I write this am I’m sat at home, on call, waiting for the phone to ring again. Today’s on-call bingo won a mark for a bleep as I left the hospital car park and a call as I was busy spilling chilli and serving up dinner. That’s just a normal part of life.
Normality is running from the wards to the day unit and outpatient clinic. Normality is a ward round, bleeps, advice, reviews. Normality is breaking good news, sharing the joy of remission, a new baby, a life being lived; it’s breaking bad news, a new diagnosis, relapse, a life being lost. For us, it’s days of chemotherapy and transplants, procedures, laboratory issues, and then going home to study, further our knowledge, raise a family, take part in sports, choirs, orchestras, religious organisations… Oh yes, with the odd on-call offering advice and reviews for pretty much anyone in the region with a haematology problem.
This is life. This is the life I chose to lead, and I love it.
I was talking with one of my colleagues in the ward the other day, and I realised we are grieving for the NHS. Life goes on, but it’s lost some of its shine. The drive to further our careers has gone.
Apparently, grief starts with denial. I don’t really remember this stage, other than being vaguely aware there were contract negotiations going on, but they didn’t involve me. An intelligent politician and a reasonable union should be able to sort it out, right? Oh yes, actually, that might be denial.
Anger. Yes, I know all about anger. I’m still there. I’m angry that I may not be able to provide my patients with an excellent standard of care. The summary of the new contract is this: more hours to cover, with a reduced salary. But how can you cover more hours if you don’t increase the number of doctors? (But you can’t do that: there isn’t the money)? Two options – make them work longer (tired doctors make mistakes) or spread them more thinly (doctors who are run ragged make mistakes). We can barely cover Monday-Friday 9-5.
Rant over. There have been a lot of rants. Also protests, articles, interviews, and finally the message is getting across. Not everyone agrees, they’re never going to, but at least some understanding is coming across.
I’m trying to hold on to my anger, just a little bit. It may be exhausting, but it feels more pro-active than the next stage: depression.
I read an article this evening that broke my heart just a little bit. A junior doctor who, having sacrificed her marriage and a lot of time with her children, nearly a consultant, who will have to give it all up as she simply can’t afford the new changes.
My own colleague has given up on all the extra-curricular things we are required to do. Her patients are taken care of well, but that’s the end of it. She’s not alone in this. This stage of the grieving process is really tough.
I forgot about bargaining. Well, we tried that and hit a brick wall. Unlike grieving for a lost loved one, there is someone to rage against and bargain with. But they are not listening.
So what is left, at the end of it all? Acceptance? Do we lie down and accept the changes? Do we accept the inexorable march to privatisation and the death of the NHS? Or do we stand and fight?
Well, I’m still angry – I’m up for a fight! We work for an amazing institution. I look around and see the lives saved, the conditions managed. I see dying patients treated with dignity and respect, and their relatives comforted and supported. And all without the production of a credit card or insurance documentation.
We may not get it right all the time, we know there are improvements to be made, it is not perfect by any means, but all the more reason to stop fighting against us and work with us to achieve this change.
We must fight. We must expose parliamentary spin, correct the misuse of data, and work out how we can keep our doors open, free at the point of use. And do all that whilst taking care of each other.
Who’s with me?