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Volume 1, Issue 4
Winter 2005:

Preface from Secrets from the Black Bag

Susan Woldenberg Butler

Cell 2 Soul. 2005 Winter; 1(4):a19

RCGP (2005); ISBN: 0850843022; 224 pages

Here are stories from, and about, general practice, particularly about isolated, single-handed general practice, across our globe. The stories are based upon interviews over ten years with general practitioners. The GPs hurrying through the night are from the early to the late twentieth century, from Pakistan to Tanganyika, from Scotland to New Zealand, all over our planet. They carry little black bags into the private worlds of patients struggling with the business of living and dying and trying to make sense of things.

The doctors speak to us of their delights and fears, their failings and successes. "The mystery and mystique of house calls is that you don't bloody well know what you're walking into," says Noose Grimely. "I was called out one cold night when the stars were out and it seemed that this was an exciting thing to be doing. It was probably one of my first," says Amaranth Fillet.

In addition to stories of doctors traversing the dark nights to patients' bedsides, theses stories comment on the National Health Service, locums, euthanasia, miscommunication, medical consumerism, the rise of the part-timer; changes in medical practice and patient attitudes over the years; computers, litigation, games patients play with doctors and that doctors play with patients; de-skilling, taking time out, ethics and changing ethics, community responsibility for illness; a spiritual dimension to work; alcoholism, firearms, the desperation of love, family networks; drug testing by pharmaceutical companies in developing countries; patients who haunt one; what makes a good clinician; third-party intervention into the doctor-patient relationship… all of life is here!

And the home visit?

"Very often you're going into the unknown…"

"Dirt road, rough as hell, no lights but your headlights and you're driving along wondering, What am I going to find? …"

"Home visits? Bloody hell! They can haunt one. The last act in a drama. Blood-splattered linoleum. They're relevant alright!"

A final word on the subject of names: most of them are chosen to be deliberately odd to underscore their fictional nature. Hugh Page-Russell, for example, is a tribute to my favourite landscape architect, the sublime Russell Page. His Education of a gardener is a personal treasure. Pretentious moi? Transforming him into the military doctor who appears in these pages is naughty. And the rest are simple Tasmanian anarchy.

So a last word to Somerset Maugham:

When someone tells you what he states happened to himself you are more likely to believe he is telling the truth than when he tells you what happened to somebody else.1


1 Maugham, W. Somerset, Collected Short Stories, Volume 2, Preface, Penguin, Harmondsworth, 1959

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