Search tips
Search criteria 


Logo of bmjThis ArticleThe BMJ
BMJ. 2007 September 22; 335(7620): 614.
PMCID: PMC1988987

A paper that changed my practice

Anne Holmes, general practitioner, Tithebarn Medical Centre, Stockton on Tees

It was an article in the Observer newspaper about 10 years ago describing how an English and French family had exchanged their 9 year old daughters for six months. Subsequently, my eldest daughter, and then all of my children, went on to do exchanges in France and Germany. You might think that this experience would have little relevance to my practice as a GP, but it shows transformative learning at its best.

For a start, I had to be approved to foster the children privately, was assigned a social worker and had to be monitored by him or her. I always had a different social worker, and I discovered how they work and how they vary.

A new child in the family who does not speak your language quickly teaches you how much you can achieve with non-verbal communication. You also discover how people learn languages when immersed in a new country and what words and phrases are more easily understood. Not only does this help with patients but also with the variety of overseas doctors I have taught for their foundation programme. Passing the Professional and Linguistics Assessment Board (PLAB) exam is not always sufficient for the vagaries of local dialect.

We are taught about achieving shared understanding of health and agreeing management plans with our patients. This has a different dimension when the child is living with you and parents can telephone you at home at any time to express their concerns that their offspring only seem to receive paracetamol whatever the problem.

I learnt, in a very intimate way, how other families function. Children have a great habit of getting to the nitty-gritty, and it is impossible to be on your best behaviour for six months. Rituals that have grown up for no logical reason are quickly exposed and challenged.

I learnt what it feels like when my children experienced racial discrimination. This happened both to my European children in this country and to my own children abroad.

As a result of the above, and most importantly, I learnt to be more tolerant. Not bad for one newspaper article.

Articles from The BMJ are provided here courtesy of BMJ Publishing Group