Dr Mark Porter
@drmarkporter
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29,396
Following
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196
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3,951
GP in the Cotswolds. 37 years @ the NHS. Columnist @thetimes & SAGA Magazine. Ex BBC. Poacher turned gamekeeper. Grandad.
Rural Glos.
Joined August 2009
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Due to the number of Covid infections - both among our patients and staff - we have decided to return to wearing masks at all times in the surgery. And, to protect others, we respectfully ask visitors and patients to do the same.
Expect similar at local hospitals.
Thank you 🙏
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The
#NHS
has faced many crises during my 37 year career but until now I have never truly worried about its future.
If it’s to survive/thrive we must first address recruitment & retention of demoralised work force. Nothing works without the right people 😔
#JuniorDoctorsStike
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I am all too aware that not everyone is into / or can have dogs, but I will never get tired of being greeted by Sid when I get home after a long day (not quite there yet). He thinks I am great when others don’t.
If only he could mix a good cocktail
#friday
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A staggering statistic in today's
@thetimes
(source NHS Resolution and Times Health Commission):
Estimated cost of maternity clinical negligence claims in 21/22 is £8.2 billion - nearly THREE times the amount NHS spends on providing those services (maternity and neonatal).
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This is what my mother (in her eighties) bought my wife Ros (in her sixties) for her birthday. 😳
Beats a cardigan 😂
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If only we all had a friend like Kevin Sinfield. The world would be such a better place.
I hope you do. Or that you make one if you don’t.
such a moving picture when you know the whole story behind it. And i a sport known for hard men
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Today is the anniversary of my father’s death (pancreatic cancer @ 69). Halfway through my eulogy a mobile phone rang for 30 seconds. I was struggling but quipped “please tell me that’s not coming from the coffin”. Dad would have loved the laughter that ensued. And it saved me.
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Since when did patients with toothache need to see a GP and get a referral letter so they can be seen by a dentist in the local NHS urgent care centre? Crazy.
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If there is one thing I wish I could guarantee my patients, family and friends it would be this.
As a Geriatrician and a fellow human, what an example of positive ageing & and what a way to go; at home, with family, comfortably, quickly and enjoying life up until your final days.
What a woman.
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Latest
@UKLabour
release highlights that "just" 72% of 27.3 million GP appts in Feb 23 in England were face to face, compared to 85% of 25 million in 2020.
Just?
@wesstreeting
We offered 2.3 million MORE appts. But only by cramming a quart into a pint. It's becoming unsafe.
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Following news of NHS blood shortages today, applications to donate soared according to
@BBCNews
Evidently lack of donors was not the main issue - staffing issues were/are - but response from British public is humbling.
Again.
Thank you for trying to help 🙏
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43 years after fluffing A levels (I went off the rails) & losing my place at medical school, I am stepping down as the (joint) lead of a brilliant 52 strong team looking after 13000 patients.
Still a busy GP, but no longer a boss - and I will working for my partners 👀 😳
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I expect this has been said many times but, given HM worked up until a few days before her death, why are so many things (including NHS stuff) being cancelled? Some I understand, most I don’t.
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@classiccarguru1
Sorry to hear this Darren 😔
A suggestion if I may (won't help now, but in future): set up a lasting power of attorney so this never happens again.
And talk to your GP about consent to discuss your mother's condition / treatment.
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A thread on what's happening in primary care at the moment - for insight (hopefully).
On Monday a colleague on here reported 1% - 1 in 100 - of their entire list rang requested an urgent appt in one day. That would be 120 patients for my practice. On top of routine appts.
Cont..
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Re Dr Hilton's letter
@parthaskar
. It was right for
@thetimes
to publish it.
Not for balance, but because you could not make up a better example of the problems raised in the recent survey.
Or as a lawyer might say: I rest my case.
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Talking of part time: a quarter of Tory MPs have at least one second job earning nearly £5million / year - an average of £56k a head.
How can this be?
Most part time GPs spend rest of the week caring for family or in research / academia etc, not advising corporations.
How can this be? Nearly one fifth of GPs work on average 26 hours a week as 50% of all patients struggle to get through to their family doctor.
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A below inflation 2% uplift for NHS primary care which completes 30 million appts / month and is on its knees, while Rwanda policy set to cost at least £400 million and has yet to handle even one a person a month.
🤦♂️
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One of the advantages of having a grandson who is yet to learn to read is that you can recycle balloons 👀😬
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Special thanks to my Grandad Leslie Scown (a gruff merchant seaman) who, on hearing I hadn’t got my expected grades asked: “do you still want to be a doctor?” When I said it was all I had ever wanted he said: “well get off your arse and do something about it.”
So I did.
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For Culverhay patients: after 36 years @ NHS I will soon be stepping down as a GP partner. Our practice team is now 50+ strong - soon to be many more - & it’s time for fresh blood.
I am going to return to being just a doctor.
I will be back (for 3 days /week) in the New Year 💙
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Fulfilled a lifelong ambition today. I flew (dual control) a Spitfire over the Channel.
1. I welled up when the engine started.
2. I was nearly sick after a victory roll
3. Do meet your heroes - they don’t always disappoint
4. Spare a thought for the pilots in WW2 - terrifying.
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Hello practice nurses, receptionists, HCAs, cleaners,pharmacists, dispensers, GPs, district nurses, HVs, midwives, paramedics, PAs, secs, volunteers - and anyone else I have forgotten (it’s late on Friday).
I know what you do.
#respect
💪🤛
Thank you 🙏
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Don’t mess with
@StormyDaniels
When asked about having to face Trump in court:
“I’ve seen him naked. There’s no way he could be scarier with his clothes on.”
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Today another patient had an appt with me (after waiting 2 weeks) to ask for a referral letter to local NHS dental clinic so they can get the treatment they desperately need. Evidently clinic insisted on it.
Why?
Waste of everyone’s time - and further delay for the patient 😞
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I may have stumbled on a solution to rising energy prices: get a smart meter fitted.
Ours has not worked since the day it was installed - still reading 00000
👀
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One of the best retirement cards today (stepping down as a partner, still a GP):
“You are the Keith Richards of medicine”
👀😂
Can I put that in my appraisal?
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After 4 months of advertising for GP to join our merry band - with no joy - I think we should take a leaf out of Shackleton’s book.
I’ll never forget that 28 men replied to this newspaper ad.
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Widely misunderstood speciality, except by doctors, all of whom eventually learn that when the s**t really hits the fan, nothing is more reassuring than having an anaesthetist at your side.
Very few people go to med school planning to do anaesthesia.
Congratulations to all those who got in today - medicine is a great career and anaesthesia a fab specialty (despite the recent negative publicity) and I’d do it all again.
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30 yrs ago, at a charity do, Lily Savage was tasked with auctioning me off as a dinner companion (bidder chose the venue, I paid).
It was an ill thought out stunt, but Paul saved the day by selling to me to my wife Ros (for £££).
I will never forget his wink 🙏
#RipPaulOgrady
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Topping my 🤦🏻♂️ list today: golf clubs that insist older/frail/less mobile members get a GP letter before they’re allowed to use a buggy.
Lucky we have nothing else to do.
And what a great use of NHS resources..
Rethink your policy please.
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Still so emotional after 3000 transplants.
Right person, in the right job. 👊💪🙏
Even after 40 years and after 3000
kidney Transplants as a Transplant Nephrologist I am overwhelmed to see urine like this immediately after kidney transplant
This Transplant Done yesterday
for a young lady 🙏🙏 to her mother the donor
Picture taken just few hours after…
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I don’t want to show off, but my wife Ros has been away for a week and the dog is still alive, the dishwasher is empty and the house is still standing.
As for the garden? Well thank heavens for
#NoMowMay
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My grandfather died on Good Friday 51 years ago following a heart attack.
Back then the only treatment was bed rest, interspersed with trips to the day room for a smoke. Not even an aspirin.
You were lucky to leave hospital in those days.
Today you are unlucky if you don’t.
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These are strange times.
I have met two people this week on inappropriate private prescriptions of Ozempic to aid weight loss (both only fractionally overweight)
And in the last 24 hrs met two patients with diabetes who can’t fill their Ozempic prescriptions due to shortages.
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I would have knighted them both.
But only if they accepted my invitation to dinner 😂
We could all benefit from friends like these.
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Sorry, but late to this, but I live and work in a part of the country with almost no easily accessible NHS dental provision AND very little immigration.
And it’s close to Bristol.
This type of claim / reporting is just deflection.
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A level results remind me of my grandad Leslie Scown, a bluff ex merchant seaman. When I was upset I didn’t get into med school he asked: “Do you still want to be a doctor”.
“Yes it’s all I’ve ever wanted” I replied.
“Then get off your arse and do something about it”
So I did.
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New fuel pump required.
Half an hour, £23 and a skinned knuckle later and all done. And I am a hopeless mechanic.
I love this car.
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A reminder that when something doesn’t feel right and you can’t explain why, it pays to keep looking. And how gratifying it is when colleagues in hospital appreciate your concerns despite a lack of hard clinical findings to back them. The specialist was the life saver here. 🙏
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You know you are getting old when you buy espadrilles with laces.
Just need to find someone who can reach down low enough to tie them up 😂
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A shout out to colleagues
@gloshospitals
who provide advice & guidance in reply to requests from GPs in Glos. The system isn't set up for a quick reply to say thank you, & we don't want to overload your inboxes even more. But we do appreciate your input.
So thank you 🙏
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Allowed?? 👀
I introduce myself as Dr Porter to all my patients. They can call me what they want. I don’t encourage Mark. But up to them.
However with all 78 of our team I am happy with whatever they want / feel comfortable calling me.
To the rest of you it’s Sir 😂
@Dr_Done_
I have never, in 48 years as a doctor, 36 as a consultant, allowed any patient or any manager to call me by my first name.
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Asked a worried looking older woman in local car park if we could help. Her eyes lit up as she handed me her laden shopping trolley, jumped in the front seat and delivered razor sharp directions to her bungalow on the other side of town 😂
Been laughing about it ever since
#taxi
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I normally consume the news, but now it is consuming me.
Heart breaking.
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Odd birthday card to receive from anyone, but when it’s from your 92 year old mother-in-law …. 👀😂
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@HannahAlOthman
A nice handwritten letter Hannah. No need for anything else. And will be much appreciated.
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So
@NHSEngland
what should we stop doing so we can take these calls?
Bearing in mind, as you must know, that we are already struggling to cope with high volumes of far more pressing queries.
Patients told to speak to their GP ‘before starting any exercise plans’
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So many more important things going on at the moment than the shenanigans
@thismorning
If only they were subject to the same scrutiny…
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I'm reminded of tips for doctors when we make mistakes/do something wrong.
Be honest.
Tell your colleagues (who may be able to help investigate &, hopefully, put things right and stop same happening again)
Apologise unreservedly to those affected
Reflect, learn & try to improve
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It won't help. No shows are factored in to most GPs' / practice nurses' lists. We are overbooked every day so 2 no shows per list per day (at worst for our practice) just gives us breathing space.
Plus there are some worrying reasons for some: from illness to safeguarding issues.
More than 15 million appointments at GP surgeries are wasted each year due to patients failing to show up.
I would introduce a temporary £10 charge for patients who fail to attend an NHS appointment without providing notice.
👉
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I have an old car with a soft top but am too embarrassed to drive it with the roof down on the hottest day of the year (so far).
I shall wait until until it's dark...
I am turning into my father.
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You might want to check the facts again
@JMCDelingpole
I have colleagues who trained at UCL and then transferred to Oxford. Indeed I trained at UCL for 2 years, before transferring to another medical school.
Sadly not Oxford because I am not as bright as
@doctor_oxford
Who actually is Doctor Rachel Clarke? Is she what she claims to be?
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@MidlandsCop
@DrLindaDykes
He would have died where he collapsed had it not been for you. You gave him a chance. And that is all any of us can do.
Thank you.
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I am now blue tick less.
Thanks Elon.
But it is the real me.
For now 😈
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🤷🏻♂️
How can you effectively commission a service without involving those delivering it?
I paraphrase but “we have a GP on the board” doesn’t really cut it.
Nor is “we need to keep the board small” an excuse for excluding dentists.
Or am I missing something? 👀
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61 and still wearing age inappropriate jeans and footwear, but I have started tucking my shirt in 😂
Beginning of the end…
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Oh, and this is typically your quietest time of year. Indeed the best months for the NHS as a whole (with the exception of some EDs that are often busy in the summer).
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First world problem, but just worked out another unanticipated result of new tariffs.
Latest rate (52p/kWh) now means - based on miles per pound - that my electric car does the equivalent of 40mpg. Down from 120mpg when I bought it a year ago.
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@cs9dmt
@thetimes
Most are settled before going to court I would think. No negligence, no claim though.
Issue is, we should spending more to make maternity care safer for all concerned. Not only the right thing to do, but a good investment.
@JamesTitcombe
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Time to log off here for a week or so. Getting told off - quite rightly - for spending too much time on my phone.
See you in the new year.
Wishing you all a health and happy Christmas.
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It’s Friday and my two partners are back from a fortnight’s leave (not together 👀).
Never been so pleased to see them.
Happy Friday 🤛
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And it’s finished.
#benchwatch
Repair or replace?
Our old bench at the bottom of the garden had finally rotted away. But I think I can save it. Job for the weekend. Results to follow.
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We see you. We understand. We have your back.
Everyone should be able to stand in front of a crowd like this once in their life.
If only.
This is quite beautiful.
And to think the GBnews lot were hating on this. Honestly there’s something seriously wrong with those people.
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Normal service has resumed.
#fridaycocktails
Bit earlier today as not working.
Still light! 😂😈
Happy Friday everyone, but particularly those in the NHS, most of whom won’t have knocked off yet. 🙏
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Lost for words. 😞
Please retweet if you think there should be a worldwide ban on trophy hunting. 😡
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Just booked an appointment with the dentist (yes it's private) and it's at 2:30👀
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The timing. Perfection.
An absolute classic featuring the now King and Queen Consort. It’s just so delicious.
RIP Dame Edna and Barry Humphries.
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Finally…
Please RT for all the incredible porters across the NHS.
Services would quite literally grind to a halt without them.
Thank you all 🙏
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Yusuf Islam / Cat Stevens. Perfect voice. Just as I remember him. The years have been kind😎
#glastonbury2023
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Now imagine you run a hair salon with 6 hairdressers. Your routine appts are booked up for 2 weeks in advance. You can handle walk ins / on the day requests but 120?
Some will be quick (gents dry cut), some will not (style, colour etc).
You do your best but..
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We have had 5 different Secretaries of State for Health and Social Care in the last five years.
Most of whom have, quite rightly, extolled the benefits of continuity of care....
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Dealing with the same day requests ties up everyone so the wait for routine appts gets longer, so more people present with urgent requests.
Your staff are tired and stressed. Your customers fed up.
Standards slip and so more people need more appts.
Solutions? More hairdressers.
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If you know, you know. If you don't, please spend a few minutes reading this thread for insight into what happens at your surgery (beyond your appt).
🙏
I know many people still think GPs are hiding, lazy or whatever.
Here is my day today, with some details changed to protect anonymity but still reflect the Monday I've worked
#teamgp
🧵1/
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Not much.
Except that we should leave her alone?
Imagine if you and your family were in this position. And perhaps act accordingly?
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I have never gone on strike or joined a picket line, but if I ever do it would be in support of
#NHS
#nurses
. They’re not all saints - what group is? - but they have helped me*, my friends, family & many of my patients out of myriad pickles over the years. I owe them.
* a lot🙏
Nurse is going on strike!! Surely if you want to do that you are in the wrong job?
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Imagine this.
You’re Chancellor & staring down the barrel of stagflation/recession/widespread strikes etc
Or you’re Health Sec facing huge waiting lists, staffing crises and overwhelmed GPs, hospitals and social care.
AND you have to cover for Boris.
Time for a sharp exit? 👀
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If you work in the
#NHS
you know 😉
It must be spring - because my office radiator has just started working again...
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Final preparations underway for Autumn Covid boosters. And we will be using new Moderna dual vaccine: Spikevax Bivalent.
At least in Glos.
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If this is as it appears then it's very worrying
@ShaunLintern
. Can you clarify how this happened
@circlehealthgrp
?
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My favourite chair would like to thank those of you that commented on the fact that, while I had obviously enjoyed lots of drinks in it, I had neglected to offer the chair one.
Beeswax to the rescue - and looks a bit better.
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I work with many inspiring colleagues but
@mdoc77
never ceases to amaze me.
She will cringe at this tweet but if you work with Emma, or are under her care, you will know why I am so impressed.
And thank you for always being calm when I am not. 🙏
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But they aren't any. Indeed your head stylist hands their notice in, followed by your number 2.
And the phone keeps ringing.
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That feeling when you realise your +2.5 reading glasses are no longer strong enough.
My eyes may be 61, but my brain still thinks I am 25.
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Good on you 🤛
I have often thought that if I was very ill, or at the end of my life, and away from home I would love a visit from
@Sidneythedog
May seem silly to non dog owners, but if you know, you know.
My favourite thing to do as a doctor is conspire with the nurse in charge to have a patient’s dog come and visit them on the ward and today I got to do that once more ☺️☺️☺️
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One thing I miss about not being a GP partner any more is unblocking the surgery drains with my partners.
Luckily I still work there so can get vicarious pleasure watching them do it.
PS the broken crutch makes a great turd basher, but the masks, aprons and gloves didn't help..
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And I have finished the new seats for the little Citroen. Not everyone’s cup of tea, but I love them 😂
#2CV
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I should add. I have posted a photo of the cake rather than Katharine because she is one of those wonderful people who prefer to fly below the radar.
Twitter is most certainly not her thing
Our practice nurse Katharine retires today (I call her The Prof due to her encyclopaedic knowledge of all matters diabetes).
She will be much missed.
But after 47 years she deserves a rest 🙏
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