TY - JOUR T1 - In search of wisdom JF - British Journal of General Practice JO - Br J Gen Pract SP - 964 LP - 965 VL - 54 IS - 509 AU - Phil Hammond Y1 - 2004/12/01 UR - http://bjgp.org/content/54/509/964.abstract N2 - The toughest part of returning to general practice after a 4-year break is witnessing the crisis of trust in medicine that I helped precipitate. In 1992, I exposed the high mortality rates for complex child heart surgery in Bristol. Alas, it was in a satirical magazine under a pseudonym, but a belated public enquiry found that the columns reached the top table, yet no-one was prepared to investigate and protect patients from unnecessary harm. When I was called to give evidence, I said that all surgical teams should have their work independently audited, risk-stratified, and published because ‘doctors can no longer be trusted to regulate themselves in secret’.I'm not sure why I'd become so pious. Certainly half a day in the witness stand had ruffled my feathers, particularly when I was threatened with a custodial sentence for not revealing all my sources. But the seeds of my doctor-baiting were sown much earlier, when I was at medical school. The hierarchy, arrogance, and ritualistic abuse of teaching hospitals were more than the Australian half of me could bear. So I laughed it off and left with a one-line reference: ‘Refuses to take medicine seriously; does not deserve a St Thomas' housejob’.I decamped to the West Country and fluked my way onto the Bath vocational training scheme, in the days when people wanted to be GPs. In 1990, fluffy medicine was at the fore. Course organisers took new recruits for walks on Weston beach with paper bags on their heads. We'd role-play kings and queens and throw cushions at each other. I bought my first pair of hiking boots and wore tortoiseshell spectacles and a cuddly lambswool sweater. I even cut a hole under one arm so I could lean back and let patients know ‘hey, I'm not a God, … ER -