Friday, December 30, 2011

Leaving Oxford in 100 blog posts: 6. 28 Beaumont Street

When I first moved to Oxford, I registered at the Kennington Health Centre, which was fine. There was the one deeply embarrassing experience when I went for a smear test and I still had my diaphragm in, and then had to count on my fingers how many hours it was since I'd had sex to see if it was safe to take it out, but that was hardly their fault. But when my Significant Ex and I moved to Cowley Road, we switched to one of the practices based at the East Oxford Health Centre. And that wasn't so great.

I never had a problem with the GP I usually went to see, though I never warmed to her. She was always a bit rushed, a bit distracted, not the sort of person who has the time or the inclination to pick up on the things you're not saying -- but I was young, I was reasonably healthy, and it didn't matter that much. But there was another GP at the same practice, the one my Significant Ex went to see about his mystery abdominal pain, who was an arrogant arse. 'It's an ulcer,' he was told, and sent away with a giant bottle of Gaviscon which made no difference whatsoever. The pains came more frequently, bent him over double and took the light out of his eyes. You don't want to see anyone in that kind of pain, and you certainly don't want a GP who says 'well, you clearly think you know better than me, so what do *you* think it is?'.

In the end, his mum took him to A&E, and they diagnosed acute gall bladder inflammation. Which is rare in young men, but HAD, in fact, been picked up by his previous GP, at the Kennington Health Centre, who unfortunately sent the referral letter to number 127 Our Road instead of number 227 Our Road just before we moved, and the people at number 127 hadn't sent it back. So he missed the appointment, then he moved GPs, and the new one did not deign to investigate that closely. Three months later he had his gall bladder removed -- they would have taken it out there and then, but it was so inflamed by that point it would probably have exploded.

I wrote a letter of complaint, but I was young, and I was reasonably healthy, and I never sent it. I wish I had. But both of us left that practice as fast as we could. We joined 28 Beaumont Street, on the recommendation of a friend, who said 'I think you'd like Dr F'.

I did like Dr F, and I still do. In fact I reckon moving to 28 Beaumont Street is one of the healthiest decisions I've ever made in my life. Dr F is the doctor I see most often. She has a certain brusqueness, but mixed in with that is a great deal of experience, especially in women's health issues, and a great deal of humanity. She's a qualified homeopath as well as a GP -- I had a homeopathic consultation with her once about 10 years ago, after a laparoscopy revealed there was nothing specifically wrong with my patently sub-optimal urino-genital system, so there was nothing specific that Western medicine could offer apart from 'keep taking the codeine, love' or putting me back on the Pill. She prescribed sepia. I can't say it fixed me (and I do basically think that homeopathy is bunk) but it did get me thinking about my menstrual cycle and its effect on me in a much more holistic way, which in turn meant things did get better.

Over the last 15 years or so she's also referred me to a knee clinic for an MRI scan on my dodgy knee (not much to be done), a podiatrist for my dodgy feet (the main cause of the dodgy knee - they made me some orthotics which I usually remember to wear when walking any distance), a breast clinic for ultrasound and a lump biopsy (turned out to be benign), a dermatology clinic for a strange mole on my foot (they took it off but that turned out to be benign as well), an endoscopy clinic for my digestive issues (congenitally sluggish, but no intervention deemed necessary), an eye clinic for a scar on my eyeball that was picked up by the optician (turns out I have a scar on my eyeball), and most recently for a pelvic ultrasound to have another look at that sub-optimal female area (still a bit shit but nothing really bad going on, so back to a review of 'other options'). Plus the odd course of antibiotics to deal with UTIs, sinus infections and the like.

This all makes me sound like a raving hypochondriac, but we're talking about a decade and a half here. The main point is that I think if over that time there'd been anything really wrong with me, a) I'd have gone to talk to her about it, and b) she'd have listened, and got a second opinion and/or more information if she deemed it necessary. I know that's what GPs are *supposed* to do, but that's not to say it always happens*. There are some skills you've either got or you haven't, and she has. I think she rocks. She's a Girton woman, I think that might be part of it.

Many of her colleagues are very fine too. The nurses can take a smear test almost as fast as you can say 'Ow!', and have blood out of you before you've even noticed. During my latest review of other options, Dr F gave me a very clear explanation of the reasons why 40-something hormone levels can wreak havoc on a person's life, and suggested I talk to Dr M, who knows a lot about progestogen management. Dr M rang me while I was waiting for a train at Radley, and we had a detailed conversation about coils and implants and progestogen-only pills which prompted M, sitting on the bench next to me, to seek more knowledge of such things himself. I don't think he'd realised there was so much to it, just that for mysterious reasons I was spending more time than usual in a sobbing heap.

Cerazette is what she recommended for starters -- ten weeks in and I've been hardly sobbing at all.

But extra-special mention must go to Dr S, who I went to see in the Dark Days in the New Building, when I was (basically) in a total state. I came down with a sore throat and tried to make an appointment with Dr F. She wasn't available, so I opted for Dr S instead. He called me in and I started telling him about my sore throat and how I thought it was tonsilitis, and I probably needed some antibiotics. Hmm, he said, and how are things at home? Well, all right, I said, bit stressful (these were dark days for M as well, all his children had fallen out with him and he was very upset). And how are things at work, he said. And I found myself telling him all about it.

Jo, he said, you don't need antibiotics, you need sleep. And he wrote me a prescription for Temazepam and signed me off for a week, which, looking back, is one of the single best things anyone's ever done for me. A month later I went back and said 'these Temazepam are BRILLIANT, can I have some more?' and he said well, they are rather addictive, so you can have one more lot, but that's it. That was over five years ago and I still have a few of them left. I use them for very special occasions when I need to wake up into a benign world.

And that, I think, is what I love about 28 Beaumont Street. They hear the things you aren't telling them. I'm not a great one for league tables, but I did check out their score in the NHS Quality And Outcomes Framework. Generally on a par or just above the average results for the PCT, and generally a little above the England average, which, knowing Oxford as I do, is just about what I'd expect. But their Patient Experience results are 99.7% -- 14% above the PCT average, and 27% above the England average. Which is basically about can you see the doctor you want when you want to, and do you get enough time with them. If you can say yes to these things, you're doing something right.

I can see that once we've moved, travelling over 200 miles to see my GP isn't going to be feasible, and they probably wouldn't let me stay on the books even if I wanted to. But on the grounds that you're nowhere without your health, I will miss that practice more than I care to acknowledge.


*I once had to get the morning after pill on a Saturday, and the GP I went to see took my blood pressure and wrote the prescription on his doorstep. The GP I had in Cambridge tried to put every female student who went to see her on the Pill (presumably so her Saturday mornings would be uninterrupted).

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