By this point it was October 2025 and as I waited in the surgery for my dermatology review with the third GP I reflected on our previous encounter almost a year earlier.
On that occasion, I'd requested an appointment to discuss my colorectal health. I'd been on regular colonoscopy surveillance when I lived in England. Polyps had always been retrieved but to my enduring relief I'd never been given a diagnosis. Along with everything else COVID stopped in its tracks, the surveillance ended in 2020 and I was told to let my GP know if I ever experienced any new symptoms.
In November 2024 I decided it was probably time to do this. The early morning rush was in full swing when I phoned to request an appointment. I could barely hear a word the receptionist said and wondered how she could possibly be expected to function in a room crowded with colleagues experiencing similar difficulties. It was a competition to see who in the room could shout the loudest. Mayhem.
I was given an appointment and met the third GP for the first time a few days later. Sitting behind her desk, she waited until I was seated and then asked me the usual: "How can I help you today?"
I described an unusual sense of abdominal discomfort and patted its location. Thinking it would be helpful to give her some history, I started off by mentioning my initial colorectal referral in England.
I didn't get any further.
In a manner similar to a police officer controlling traffic at a busy junction in the days before coloured lights took over, she raised an arm, presented an open palm towards me, and stared at me in total silence.
Speechless and surprised, I stared back at her.
"This," she announced in barely controlled fury, "is the skin clinic."
I responded that I hadn't requested an appointment at the skin clinic.
In a move I found so unethical that it infuriated me, she then read out loud the incorrect reception notes on her desktop and proceeded to cite the evidence against me. Apparently I'd told the receptionist I'd noticed a spot where my skin colour had changed. The third GP then glared at me and awaited my defence.
I clearly recall saying: "I said nothing of the sort. I was talking about a sensation inside my abdomen."
She didn't respond. This was a clinician trained in a bygone era when doctors were gods and patients knew their place.
I wasn't going to waste another minute. I told her I would request an appointment with another GP and started to stand up.
That seemed to do the trick. I think she probably realised she'd overstepped the mark. The appointment proceeded and as I left her office I briefly considered the mechanism for raising a complaint with the General Medical Council. I decided not to bother. She was probably having a bad day and we all have those.
Things were completely different when I returned to her consulting room in 2025 to discuss my scalp. I was in the right place and the atmosphere was much calmer.
She actually smiled at me as she stood up and walked around her desk until she found a suitable spot to perch and relax. All very casual. I thought she was making the effort and appreciated this.
I told her there was no difference with the Solaraze so far, but I understood it was still early in the four month trial period. She nodded and, wonder of wonders, even agreed I could have a script for Efudix in February 2026 if there was still no improvement by then. Apparently she was retiring at the end of the year and would make sure this decision was recorded in my notes.
Finally, in a gesture perhaps intended to bring our therapeutic relationship to a positive conclusion, she took a final look at my scalp from all angles by walking around me. Her circuit complete, she confirmed: "It's benign."
I considered this at length throughout the rest of the day. I had a pre-cancerous condition. How could it not be benign? If it was malignant it wouldn't be actinic keratosis any longer. It'd be cancer.
