Be My Permanent GP, and Be With Me Until I Die
When I first started my medical career in Australia, in a small rural town, I met a 70-year-old lady who had once been a nurse herself. She lived alone.
She came to see me with a cough. As I investigated her symptoms, we discovered that she had lung cancer.
She chose not to have medical or surgical treatment. Her wish was simple: she wanted to live the rest of her life as comfortably and pain-free as possible.
But there was something else she asked of me.
“Be my permanent GP, and be with me until I die.”
Those words have stayed with me ever since.
For the next 18 months, I had the privilege of caring for her. Somewhere along the way, she stopped being just a patient to me. She became someone who had a very special place in my heart.
One day, during one of her follow-ups, she told me that she hardly had an appetite anymore, but she was craving spicy food.
So I cooked some my asian spicy food for her.
From then on, whenever she came for her appointments, I would bring her a little food pack that I had prepared for her. Sometimes I brought her flowers too. They were small things, but they were my way of saying, “You are not alone. Someone cares about you.”
She had a very strong faith in Jesus, and that faith gave her enormous strength throughout her illness.
As the weeks passed, she became weaker. Eventually, she moved into a nursing home close to my practice. Although visiting her was no longer part of my normal duties, I found myself going there frequently.
Sometimes I would simply sit beside her, hold her hand and talk to her.
There was no medical procedure to perform. No investigation to order. No treatment to change the course of her disease.
Sometimes, all I could give her was my presence.
And perhaps, sometimes, that is what a patient needs most.
I remember one of my last visits to her. I was getting ready to leave after sitting with her for a while. As I stood beside her, I said, “God bless you.”
She looked at me and said something I will never forget:
“God is surely blessing me. That is why He gave me an angel like you.”
I don’t think she ever realised what those words meant to me.
She passed away the day after my birthday.
I was able to care for her for 18 months, right until the end.
Years may pass, patients may come and go, and so much of medicine may eventually become a blur of consultations, diagnoses, prescriptions and paperwork.
But some patients never leave you.
She is one of them.
She taught me that being a doctor is not always about curing a disease. Sometimes, when we cannot cure, we can still comfort. When we cannot change the outcome, we can still walk beside someone. And when medicine has little more to offer, our presence, our kindness and simply holding a patient’s hand can still mean everything.
She chose to live her final days without aggressive treatment, but she did not choose to face them alone.
And I feel deeply privileged that, for those 18 months, she allowed me to walk beside her.
She was my patient.
But she was also one of the people who taught me what a big healing can be done by just being present..
No New Clothes
The first time he walked into my room, I don’t think he trusted me. A big man in his late seventies — a Vietnam veteran, the kind who filled a doorway — and me, a young doctor with an accent and a face that didn’t look like his. He’d come in for repeat scripts. A transplant, and a list of medications long enough that I read it twice. Then I learned he was living in a tent with his wife. A bushfire had taken their house and everything in it. He hadn’t been planning to mention any of that.
Somehow, we became something like friends. He learned my parents’ names. He asked after them every visit, and remembered the answers.
Then a lump, and a scan, and a diagnosis that didn’t respond to anything. The day he got his verdict, he came straight from the oncologist, sat down, and asked about my family first. Eventually I couldn’t wait any longer. I asked him what the specialist had said.
He smiled. “He told me I don’t need to buy any more clothes for myself.”
Less than six months. And even then he was careful with me — he didn’t want to be the one handing me bad news.
That was him, all the way to the end. He never complained, even at his frailest, even in pain that kept him up most of the night — I’d only learn of it if his wife told me, or if I pressed. He downplayed everything. His pain was his, and he made sure it never landed on anyone else — not his wife, not the clinic staff, not me.
He was protecting his own doctor from his own dying. I don’t think I’ve ever fully taken the measure of a heart like that.
He asked me for one thing only, and he asked it gently: that when the time came, I wouldn’t let him be in pain. I kept that promise as well as medicine allowed. He went sooner than they said. That was more than a decade ago. I still think about him. Some patients don’t end when they die.
Experiences in Inexperience
I was an RMO when I first encountered him.
He was an inpatient with schizophrenia and several other mental health conditions. I was sent to the ward to review him, as junior doctors do. I had a list of things I needed to accomplish: take a history, perform an examination, assess his mental state, document my findings and move on to the next patient.
He was not interested.
He was guarded and passive-aggressive. He did not want to talk to me. He did not want me examining him. He barely wanted to acknowledge that I was there.
I remember trying to do what I had been trained to do. Ask the questions. Build rapport. Understand what was happening. Find out what he was experiencing.
Then, in a moment of clarity, he looked at me and said:
“You don’t even have psychosis. You don’t even hear voices. How would you know how I feel? You can’t even empathise with me. What’s the point? Go away.”
I was completely taken aback.
I had no clever response. No reassuring phrase. No piece of medical knowledge that could answer him.
I couldn’t tell him that I understood what hearing voices felt like, because I didn’t.
I couldn’t tell him that I knew what it was like to experience the world through psychosis, because I didn’t.
So I hesitated.
He saw it immediately.
“See? So go away.”
And I did.
Years passed.
I entered GP training through the AGPT pathway. I sat my exams. I completed my training. I saw thousands of patients with problems I had never personally experienced.
And eventually, I became a Fellow of the RACGP.
But that sentence never quite left me.
For years, I carried it.
It took me becoming a more experienced clinician to understand something that I could not have understood as that junior doctor.
He was right about one thing.
I had never experienced psychosis.
I still haven’t.
I don’t know what it is like to hear a voice that nobody else can hear. I don’t know what it is like to have your perception of reality disrupted by an illness that everyone around you tells you isn’t real.
But he was wrong about what that meant.
If I had to personally experience every illness before I could understand and treat it, I would be a very poor doctor.
I have never had appendicitis, yet I can recognise it.
I have never passed a renal stone, yet I can diagnose and manage renal colic.
I have never experienced rheumatoid arthritis, yet I can recognise the pattern of inflammatory arthritis and know when someone needs treatment and specialist care.
I have never experienced sepsis, thyroid disease, heart failure, cancer or any of the countless other conditions that I diagnose and treat.
Medicine would be impossible if experience were the prerequisite for understanding.
And that, eventually, became the lesson I carried from that encounter.
Empathy does not always mean saying, “I know exactly how you feel.”
Sometimes it means being honest enough to say, “I don’t know what this feels like for you.”
And then being curious enough to listen.
Knowledge can tell us what a disease does to the body. Training can teach us how to recognise it. Experience can teach us how to manage it.
But none of those things gives us the right to assume that we completely understand another person’s experience.
The job is not to have lived every life.
The job is to meet people where they are, recognise what we can, acknowledge what we cannot, and still care enough to walk alongside them.
That patient probably never knew what his words left behind in me.
He probably never knew that a sentence he threw at a junior doctor in frustration would stay with that doctor for years.
But I carried it.
Through medical training.
Through exams.
Through thousands of consultations.
All the way to Fellowship.
And perhaps that is one of the strange things about being a doctor.
We spend years learning how to diagnose and treat disease, while quietly accumulating fragments of the people who taught us how little we truly know about what it is like to live with it.
Some of those fragments are heavy.
But sometimes, if we carry them long enough, we realise they were not stones after all.
They were lessons.
And perhaps the deepest lesson he gave me was this:
You do not have to experience someone’s suffering to understand that it is real.
You just have to be willing to listen.
The Patient Who Never Left the Practice
What do we carry as GPs? Not just a stethoscope, a clinical bag, or the weight of a busy day. We carry fragments of people’s lives. Sometimes, we carry a patient long after they have left our consulting room. It was an ordinary day in 2012. I was performing a skin procedure. In the cubicle next to me, a two-year-old girl—a regular patient of another GP—was having a dressing changed for recurrent burns. She was crying while a young nurse tried to comfort her. After finishing my procedure, I went over to support the nurse and offered the little girl a lollipop. A tiny gesture. But it became the beginning of a friendship. She returned every week for another dressing. I was not her GP, yet somehow I became her “lollipop GP.” Sometimes Mum brought her. Sometimes Dad did. Then a question began to follow me: Why was this little child being burned so often? I spoke with the nurse and her regular GP. During one visit, I gently asked Dad about the recurrent injuries. I learned he was her stepfather. He explained that she loved playing in an inflatable pool and that this was causing the burns. The explanation was plausible. Yet something in me remained unsettled. Then I went on vacation. When I returned, she was missing. What followed was devastating. The little girl had been the victim of homicide. Fourteen years later, I still remember her face. And the lollipop. For years, I wondered whether I could have done more. Eventually, I realised I had a choice: carry her as guilt, or carry her as a lesson. I chose the lesson. That lesson has become something I now teach my registrars: Know the relationship of whoever accompanies your patient. Don’t simply record “mother,” “father,” “partner,” or “friend.” Pause. Ask yourself: Why are they here? Are they here for support? For accompaniment? To help communicate? Or are they answering questions that the patient should be answering themselves? It is not about suspicion. It is about professional curiosity. A repeated injury. An inconsistent story. A sudden change in behaviour. A child’s silence. A relationship that feels uncomfortable. None of these, alone, proves anything. But they may be the loose thread that deserves gentle attention. As GPs, we often encounter people in the ordinary moments of their lives. Sometimes, hidden within an ordinary consultation, is an extraordinary story. We may be the person who notices the detail everyone else walked past. That is our third eye. Not paranoia. Not judgement. Just awareness. I never stopped being the lollipop GP. But I became a more observant one. And I still tell this story—not to create fear, but to remind us of the privilege and responsibility of general practice. Look beyond the diagnosis. Listen beyond the words. Understand the relationships. Ask the extra question. Because sometimes, the smallest observation can become the difference between simply treating a patient and protecting a life. Some patients leave our consulting rooms. Some become part of our conscience. And some remain with us for a lifetime. That is what we carry.
Reasons To Let Go
My colleague was away so I saw him. He was her regular patient. A simple man in his late 60s. He told me about a lump that he felt in his left side under his ribs. He was examined by my colleague a few months and nothing was found. I sent him for a scan and of course it was a cancer. On our second appointment I had to break the bad news. I told him about the cancer and his reaction was telling me of what his father did to him when he was a child. All the abuse and all the pain. I couldn’t comprehend what he was saying, words were coming out differently when he was sobbing.
I had to leave that practice soon after those two consults for some personal reasons . I don’t know what happened to him. But I still think about him. His anguished voice, his tears. Cancer was an excuse to cry for himself, for his gone childhood, for how this world is unfair.