The pain of homecoming…

Yesterday, I attended the South Yorkshire and Clumber Vocational Training Study Day at the New York Stadium in Rotherham. Present were a hundred or so young doctors training to become General Practitioners.

The day began with a presentation by Clare Gerada, past president of the British Society of General Practitioners. In her talk she discussed the disease of nostalgia.

Nostalgia the phenomenon, derives from the Greek words Nostos, meaning returning, homecoming or the past and algia, which means pain; this being a malady endemic within the medical profession today.

Repeatedly, we look back on yesterday, yearn for the past, the good old days when doctors were regarded as professionals, had autonomy and earned an adequate daily wage. The times when patients were appropriately deferential, nurses and physiotherapists knew their place and the (usually male) consultant knew best.

The best of times or not;

Not the dissatisfaction, burnout and mental health traumas experienced by doctors of today, not the early retirement, litigation and complaints, the disempowerment or general professional degradation we experience now.

Yes, it is a topsy-turvy world, one of contradictions, complications, improvement and innovation.

Just like the Labour Party’s rise to power in the 90’s accompanied to the sounds of D:Ream singing, ‘Things can only get better,’ which was followed in 2001 by Polly Toynbee’s book, ‘Did Things Get Better?’ We move forwards, we learn, we grow.

And, despite the threats of nuclear war, global warming, artificial intelligence, obesity, the ageing population, the world today has never been better – we have fewer wars, less starvation, more education, love and prosperity. It is hard to disentangle the good from the great.

Yes, things were better yesteryear – in healthcare a patient knew their doctor and continuity of care – one doctor and one patient developing a relationship that saw them through the highs and lows of life, was a miracle we have lost today, yet the advantages of modern healthcare are overwhelming.

When I began working, patients lay in beds, in pyjamas, often infected with MRSA, C. difficile or harbouring Pressure Ulcers. Now the world is entirely different. Now, if you walk onto my ward you might see an older person dancing, sometimes singing or engaging in conversation. MRSA, C. difficile and Pressure Ulcers have been eliminated. Mostly our patients are laughing, as are the staff and no one has a problem questioning my authority, or, engaging me in discussion about alternative avenues of treatment or care; the world is open, the future is a blank canvas.

We cannot change the past and the future is always out of reach, only the present.

Nostalgia is not harmful, it can be comforting to look back on the past and remember summers gone-by, particularly in the midst of winter; the smell of my dad’s cigarettes, my mum’s apple pie or gefilte fish, Papa’s Ralgex.

As we move through time we have evolved to forget or diminish the traumas, the negatives whilst holding on to the smells and tastes of the past. And, for this there is a reason, the past can support us with tomorrow, it can help us through the bad times, when our resilience is low and we are lacking alternatives.

Here to the past and also, to tomorrow.

Long live the present – the time to be mindful.