Reflections on GP training by Dr Batool Albatat

GPT1/GPT2 (General practice term 1/General practice term 2)

 

It's been a year since I started my journey as a general practitioner, and it's been an incredible experience. Initially, when I finished medical school, I wasn't sure which medical pathway to choose. I worked for a few years at the hospital as a medical officer, doing surgical, obstetrics & gynaecology, paediatrics and general medicine, enjoying every aspect of medicine, but not knowing which medical pathway to choose. General practice never seemed like an attractive option for me. I had all the worries and fears that I might not enjoy it and that I would just be sitting at my desk signing medical certificates and renewing prescriptions. But as soon as I dove into my work, I quickly realized it was the perfect fit for me.

 Starting off was scary and very overwhelming. After orientation, I found myself alone with patients coming to see me. The responsibility and pressure of being the primary doctor was overwhelming. I was no longer a medical student, intern, or the hospital medical officer who was given instructions on how to manage patients. I was now the doctor, and the weight of that role was heavy. The imposter syndrome kicked in, and I felt like I didn't know what I was doing. I found myself constantly looking up guidelines and searching for information. But as time went on, I began to find my footing. The learning curve was steep, but also expansive. I discovered new things about medicine and about myself as a doctor. And as I continue on this amazing journey, I know that I will always be learning and growing.

The year was filled with a variety of patients and experiences. I've had the privilege of seeing women's health, performing simple procedures, treating paediatric and geriatric patients. GP may not be as "sexy" as other medical professions, and we are not often depicted in movies like "Scrubs" or "The Good Doctor," but we are the backbone of all medicine, and I am glad to be a part of this community of amazing colleagues.

 

Throughout my year as a GP, I've had the opportunity to share so many unique stories and provide as much care as possible to all different people from all walks of life. I've seen patients with alcohol addiction and walked alongside them on their withdrawal journey. I've reassured mothers and given them a listening ear. I've seen older patients and given them my time, my attention, and my care. I've seen patients in their most vulnerable states, opening up to me about their mental health, and placing their trust in me to guide them towards hope and healing. I've given immunizations to people of all ages, knowing that I am preventing them from getting ill in the future.

I've sent patients to the hospital for surgery and helped guide them through their recovery process post-surgery. I've done simple things like ear syringing, but with a big impact on my patients' hearing. I've done iron infusions and seen patients come back saying they feel amazing. I've seen so many undifferentiated diagnoses and followed up with patients throughout their journey with their symptoms. I've seen patients being diagnosed with cancer and have helped them and their families find the right medical pathway and treatment.

Through all of this, I've made strong connections with my patients and their families. Being chosen as their doctor is truly a privilege. It's been amazing how much I could help patients not just to survive, but to thrive. I was able to make a real difference in people's lives, and that was incredibly fulfilling. It's very rewarding for me to see my patients progress and to know that I played a small role in their journey towards recovery and well-being. I am thankful to the Lord for giving me this privilege to be a carer, provider, friend, and companion to so many people that I encounter daily in my life.

Being a GP is challenging at times, but it's fulfilling, heart-warming, and rewarding in many ways that I never imagined. Caring for my patients with empathy and fairness is a constant endeavor that has certainly been a big leap for me. But I feel proud to be part of the GP community and have joined an amazing group of colleagues who have the same dedication and passion for providing care to patients. I am grateful for this experience and look forward to many more years of providing care with passion.

Words by Dr Batool Albatat, images by Dr Wendy Burton

Finding Hope

Seven years. It took seven years for her to open up. Seven years to start to tell her story. Seven years of repeat medications. Seven years of small talk. Seven years of watching her twist as her back pain took hold. Seven years of hearing snippets about how insecure she felt in her job. Seven years.

And then came an event so devastating that there was no one else to tell. So devastating that it ripped the scab off her wounds and left her deeply, deeply pain-ridden, damaged inner self exposed and vulnerable. So devastating that the only logical response was to contemplate suicide.
Merciless devastation.

“Please stay.”

I don’t remember what else I said that day, but I do remember saying “Please stay”.
I remember because she remembers.

Traumatised, abused, misunderstood, labelled. Navigating the world through shrapnel. Nowhere is safe. Systems that failed. Carers who didn’t care. Helplines who didn’t help. Professionals who walked away, no risk of attachment issues because there was no one who stayed around long enough to attach to.

Screen Shot 2020-01-16 at 6.37.40 pm.png

Months and months of slowly, cautiously discussing the abuse. The betrayals. Those who looked the other ways. Small, infrequent acts of kindness. Achievements not seen as such as the endless reel of negativity plays over and over and over and over in her head.

And yet. Writing. Powerful poetry, excellent essays
Desperately reaching forward, communicating, educating
Increasing my understanding, the understanding of others
Bridge building
Generous. Kind. Compassionate

Beaten, berated but not broken

A little light in the darkness. Journey not completed, but underway
A glimmer — did I really see it?
Did I imagine it?
No, there it is again!
A glimmer of hope
A sense of purpose

Hope, rising from the ashes

“Drench yourself in words unspoken
Live your life with arms wide open
Today is where your book begins
The rest is still unwritten“ Unwritten, Natasha Bedingfield

Dr Adele Victoria
January 14, 2020

Screen Shot 2020-01-14 at 1.17.50 pm.png

The cancer journey

Too often, I hear the phrase that someone has "lost their battle" with cancer
This makes me angry - this is not a war with bayonets, bombs and bullets

Cancer does not
shatter hope
corrode faith
destroy peace
suppress memories
silence courage
invade the soul
kill friendships
or conquer the spirit

Cancer does not cripple love

These people precious to me have not "lost"

They have lived, endured, loved, been angry, cried but continued to live, until the very end.

Dr Gretchen Hitchins 
December 18, 2017
With thanks and acknowledgement to those who work in palliative care and to others whose writing is similar
First published on the private Facebook group, GPs Down Under Dec 2017

grevillea-1054707_1920.jpg

It's quiet

Usually in summer we hear sirens, jet skis and illegal fireworks, brought on by the influx of Sydney tourists, but this summer I can only hear the relentless wash of the waves on Collingwood Beach.
It’s almost a relief, until I remember why. 

Relentlessness is what characterizes this summer’s fire emergency.

It’s not a single event where the plane has crashed, the waters have risen, and you can be pretty comfortable that the recovery phase is what comes next.
A month ago during our regular treatment trips to Children’s Hospital Westmead, the ward was full of smoke.
On New Years Eve I was on a pontoon boat with my husband and daughter getting home to our other daughter, because the Princes Highway was closed at South Nowra.
This time last weekend I was setting up our little room at St George’s Basin Country Club evacuation centre.
On Thursday I was prepping in case it happened again.
Last night the southerly buster threatened to push more fires up to us. 

So far in Jervis Bay?

Nothing

The embers were defended by the unsurpassable New South Wales Rural Fire Service at Sussex Inlet, Basin View and Tomerong.
Our trees are standing, our kangaroos with joeys happily grazing on my green front lawn, our roads are open.
But here’s the thing - we have fires to our North, South and West.
We have dense bush that hasn’t been burned since 2001.
We have 2 months left of the longest, scariest bushfire season we have ever experienced.

We watch, in a bizarre mix of survivor guilt and vicarious trauma, while our friends and colleagues around us burn and struggle.

And we wait, hoping we will get through unscathed.

Dr Kate Mandelson, GP
January 11, 2020 #AustralianBushfires
First published on the private Facebook page, GPs Down Under

fire-extinguisher-3891361_1920.jpg

Sitting in the darkness

As I lay in bed at 4 am this morning, reflecting on the difficult life journey of a colleague, the following thoughts came to me and I hope you don't mind me sharing them.

Perhaps the most profound thing any of us do, as fellow humans, is to sit in the darkness with another. 
No magic wands
No silver bullets
Just to sit and to be
Some pains run so deep there are no words

For those of you in the darkness, please know that you are not alone.

For those of us privileged to sit awhile with another, never let us forget how important this can be. How simple things, like an appropriate touch, can make a difference.

Stay safe. Be kind to yourself and to others.

Merry Christmas

Follow up: Following on from this morning's musings and mindful of a reflection about (not) "feeling the need to switch on the light" I thought I'd share the following words. I have always been taken by the last two sentences, especially when "all" you seem to be doing is sitting in the darkness.

"Every bit of light, every small gesture is needed. It is not our task to judge the worthiness of our own light or even to know if it is seen. We are too quick to measure our lives by dramatic moments, too ready to minimize the light that we shine into the small darkness of everyday life. It is not given to us to know who is lost in the darkness that surrounds us. We can only know that against even the smallest lights, darkness cannot stand. A sailor lost at sea can be guided home by a single candle. A person lost in the wood can be led to safety by a flickering flame. It is not an issue of quality or intensity or purity. It is simply an issue of the presence of light."

-- Kent Nerburn –

Dr Wendy Burton
Christmas Day, 2016
Originally published on the private Facebook group, GPs Down Under

shutterstock_89193508.jpg

Emergency response

It is January 2020 and Australia is on fire. The following is a story from a GP on the front line who seized the initiative to safety net her community.

My colleague Dr Lee Simes and I have put together a medical room at the St George’s Basin Country Club evacuation centre, and have a list of 5 local GPs and 8 local nurses who are ready to come in as needed. We decided to offer our services because we expected our community might be isolated by fires for days, possibly without power. The evacuation centre team welcomed us with open arms, and our conversations since then have been about “why don’t we have General Practice embedded within our emergency and evacuation plans?”

Calling an ambulance or driving to the hospital are absolutely the right thing to do for the right patient at the right time, but when there are embers and dense smoke closing our roads, maybe having patients seen by GPs and community pharmacists - with the right equipment, training and experience, working with NSW Health and St John Ambulance volunteers - ought to be an option included in the emergency plan, and not just something that the local on-call doc and pharmacist put together on their own. The experiences from our GP and pharmacist colleagues further south demonstrate the value and importance of the primary care team when the ambulance and hospital are simply not available. 

I’m looking forward to meeting with the right people in leadership positions to make sure this can be done for when the next (inevitable) fire emergency comes around. For now, I’m just looking forward to packing up my gear, blissfully unused I hope, a few days from now .... fingers crossed!

Dr Kate Manderson
GP from Nowra on the NSW South Coast
January 4, 2020

Screen Shot 2020-01-05 at 3.07.37 pm.png