t be lost.

When I started as a GP, I began to see a patient, K, regularly. She was struggling with many difficulties, centred around her pretty precarious mental health and the challenge of caring for a young family affected by a few different childhood illnesses. In our regular appointments, she began to talk about her early life which was marked by what remains one of the worst cases of child abuse I have encountered. The sheer, deliberate cruelty that she met with on a daily basis was almost inconceivable to me, but with the honesty she told her story with, I came to know just how awful her childhood had been.  Looking after her led me directly to my clinical interest in child safeguarding, which I think is the most valuable part of my job.

What was remarkable about K, however, was that she found the courage to confront her abuser in open court whilst a teenager, and her testimony led to his conviction. The path that led her to that point began when she disclosed what was happening to the man who was her GP at the time; my father. I once asked her why she had chosen him: she replied that every time she had seen him as a child, he’d been kind to her.

Now, my father’s kindness comes instinctively to him, it’s his chief characteristic. But it is something that we can learn to adopt, and there’s a wealth of work about the importance of this simple human trait in our daily work with patients. A YouGov survey last year highlighted that the single biggest source of complaints isn’t misdiagnosis, it’s attitude and manner. There can be few people in our profession who can have been unaware of the wonderful work done by Kate Granger’s Hello My Name Is campaign – and if you’re one of them, follow the link right now – and the two billion views her hashtag has seen on Twitter testifies to the power of such a simple act of compassion. 

When I think back to my own time at medical school, I can think of times when I winced at the way in which doctors spoke to patients. I’ll never forget the elderly man brought to tears in front of his son when a cardiologist bullied him over his weight, nor the grand round in which the prognosis of a teenager was baldly discussed in the earshot of his family. I’ll also never forget seeing an A+E SHO spending an hour gently persuading a woman with a broken arm to speak to the police about her husband, or the professor of medicine who treated every person he encountered with decency and warmth. I also remember, as a student at a GP practice I was later to train at, hearing a patient talk about a now retired doctor locally took on a job caring for women at a refuge locally, and how decently and respectfully he treated people who at that time, were often met with disregard by professionals. It’s a truly heartening and positive thing that the CQC criterion most commonly rated as good or outstanding is whether or not a service is caring. 

What K taught me was simple, and it is something that I highlight every time I do safeguarding training for colleagues. She felt able to seek help because she had come to see a doctor as kind; and that wasn’t something that was deliberately directed at her, or a change in attitude in response to something she did, it was a natural part of her consultations. So, I think my first lesson to our new students will be this; be kind. Be kind and make your surgery a place where patients feel safe, and listened to, and met with compassion. It’s this that will make you the professional that we all hope to be; the doctor who leaves work each day having improved the lives of those who came to see them.

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James Booth

James qualified from UCL in 2002 and has been a GP partner in Chelmsford since 2006. He is also the named GP for Safeguarding Children locally. All views expressed are his own.
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