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The week just gone marked 15 years in medicine. Two of those years were spent in New Zealand, the rest in England, and the last 10 in general (family) practice. It also marked the end of my clinical career—I'm hanging up the stethoscope and starting down a new path. I don't yet know where that path begins, let alone where it leads. But it's something I have to do.

Leaving clinical practice is not a rash decision; it was in fact made during Project Koru. I had wanted to re-train in public health, but my application to do so in New Zealand was rejected. For a variety of reasons re-training within the UK National Health Service holds little appeal. So I thought I could return to general practice for a time while I considered my options. Thus I returned to the despair, hopelessness, poverty, psychosomatic illness, the reek of stale sweat and urine in nursing homes, and of cigarette smoke that lingers in your clothes and hair. And I found that I just can't do it any more.

Herewith I present an Ode to general practice:

I don't want to stick my finger up any more bums;
I've had my fill of free-range brats and control-less mums.

A look at your tonsils and throat I ask;
You cough in my face as I perform this task.

Stop smoking and loose weight I hear myself say,
But taking some responsibility is not your way.

Your job/ lover/ mother is making you ill;
Nothing I can fix with patience or pill.

The poverty and despair from which you cannot flee,
Proclaim a jaundiced view of life to me.

Late for your appointment you come with a list,
But when my surgery runs late it's you that is pissed!

It's caused by those little white pills you firmly state;
Not the untested herbal concoction you happily take.

We've just 10 minutes so you detail the spread on your toast,
Yet don't recount the medical history that matters most.

Fresh out of prison a club note to avoid work you need,
Plus of course sleeping tablets for your habit to feed.

In your daughter's appointment your son also needs seeing,
And "while I'm here..." your impinged shoulder needs freeing.

For that urgent problem that cannot wait,
You can't come now if for your hair appointment you're late.

I stick to the carpet when I visit you at home;
In such filth your life totals the TV channels you roam.

Multiple conflicting guidelines I must heed,
Frustration and resentment is what they breed.

My sanity is threatened and my own health at risk;
Burnout is the reason that my tone is brisk.

I can't take anymore—
I'm heading for the door.

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