Confessions of a GP
in my shiny shoes and matching shirt and tie. A mental note was made to keep a spare tracksuit and baseball cap in the car to disguise myself on my next visit.
    I was annoyed and ashamed by how uncomfortable I felt in Somersby House. When I started medical school I felt distinctly ‘street’. While most of my compatriots were privately educated somewhere in the Home Counties, I went to an inner city comprehensive. Why was I feeling so bloody middle class? Medical school had not only desensitised me to death and suffering, it had also turned me into a snob.
    I finally got to Mr Tipton’s flat. After several minutes of knocking on the door and shouting through the letter box, he finally answered. Walking unsteadily with the aid of a Zimmer frame, he was wearing a filthy grey vest and nothing else. As I followed him into his flat, his bare buttocks were wasted and smeared with dried faeces. The flat was like nothing I had ever seen. There were beer cans and cigarette butts in their hundreds. The floor was brown and sticky and I tried desperately to manoeuvre myself down the corridor without touching anything.
    It was the bedroom that was truly shocking. It transpired that Mr Tipton had been pretty much bedridden for the last few days with a bad back and he hadn’t been able to make it to the toilet when the diarrhoea struck. There was shit everywhere! His bed consisted of a bare mattress and a coverless duvet. Both were covered in an unfeasible quantity of faeces that looked both old and recent. There were cider bottles filled with his urine and an empty takeaway wrapper covered in vomit. It was truly grim. Amazingly, as we arrived in his room, Mr Tipton calmly laid himself back on the mattress and pulled the shitty duvet over him. I donned some gloves and half-heartedly had a prod of his belly. I made a few token comments about letting viruses take there their course and then fled.
    I gave social services a call and asked them to go round to do an ‘urgent assessment of his care needs’. In other words: ‘Come round and clear up this shit.’ I made it very clear to the social worker that I didn’t think that Mr Tipton required any more medical input as I had done a thorough assessment and diagnosed a self-limiting viral gastroenteritis. I hoped she wouldn’t see through my bullshit and realise that I was, in fact, just desperately trying to wash my hands of Mr Tipton and make him someone else’s problem.
    On my drive back to the surgery, I wondered why Mr Tipton had allowed himself to lie in his own shit for the last three days. Perhaps he was in some way allowing himself to be punished for his awful crimes. Or was it just that he had a dodgy back and couldn’t get to the phone? Maybe there was simply no one else whom he knew he could call on. I often visit lonely, isolated people for whom the GP is their only contact with the outside world. Normally, I reach out to these abandoned people with some compassion and kindness. Why hadn’t I done this for Mr Tipton? Reflecting back, I know that my knowledge of Mr Tipton’s crimes influenced my behaviour towards him. Although I couldn’t have offered him much more as a doctor, I could have offered him a great deal more as a human. The Hippocratic oath tells us that it is not our place to judge our patients but only to treat each one with impartiality and compassion. I think I agree with this in principle but offering kindness and empathy to a paedophile covered in shit isn’t always easy.

Average day
    I sometimes think that people have an odd preconception of what makes up the typical day for a GP. These are the exact patients that I saw one morning, a wet Tuesday in November in a typical practice somewhere in the south of England. None of the consultations are outlandish or exciting enough to deserve their own chapter, but they are a very typical reflection of a GP’s average morning.
A seven-year-old boy having tummy aches. Mum was very worried, as her nephew had
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