Tag Archives: consultants

When an NHS relationship ends

Oh how sad it is when a relationship ends.  The pain of losing that one person who understands you more than anyone else.     No more chats as you lie in bed.  No-one around who you really trust as much as you trusted him.   Having to start a new relationship with someone else who might not prove to be as reliable, or thoughtful .

I have lost my consultant.   And I am grieving.

It sounds daft doesn’t it?  But for us NHS patients, having a long term  relationship with a doctor who we really trust makes a  difference.   I met my consultant  11 years ago.  I’d spent 2 or 3 years being passed around the NHS, short term dates with doctors who knew very little about my immune system problem and often couldn’t even remember my name.   I remember hearing his voice for the first time outside my  room, telling a cluster of junior doctors about my condition.   ‘This might actually be someone who can help’, I thought.

And he did.  I’d been warned to have no more children, but he said I could.   I’d been told there was nothing that could be done to stop the damage to my kidneys, but he said there was.  I’d been left with no hope but he gave me bundles of it.

Over the past decade, he has fought to get me the best,  and often very expensive,  treatment.  He has rushed me into hospital on a few occasions, insisted I got a bed on the right ward.   He’s overridden hospital procedure when it’s not in my best interests.   He’s been blunt with me about the future when I’ve been scared about new therapies. He’s given me his mobile for whenever  I needed to talk directly to him ( I’ve used it twice in 10 years).  He’s been the only person in a long line of medics who asked me how I felt emotionally after being put under sedation for five days in intensive care.  Without doubt he has saved my life on a couple of occasions, and without him my cheeky, lovely 9 year old son would not be here.

And now he’s gone.    And unlike most normal break-ups, I’m given no warning and no reasons.  I turn up to clinic a few times and he’s not there.  I ask and I am told that he’s taking leave, and then it’s extended leave, and then it’s ‘no we don’t think he’s coming back’.

It has to be this way of course.  Anyone is free to move jobs, retire, take a break.    You can’t have patients knowing about a doctor’s personal life.  It’s just not appropriate for anyone in the NHS to tell me why he’s no longer my doctor.  I completely understand and accept that.

But I am bereft.  And worried about him and his sudden departure.  I hope he is well.  I can’t even write him a note to thank him.  To point out to him the immeasurable effect he has had on our family.

Instead, somewhat wearily, I start the search for a new relationship.

Careless Words

I have an amazing friend.  After years of struggling with alcohol, she’s managed through a great deal of pain and endurance, and a little help from AA, to stay off the booze for 4 years.  She pointed this out to her GP recently.  His response? “Good .  Now you need to lose some weight.”

Another friend tells a tale of talking to a doctor about fibroids.  They discussed whether it could affect her fertility.  On finding out she was 35, the doctor said, “Well, what have you been waiting for? You need to get on with it.” She promptly burst into tears.

I can tell a couple of stories too.  The time a midwife gave me an injection just before I was due to have a D and C to remove my miscarried baby.  ‘Injection done.  That’s the worst over with.” Really?  The time a doctor berated me for putting on weight before realising I’d been on a large dose of steroids for six months.  The time a consultant who’d never met me before insisted I was facing the rest of my life on dialysis.  He was wrong.

Everyone can put their foot in it now and then.  I’ve dropped some right clangers in my time.  But I think working with patients requires an extra effort in choosing the words you use.

I have another story of a junior doctor, who came across me in tears after I’d received bad news.  “Fiona,” he said.  “This time will pass.”  He was right, and like the ill chosen words above,  those 4 words he uttered have stuck with me and helped me through the darkest of times.

Dear NHS staff.  Us patients are really vulnerable.  We’re often at one of the most difficult points in our lives.  Our conversations with you are about intensely personal subjects.   We’ve waited for hours for the doctors round on the ward.  Or months for the outpatient appointment.  You are the person who we think can cure us.  Or who we trust to care for us when we can’t care for ourselves.  We hang on your every word and analyse them after you’ve gone.

Careless words might not cost lives, but they can cost peace of mind.   And a loss of confidence in those who are treating us.   But well chosen words can bring hope too.  Remember that when you talk to us , and remember that your words will stay with us long, long after you’ve moved onto the next patient.

 

 

An NHS waiting List

Ok.  I have an NHS waiting list for you.  Oh.  Not that type.  That’s a completely different blog. I haven’t written it yet.  Too busy harassing my consultant’s secretary to find out when I’ll get the treatment I need.

No, I’m referring to that other type of waiting, which is just as prevalent in the NHS but doesn’t get talked about half as much.  The one in outpatients where we sit for hours on uncomfortable plastic chairs, waiting for our name to be called, staring at posters reminding us of all the ailments we may yet succumb to.

It seems to be accepted behaviour within the NHS that patients will have to wait for anything from 45 minutes to 3 hours at outpatient clinics.  A consultant at once said to me, “You know how most people bring a book to clinics?  At this clinic we suggest you bring a tent!”  Ho ho ho.

If a clinic has an average waiting time of over 90 mins, (which mine does), surely there is something wrong with the way it’s set up.   And yet no-one within the NHS seems to take responsibility for it.  Us patients don’t complain of course; we’re too desperate to see our doctors.  And most of us accept that in our stretched-to-bursting NHS, there are too many patients, waiting to see too few medics, getting squeezed into clinics that are full already.

What to do then? The obvious answer is just not to put as many patients in the clinics.  But I want everyone who needs to see their doctor to get an appointment.   And I’ve been squeezed myself into too many clinics that are already full to complain about that.  But I do have an NHS waiting list, designed if not to solve the problem, perhaps to make the process of being ill, a little less painful.

  1. Information is everything. If I know my clinic is overrunning by two hours, and the reason why e.g. my consultant has had to attend an emergency, then I can decide to come later, nip to the supermarket on the way in etc.  My mobile phone number is checked by the receptionist every time I go to clinic.  Why then does no-one ever phone me?
  2. At the very least tell me when I get there. Take a tip from the train companies who have now mostly learnt this lesson. At the moment the only way I can work out how long I’ve got to wait is by eyeing up the pile of medical notes and the people around me.  Massive pile of files and 20 people scrunched up on the flip-down chairs with their legs being tripped over in the corridor equals a long time to wait.  Small pile and just a couple of people not looking too fed up, equals  I might be seen within the hour.   A more scientific means would better so I can choose to go and get a coffee or at least text my lunch meeting to tell them I’m going to be late.
  3. Barring emergencies, insist every clinic, yes every clinic, starts on time. It’s a tad frustrating to fight through rush hour traffic to get in for 0830, only to see your consultant arrive at 0915 and start making coffee for every member of staff there.   First patient is seen at 0930, an hour after they were told to arrive.   I love the fact my consultant is the human type  who would make coffee for everyone,  but frankly his brain is so huge it should be used for curing patients rather than checking who wants milk.   Get someone else to make the coffee.
  4. Treat us as human beings and make it as comfortable as possible for us to wait.  I’m not suggesting sofas and smart TVs but an apology,  updates on our place in the queue and some comfortable chairs for the elderly and infirm wouldn’t go amiss.
  5. So we wait 90 minutes to see the consultant, and then another 30 to get our blood taken. Guess what?  We’ve gone over two hours in the car park.  So not only have we spent all morning sat on plastic chairs with no one telling us how long we’ll be there, but the hospital trust is actually going to charge us an extra couple of quid in parking for the privilege.   There’s an easy solution to stop us muttering as we head to our cars.  Put in the sort of system that shopping centres have where you can get your car park charge reduced by getting it stamped by reception.  Job done.

A final thought.   If we’re not careful, we patients can head down into a spiral of self-pity.  The ‘why me’ thoughts.  Most of the time we try to forget our illnesses, make them fit around our lives rather than fitting our lives around our illness.  But an outpatient appointment is a stark reminder that all is not well and a long wait can lead to thoughts we’d rather not contemplate.  Keeping us cheerful as we squirm on the plastic seats might just help.

 

Gods (or hospital consultants)

What you have to realise as a patient is that however important you are outside hospital, however many lackeys jump to your call, inside hospital you are merely the patient in Bed 10. You are no more important than the patient in Bed  11. Or 12.  Yes you’re the reason the whole place exists …but  the man or woman who calls the shots, for whom everything stops on the ward, is the consultant.

Not surprising then that some of them have God-complexes.  The worst one I ever had  used to stride into the ward with his team of junior doctors, medical students and the ward sister scurrying after him.  He’d barely look at me…and would call me Mrs Brown throughout,  much to the consternation of everyone else around him.   But contrary to popular belief,  my experience is those types are few and far between and actually it’s us, the patients who have a tendency  to put consultants up on a pedestal.  The highlight of our hospital day is when they appear at our bedside. We listen intently to their every word, desperately trying to remember what they’ve said so we can repeat it at visiting time.  We assume they are all-knowing and all-powerful in their ability to heal.   Sadly that’s not always the case.

It must be quite hard not to develop a God-complex if you’re a consultant.  They live in a world where the patients are desperate for a word of wisdom from their lips, and in a hospital hierarchy which places them firmly at the top.   They are always surrounded by at least two or three  minions to take notes, hold the stethoscope, or pass them a pen.  They test their minions all the time too.  What does this C4 complement result mean Junior Doctor?  What’s your diagnosis Lowly Medical Student?  Watching from the bed as the Gods torment their minions can be most entertaining …… or agonizing.    And of course consultants have the ultimate God characteristic.  Their decisions can decide if someone lives or dies.   What power ……and responsibility.

In reality even they can’t perform miracles.   Sometimes the superheroes just don’t know why your body is functioning so poorly or what to do to make it better.  The realisation as a patient that your doctor doesn’t know everything, that he or she is actually human, can be pretty depressing.

I now have a  consultant who having decided in an outpatient appointment that I needed to be admitted straight into hospital, zoomed across town on his motorbike to get my medical records from one hospital to another.   As he strode into Accident and Emergency in his leathers with his helmet and my notes under his arm, in my head I gave him superhero status, right up there on a pedestal  where he’s pretty much stayed  ever since.  It helps that he’s super brainy and has saved my life on a fair few occasions.  He also always remembers the names of my kids, and was the only person in a long stream of doctors to ask me how I felt emotionally after five days under sedation.   I used to think I was special, that my complex medical needs (or alternatively my witty personality), was why he remembered me but over the years  I’ve eventually worked out he’s like that with all his patients.  Somehow in that God-like way, he makes us all feel special.

So hospital consultants, if you are reading this, it’s simple.  The best consultants keep their God- like tendencies (and egos) firmly in check, just bringing them out to dazzle us when we really need their  healing powers.  And us patients hang on your every word.  We live for that 3 minutes every other day, or once a week, that we might see you.  We all like to think that we are your most important/medically interesting/favourite patient – so please be nice to us and if nothing else, make an effort to at least remember our name.