I had a bit of an epiphany recently. In fact, let us call it a rejuvenating time in my career.
One of my patients had come to the front desk asking for help. He was desperate. He said his wife was very ill. The last three nights they had been to the emergency department and sent her home with some anti-reflux medication. He wasn’t convinced. He said she was worse. Now – with no appointments available – he wanted us to do something.
He saw me from the corner of his eye whilst I handed some administrative chaos to the staff. He caught me and said “Please, you help me. You help my wife?”
Guess what? I was due home three hours ago.
I started to have a momentary cognitive ethical dilemma: home to my family or see this chap’s wife? I told him to bring her now. He went home and came back immediately, some 45 minutes later.
She was very ill, pale as a ghost. I did all the vitals and examined her, realising she was in septic shock. I had to bring in the Resus trolley and call for help. After two hours she was admitted to the nearest hospital in their ITU, where she was kept for over two weeks.
There’s no blame at the moment – just momentary stressful chaos. Targets have come before patients and so she was tossed from pillar to post. At least that’s how they felt.
Two weeks, four additional medications, one stoma bag and two surgeries later, this lady found herself at home with no care package. What now? The NHS is just about managing in my part of town, and social work is at the brink of dangerous decision-making. We are overwhelmed.
The husband attended my clinic a few days later. I managed to sort out (with help) a care package for the lady.
He comes straight for me, cries, hugs and then kisses me once on each cheek. His Arab culture took the better of my western professional boundaries. Truth is, just for a moment I embraced the hug and his culture.
Just those few seconds meant the world. It meant I could work for a few more years without needing any thanks, any gratitude or any welcome. Although I wouldn’t say no if someone wanted to!
I’ve got used to not being thanked.
We very often forget the reason we have been working. For me, it’s to manage a good nights sleep, knowing that I’ve done something worthwhile. Quite difficult, but sounds so simple.
It has been tough over the years, going from one career to another, yet the hardest time has been in General Practice. I feel like I’m playing catch up. People used to say, “it’s really great in general practice, you get to follow the patient through a journey.” So why don’t I feel the greatness at times? The journey comes with endless bureaucratic administrative burden…that’s why!
Seldom do we get a ‘pat on the back’ in the NHS. In fact, we don’t. Times have changed and we are being reminded to do that to our juniors, even if no one bothers to do it for us.
It’s not right and I now look to thank my trainees, patients, carers and the multi-disciplinary team I work with. All of them are doing a very difficult job and struggling to cope. I thank them all.
We all need to be embraced and recognized every now and then. If it wasn’t for this job and its continuity I would’ve never have seen the patient again, and would not have been able to help them, and I would not have known what happened.
He would not have returned and I would not have felt supported. Or had my thanks.
Dr Mateen Jiwani
Clinical Lead GP
NIHR CLAHRC fellow