‘We use the word ‘unbalanced’ to describe an insane mind. Thus the accumulated wisdom embodied in the very language we speak acknowledges the fundamental role of balance in the definition of sanity. So when I say that the common mind of our society is unbalanced, I am making a very serious diagnosis. I am saying that the common mind of society is, to some extent, insane. But that is what I do say.’1
I learned today that medical students in Wales (at least) cannot go out in an accident ambulance unless they have had a 3-day course of ‘violence training’. (So they don’t.)
This is madness. The people who make these rules are fools. They commit their follies because they view the world from a narrow, artificially-mediated perspective which, for a generation, society has been encouraging them to believe is a better and more valid perspective. But this is illusion. In fact, theirs is a view which lacks breadth, which lacks depth, which lacks experience, which lacks common sense, which lacks wisdom. Which is out of touch, in the literal sense. Which lacks humanity.
As a result, like absentee landlords, these curious constructs of the last couple of decades lack understanding of the very areas of life which they are allowed, and indeed expected, to orchestrate in ever-finer detail. Their lack of balance, and insight into the inhuman pressures they are imposing is the daily, if not the hourly, talk of the people who do the work that really needs doing in the world.
I started writing because I wanted to communicate my conviction that GPs, above all people, have the power, the experience and the authority to begin to show the way out of this morass for our society. It was a ridiculously ambitious project, and of course it has yet to succeed. But the time is ripe and GPs have everything to gain by reclaiming their true role.
The usurping of professional freedom; the imposed supremacy of rules over judgement, of rote over understanding; the devaluation of personal care; the recoil from touch; the abdication of access to the home; all these and many more are elements of ‘progress’ whose immediate, tangible, measurable benefits are now, at long, long last, being generally recognised as being outweighed by remote, intangible, but pervasive harms. Immeasurably outweighed — that is the point.
The Royal College of General Practitioners was complicit in the changes which began on April Fools Day 1990. Its leaders at the time honestly believed they were promoting ‘progress’. But in recent years the College has been led by a very different breed of remarkable men and, latterly, women. In our current President we have one of the most profound and eloquent thinkers about the humanity of the doctor’s role the world has ever seen. Her recent Harveian Oration made those of us who sat among the throng of dignitaries at the Royal College of Physicians immensely proud to be GPs and not specialists. With the immensity of all that that implies.
When I have submitted this piece this morning, just before my deadline as always, I will for the first time in nearly 20 years no longer have a platform in prospect for my zany views. Provided I keep within my word-limit, I know that not a comma will be changed by the wonderful journal staff. This has been the most extraordinary privilege. I thank Alec Logan and the College from the bottom of my heart for giving me such an opportunity for so long. I thank all of you who have given me any part of your wildly over-subscribed attention.
I have tried to follow my father’s advice: have something important to say, and then say it as simply and clearly as you can. Simplicity and clarity is not for me to judge, but the importance of what I have tried to say I have not, for a single moment, doubted.
- © British Journal of General Practice 2011
