Then the Door Opens and We Call the Next Person In

A new patient came to see me today, looking for a female GP to help with menopause. Somewhere in that first consultation she told me she has bipolar I, diagnosed 20 years ago. Almost nobody knows. Her husband, her psychiatrist, her previous GP. And now me, a complete stranger until today.

There is something quite extraordinary about that kind of trust.

We started a small dose of oestrogen, cautiously, because even something that may help her menopausal symptoms carries the risk of tipping her into mania. Two weeks later she feels so much better, and now we carefully add progesterone.

I sometimes wonder if people realise what GPs carry. These deeply private stories, fears and secrets, entrusted to us, often one after another, back to back. Then the door opens and we call the next person in. Nobody outside knows what has just happened in that room.

That trust is a privilege. But also such a strange, quiet weight to carry.