Ever feel out of your depth?

GPs deal with "undifferentiated disease". That's medical speak for "anything can walk through the door". Dr Genesis lends his mind to so many different areas of medicine, I sometimes wonder if I actually know anything substantial about anything. Can my job be done by a nurse, or even just someone with a bit of common sense?

I saw a woman in her 60s who'd had a hip replacement recently. The operation was a success but she's been left with some emotional issues about adjustment to her new (mobile) life, feeling dependent on people post-operatively, and apprehensive about going back to work (having been off for months with the arthritis). She came with her husband.

I'm not sure why, but the image of them in bed came to mind. How easy is it to have sex with severe arthritis of the hip? Have they tried to have sex since the operation? Is she worried about the metal hip coming out of joint? I tentatively suggested a holiday with some "romance". The husband nodded. She nodded. Then she promptly changed the subject.

A young doctor asking a couple in their late 60s about their sex life.

Am I cut out for this?

How can I help, when I can't help myself?

To impart guidance, one must be a master

Dr Genesis is having trouble sleeping.

He is not enjoying his job. The patients are too demanding, the staff too sparse, the practice manager out of his depth, and the partner too inexperienced. Dr Genesis is just a locum, but has a notice period of several months. He feels underpaid, overworked and exploited. But this is nothing new. During the years of hospital training, I often felt overworked and underpaid. But this is different.

There is no one to look up to. At least in hospital, I may think: goodness, the consultant's skill is really exceptional, I don't mind working like a dog because I have respect for my senior. But in this GP practice, the "partner" to whom Dr Genesis reports, is only slightly older but does not engender professional respect. Dr Genesis does not agree with his medical decisions and is not impressed with his clinical acumen.

And thus Dr Genesis found himself awake at 4am, two nights running, worrying about work.

Later that day, the familiar patients with their familiar concerns. "I'm having trouble sleeping, doctor". So am I, I think. What can I do for you, if I cannot help myself?