General opinion, NHS, personal, political, Uncategorized

For the junior doctor who might have saved my life

When I started this blog, my main aim was to talk about science and science fiction and the overlap of both. I also have some pieces on the backburner about working life as a scientist, but that’s where they’re staying for the moment. A couple of areas I decided to stay well clear of are the personal and the political: the former because, well, that’s what friends and family (or at most Facebook) are for, and I’m too much of an English stereotype to be getting all that confessional; the latter, because I would rant, and rant, and rant…

I am now about to break that resolution, for a special case. This is in response to the ongoing dispute over “Junior” doctors’ contracts in the NHS in England. I do promise not to rant too much, however.

Yesterday afternoon I had surgery to remove a number painful varicose veins (thanks pregnancy). As with every other time I have used the NHS, I was treated with professionalism, courtesy, dedication and compassion, kept informed every step of the way. My surgery went well and I was back home, groggy but otherwise fine, last night. In fact, when I went to sleep that night, my leg actually hurt less than it has on bad days recently. But at one point in the night, I woke, thirsty, and I lay there awake for a bit, thinking. Mostly I was thinking about a Friday night in A&E in November 2014, when a junior doctor came to my rescue.

When my baby was born, he was seriously ill; a freak event of catastrophic bad luck that nobody could predict or prevent. He spent several days firstly in intensive care and then in special care at the hospital. I hadn’t had the easiest of times myself, and was reeling after a 22 hour labour and substantial blood loss. They didn’t let me home for a couple of days, and probably would have let me stay longer, but I couldn’t stand being on a maternity ward with everybody else’s babies whilst mine was fighting for his life upstairs, and I wanted to get home. That Friday, however, had been a good day, the first good day of that week. He’d come off the ventilator and come round; I’d got to hold him for the first time, a full five days after he was born; I’d even got to breastfeed him, festooned in tubes as he was. Buoyed up, I pushed myself far too far that day, on the back of five days of overdoing it; sitting with him, expressing milk for him, not resting enough, not drinking enough water…and on that day, one of the many pains I was ignoring started getting worse and worse…By the afternoon, the sore vein at the side of my leg was more than sore, and throbbing. By the evening, it was swollen, inflamed and really hurting quite a lot, thank you very much. Everybody (up to and including my mother) had been telling me to get it looked at all afternoon. Finally, the breastfeeding specialist nurse (one of many people I owe a huge debt of gratitude to) effectively escorted me down to A&E, where I would be seen the quickest, with a suspected thrombosis (blood clot).

It was at that point that I pretty much hit rock bottom, and all the trauma, stress, pain and sheer exhaustion of the week completely overcame me. I sat in A&E, sobbing continuously on my poor husband’s shoulder (and I hate crying in public), despairing that just as my baby was starting to get better, I could have a fatal blood clot or embolism and leave him motherless. I was still sobbing when the junior doctor came to examine me (and no, I didn’t have a massive wait, despite it being Friday night). She looked as exhausted as I felt; I have no idea how long she had been on duty; I frankly dread to think. This didn’t stop her treating me professionally, thoroughly, and more than competently. She asked me all the critical questions whilst gently probing my leg. She diagnosed a blood clot, but in the superficial vein, and not going anywhere for the moment. So she sat me down with some nice nurses who offered me tea whilst she got me an anti-clotting injection. She got me antibiotics, concerned that the angry inflammation meant it was infected, and explained how and when to take them, and what symptoms to watch out for that might indicate an embolism. Twice. Because I couldn’t remember. (And she wrote everything down for good measure). She phoned obstetrics (having to try three times, because they were busy delivering babies, I imagine) to check with the consultant that it was safe for me to breastfeed with all the medication she had given me. She was sure it was, but she double-checked anyway, because I was anxious about it. She booked me into the clinic herself to get the leg scanned and the clot confirmed, and also arranged for me to return to A&E the next day when I’d be at the hospital anyway, to get another anti-clotting injection: “Because you have enough on your plate right now.” At some point, without apparently trying, she also managed to calm me down. She asked what I did for a living and when I told her, she said, “Ah, you’re the clever type of doctor” (i.e. a scientist); I laughed, whilst I was thinking to myself, “Good god, I could never do what you do.” I made a special effort to remember her name, but it was gone the next day. I only remembered her face, and the luminous compassion in it, that I so desperately needed that night. I don’t think I even thanked her properly. She wasn’t on shift when I returned the following evening (having finally been sensible and rested that day). I hope to goodness it was her night off.

The scan confirmed her diagnosis was spot-on: there was a 4cm blood clot in the superficial vein, fortunately not a deep vein, but it wasn’t going anywhere or blocking anything vital. Eventually, it resolved on its own. Yesterday I had that lousy (and now useless) vein removed, plus some other problematic ones, and I woke in the night and thought of that doctor, who looked younger than me. I wondered whether she’s been out on strike against the new junior doctor’s contract which the health secretary is trying to impose on them, or maybe she was providing emergency care, back in A&E again, with the angry, thankless drunks; the frightened, wounded people. I wonder if she is despairing, now, at what the government is doing to the NHS, and to her profession. I wonder if she is sitting at home thinking that she’s already having most of her salary eaten up by rent, and now all those weekend shifts won’t even count as unsociable hours; will she ever be able to afford her own place? And with the huge debt she racked up for her medical studies? I wonder if she thinks that it is impossible for her to have her own family in the career that she is in, how she could never get the childcare for 11pm even if she could afford it. I wonder if she is angry, or hurt, that nobody seems to appreciate or value what she does. I wonder if she is considering giving up. If she is, it would be a great loss to the profession and to society at large. I think, too, of all those others that week, who worked so hard to save the life of my baby. I think of the wonderful specialist nurse, who’d had to fight to get funding for her milk expressing room and the machines, and wonder if that will be the first to go as “non-essential”. Without her help, I wouldn’t have been able to breastfeed my baby. That means nothing to the likes of Jeremy Hunt but it meant everything to me, cementing an irreplacable bond with the child I hadn’t been able to hold when he was born. When will we ever learn to prioritise simple caring over money? Such things cannot have a price tag put on them, but, since everything does have a price tag, I think that she, and that junior doctor, and the others like her, deserve rather more than they are getting, not less. And anyway, a lot of what they are arguing against is the impact on patient safety. Of course it is. That’s what they care about.

I remember that junior doctor going the extra mile for me that night when she really didn’t have to. And I wonder: who will go the extra mile for her?

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