Posts tagged with Working in the NHS

Now that Dr No is out, he can write more freely of his past. Details he before kept back can now be brought forward, free of the anxiety of unintentional exposure. Indeed, this was one of a number of reasons why Dr No lifted the veil. He can now write of where he trained, the places he has worked, and the doctors, some outstanding and some rather less so, that he has known over the years; and of the capers and calamities that have lightened and darkened his career. For with a name comes the history. Anonymity, like virginity, once lost, is forever gone; that which was hidden has now become known. And – he might add, for those who detected a valedictory note in Dr No’s last post – let him assure them that, just as the ex-virgin rarely forsakes future carnal knowledge, so the ex-anonymous Dr No has no plans to forsake further appearances. Rather the opposite, in fact, but never, of course, to the extent of wanton promiscuity…

By way of a reply to WD and Dr Boots' latest comments on Dr No's last post.

In Dr No's medical student days, most medical students were WASP males. There was a lot of rugger, and high jinks, à la Daily Hail, only in those days, having studied Latin and so Roman habits, we knew how to throw up properly.

About fifteen years later, about ten years ago from now, Dr No had already noticed a shift away from WASP medical students towards more BME and more female students. He even remarked on it during a tea and biscuits break on a ward round - and a health service fattie, a psychologist of all things, all but exploded, but thankfully didn't, because all the tea and biscuits inside her would have made a terrible mess.

Who, or even what, we might ask, lies at the heart of the NHS?

The short Ester Rantzen answer is of course the patient.

But this is the glib answer. It ignores, for example ‘why’ questions: why, for example, is the patient in the NHS at all?

The answer of course is to avail him or herself of what we now call ‘healthcare’, which is in fact medical care, and medical care is provided by medics – doctors. The doctor is as central to the NHS as the patient. Like a ship and her captain at sail on a sea of sickness, patient and doctor sit together at the heart of the NHS; for a ship without a captain is apt to founder; and nothing is bleaker than a captain on the beach.

Today is Mothering Sunday, the day when we thank and honour the mother who has nurtured us. Dr No has been doing his filial duty - when it comes to Mothering Sunday even Dr No says 'Yes' - but thinking of nurturing set him thinking of the other nurturances and influences that have shaped the way he is. There are a number, but without doubt many cluster round his years as a medical student, when a young, volatile, opinionated, yet still malleable teenager was transformed at the anvil of apprenticeship into a brash and brittle junior Dr No, who walked the wards burning bright from the heat of the forge.

Dr No has a close non-medical friend – a salesman - who is forever trying to sell Dr No the idea that medicine is really just like any other job. All that special pleading, all that vocation nonsense, is so much hot air, he says. Other jobs have just the same stresses and rewards. Medics have no ‘special case’.

Dr No begs to differ. Dr No suspects that most doctors have an affair with medicine, and that that adds an intensity to the relationship that most jobs lack. He is not convinced that those who sell stationery for a living – as his friend does – have affairs with selling, let alone selling stationery. If they do, then there must be an eroticism to ring binders that has quite passed Dr No by.

Dr Helen Bright once observed that locums are all too often asked to “swim in troubled waters”. Many locums will agree. Often the clues that the trust is in trouble can be spotted early on – provided one knows what to look for – which allows one to beat a hasty and hopefully painless retreat before the sharks come out to play.