Family doctors know that work seldom goes as planned. The afternoon when we finally clear off a pile of forms can transmogrify into a long house call, and the quick eye test for the driving licence may turn into a new presentation of depression.
If we could not roll with it we would not be GPs – and it explains why most of us are behind in paperwork. So we are still working away, even if the doors are closed.
Everybody is getting used to it. When I last wrote a dispatch from the front line for The Irish Times, during in the first lockdown, we had just closed our waiting room. Now it is no longer called the waiting room. The space has been cleared for easy cleaning and the toys are in the attic.
Despite this, we regularly have couriers delivering boxes of glossy leaflets and posters “for the waiting room”. Most of these come from the HSE. It is a complete waste of money and resources and it all goes straight to recycling.
Most patients wait in their cars. We have perfected the art of the drive-through flu jab.The smell of disinfectant follows us from room to room and we carry our thermal scanners like six guns.
I have not yet met a Covid-19 denier, not face to face anyway. If you go on social media you would be forgiven for thinking that the country is full of them, but here everyone wears a mask, squirts the hands with good humour and keeps it quick.
But some people with chronic problems have confessed that they are terrified. I have learned to hate the expression “underlying conditions”. It seems to feed some Trumpian notion that their lives are less important than those of healthier people, that they should stay at home forever, their condition is their own misfortune and money is more important than they are.
As I cycle through the silenced town I often spot the young man on immunosuppressants or the girl with diabetes trying to quickly buy some essentials and I know that, although they look well, they are at the mercy of those who are sure that they know best.
There is no friendly coffee on the way to work and no relaxing pint on the way home. The Christmas party will not happen.
Never mind. We had fun when we could and we will again.
Virtual consolation
When I get to work the screen is full of telephone and virtual consolations. I have to confess that a telephone call was never an item on the screen before Covid and they were often fitted in haphazardly between other jobs. Now each call is given full attention and the history is scrupulously taken as the face-to-face consultation is avoided if possible.
The prescriptions are now sent online. We used to read and sign long scrolls of green paper prescriptions, looking like Harry Potter’s homework, and consultations would end with the screech and rattle of the old Dot Matrix printer.These will soon be decommissioned forever.
The patients still come for their blood tests and blood pressure checks and ask about lockdown and how long do I think it will go on. They agree that we are lucky to have a country where they listen to scientists, although we may not all agree on certain details. They ask about a vaccine and would I get it myself. I tell them that I will be first in the queue.
The working day is definitely longer and we go home in the dark.
The Irish College of General Practitioners continue their weekly webinars and updated algorithms are printed and put on all the desks. There is not the same atmosphere of fear as there was in spring because now we have a clearer view of the enemy and a combination of rapid tests, vaccines and better treatments are surely on the way.
Is it the end of the beginning, the beginning of the end or halfway there? Who knows? But general practice is open.
The GPs were on the front line during the first and second wave. But at the back of our minds we know that small problems become big problems if left alone. The analogy of the red light on the dashboard has never been more apt: if it is ignored it can lead to trouble.The painful joint that could have been sorted out needs replacement, the cardiac pain turns into a bypass, the ignored hernia presents as a full-blown emergency.
The next wave to worry about is likely to be a record breaker of chronic problems becoming acute.
We are still here and have not stopped working throughout the pandemic but we are that bit older and a lot more tired.
If the country has decided to bounce back by investing in our health and our future then Irish family practice should be at the head of the list.
Every doctor knows that health is never seen as important until it goes wrong.