Depression

Abstract

A proper description of what happened to me requires some brief autobiographical details. At the time the story begins, I was in my mid-30s, married, with no children. I am a general practitioner. This is a peculiarly British occupation by which I contract myself to the Health Service to provide primary health care to all who register with me as patients. I am totally responsible for these people—nearly 2000 of them—24 hours a day, 7 days a week, 52 weeks a year. Unlike most general practitioners, I am not in a partnership, although I share on-call with another doctor for nights and weekends. When I took on my practice I had been working in hospital medicine for several years but had had only one year’s experience of general practice. There had been several changes of doctor in the previous few years and the practice was a mess—records badly kept, patients dissatisfied. Apart from the other doctor with whom I shared cover, there were three other general practitioners in town. There was a long tradition of rivalry between the practices, not improved by irregularities in my practice that had occasionally given my colleagues extra—and unpaid for—work. All four of my colleagues were men, and I felt they did not look kindly on an inexperienced woman taking the post. My practice is in a seaside town in west central Scotland, an area of dying heavy industry, urban decay, and high unemployment. It is also home—where I wanted to live and work. It takes about an hour and a half to get to Glasgow, the nearest city.

Dr. Rosemary MacKenzie is a single-handed general practitioner working on the island of Bute, a holiday resort in west central Scotland. She is married with no children. The little time she has to spare from general practice is spent gardening and writing.