Aren't reputations strange things? Frequently based much more on fantasy than fact, they are often completely out of our control, and - whether good or bad - often ludicrously undeserved. These thoughts were triggered by a patient who had just registered with us. He had a wealth of medical problems, and was going to be someone I would get to know well over the coming years. At the end of the consultation he said: ‘I hear you're a pretty ace guitarist too.'

"That's a fair amount you've got to deal with. You must be worried sick." I waited and the penny dropped

'I wake in the early hours suddenly wondering if I got a particular case that day right or not'

‘I always go back to first principles and explore the individual’s ideas, concerns, and expectations’

'He could have looked cross. Instead he just looked through me into the middle distance as his eyes very slowly filled with tears'

'When, 20 years later, I saw him happy and healthy then I knew that particularly stressful day’s work had really been worthwhile.'

'Will we still have a system that allows patients and doctors to develop a long-term relationship, in which trust is paramount?'

'I was deeply touched...It was certainly very generous, but there was no way I could ever let on.'

'There are the occasions when you decide to visit, rather than advise, and realise how close you might have been to a major error.'

'Maybe my patients pretend they know what I'm talking about on occasions too, without actually understanding a word.'

'The only way to achieve this appearance of serenity is to sweep everything into drawers.'

'All of us have seen cases that are unique - the only one presenting in that way in the world.'

'Many patients would prefer to see their "own" doctor, rather than one they don't know'

'Back in 1868... life for many people was very hard, and the life of the doctor reflected this.'

'The parents say you've ruined their holiday. The doctors say you probably saved her life.'

'Patients have a choice, and the less we are engaged in their lives, the less we will be that choice.'

'I have puzzled about cases like this – the patients whose problems are in no way medical, but who see us as the logical place to turn for help and advice.'

'Recognising that much of life is odd is part of our role as GPs.'

'A total absence of any risk seems a recipe for existence, rather than life.'

'The flattering, extraordinary thing is that the patient's mum thought I would know what to do.'