Editorial

I was lucky to be invited to ‘Parental Guidance’, an evening of poetry and words performed for the Actors’ Children’s Trust at the beautiful St Paul’s Church in the heart of Covent Garden, known affectionately as ‘The Actors’ Church’. This was offered as ‘a chance to come together as a community of actors and arts lovers to listen to some beautiful words in a gorgeous setting’. And so it was.

The readings were chosen ‘to remind the audience of the privilege, pain and lack of privacy that comes with being a parent. The highs, the lows and some of the hilarious moments in between’. Particular favourites included ‘Jim’ by Hilaire Beloc, ‘Can I please poo in peace?’’ by Giles Alexander and ‘To A Daughter Leaving Home’ by Linda Paston. Another reading amused but triggered simultaneously reflection on the nature of gratitude. ‘The Lanyard’ by Billy Collins is a poem recounting discovery by the author of the word lanyard in a dictionary, a trigger for the distant memory of making, with a braid of plastic strips, a lanyard. This was a gift, from the author to his mother, to repay her for all she had done for him: ‘I was sure as a boy could be that this useless, worthless thing I wove out of boredom would be enough to make us even’. Aside from the central message of this piece, it highlighted the rather odd emblem of status worn by many in the workplace, including healthcare workers; a sometime ‘badge of honour’. It should now become, I suggest, a small symbol of gratitude; an emblem described and infused with a degree of comic grandiosity, by the word lanyard. Wear your lanyard with pride! It will get you through a few doors and signal identity, but with poetic licence it can be a gift from the grateful, to keep you smiling!

This issue brings more than just a lanyard. Apurva Mishra and Wendy Watson cover diabetic kidney disease, a very important complication for our close attention in the care of diabetic patients. The article highlights what is important to detect, monitor and manage in primary care. Jakir Ullah offers an account of cardiomyopathy, detailing causes, diagnosis and treatment. Early diagnosis is a challenge we can meet in general practice. Gestational diabetes is becoming more common and requires detection and careful management in the community. Elizabeth Dapre details how to achieve this. The ever-present spectre of sepsis hangs over every patient presenting with fever. Elizabeth Morgan reminds us of what to look out for and the guidance on management. Headache is one of the most common symptoms we experience and a very common reason for patients to seek the help of GPs. Rosemary Hickman and Simon Hickman take us through diagnosis and the finer points of management to provide that help. Acute abdominal pain has many causes; Sarah Allen and Charles Wallis have bravely taken on the challenge of describing the varied causes and their management in this succinct, helpful article.

This month we were short of a non-clinical article. I hope you will feel inclined to offer one up. We have the titles if you need inspiration. There are many possibilities, just contact the editorial office for suggestions or to share ideas for an article. We will grasp our plastic lanyards and breath a deep sigh of gratitude with every submission. Just remember as you slog round the practice or the hospital wards that lanyards can be more than just strips of plastic for identification and access. With imagination and poetic licence, they can remind us of the many shades of gratitude for a job well done. And an appreciation of the comedic potential of lanyards. We remember, I am sure, busy days and nights when the words of Giles Alexander are all too poignant. Whether tired parent, resting actor or hard-pressed junior doctor, I wish you a Happy New Year, all the best for 2024 and the peace to do what needs to be done.

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