I am a medically complex patient who spends long periods in hospital, whose care is spread across 7 different London hospitals with about 12 consultants involved in my care, and who relies on and is kept alive by our NHS. I have been ill for 8 years now, and spent a lot of time in hospital as well as at appointments, scans and clinics throughout this time. I was diagnosed with Ehlers-Danlos Syndrome in October 2008, days after my 15th birthday after becoming disabled aged 14 following a lifetime of problems that were never connected. My health has rapidly deteriorated in 8 years and I would simply not be here without our NHS. I am testament to how our NHS both works for patients like myself, but also how the NHS fails us at times. With all the cuts and the proposed changes to the working hours and pay of junior doctors, and trying to create a 7 day NHS (which may I add, it already is), I fear greatly for the future of the NHS, but also the future of the care of medically complex patients, as well as general patients but especially for those of us who would not survive without our NHS, the ones who owe our lives to our NHS. In my case my condition is life-limiting, and my condition and related complications have nearly killed me on a few occasions. Without our NHS, I’d have simply died on any one of these occasions. I would not be here without the NHS, and it keeps me alive to this day.
However, with the proposed salary cuts, increased working hours and the resulting disheartened feelings of doctors, I fear for the future of our NHS. I especially worry about junior doctors. They are the future of our NHS, the future of medicine, the medical lecturers of the future. They keep the NHS going; a consultant cannot work without his/her junior doctors. The junior doctors take the brunt of the work, sprinting around hospitals the whole of their shift to see to patients, write up notes, chase test results, re-board the medication charts, write discharge summaries, prescribe medications, cannulate, are the first responders to very poorly patients, have to skip breaks, barely get to sit down and yet they do this every working day, plus all the extra hours they do, often unpaid. Life as a junior doctor is tough, they sacrifice their lives to work; medicine is not a job it’s a vocation (and a lifestyle really). They will miss seeing their families, miss celebrations and get togethers, miss important milestones in their children growing up, they sacrifice their social life, they cope with any number of horrific things they may see or experience each shift, they push themselves beyond the point of exhaustion, they stay way past their shift to get things done as well as doing ward rounds with their consultant, and they do all this with the debts of their medical school fees and associated costs, on a salary that barely allows them to survive now, and yet they will have to work more for less pay?
Junior doctors are the future of medicine, and they need to be paid a decent wage and to be appreciated for what they do for the NHS. I owe so much to the many, many junior doctors who have been involved in my care in the 8 years I’ve been ill. I empathise with them so much; this would’ve been me if I wasn’t ill. I had my sights set firmly on a career in medicine, despite the debts I would incur and the sacrifices I would make. I wanted to make a difference, I wanted to treat patients, I wanted everything that came with being a doctor, and was prepared to take the rough with the smooth; but in the current proposed cuts and changes, would I be able to sustain myself or even consider a career in medicine? I have so much empathy with the junior doctors because in a year or two’s time, I could’ve been one of them. I could’ve been one of the junior doctors who feels demoralised and questions their future in medicine, who wants to strike because what is happening is not going to benefit junior doctors, not benefit patients and certainly won’t benefit the NHS. It could’ve been me on the receiving end of this.
To put it simply, I would not be here without the junior doctors who have spent hours with me, stayed after their shifts, shared parts of their lives with me, fought to get me the treatment I need, written up my medications when re-boarding my chart over and over, comforted me, laughed and cried with me, chased up test results and more. One junior doctor I remember spent 8 days (yes, 8 days), on top of her usual workload and treating me on a day to day basis along with all the other patients under her care, writing up my history, all my notes, test results and more for my referral for a bowel transplant at Addenbrooke’s Hospital, Cambridge. 8 whole days work on top of her usual workload, purely for my benefit, only for me to be turned down as I would not survive a transplant and TPN (feeding into the bloodstream) is still successful at the moment. Yet she was not disappointed. She was just glad to have played her part in helping me. There was the junior doctor who whistled her way round the ward every day, in her neon pink trainers, who spent many hours trying to cannulate me, who checked I was ok when the patient in the bed opposite me died, who laughed with me at the fact that my veins are useless; she listened to me about every spot which might work, and would come onto the ward, give me a tourniquet, get me to pick a vein I think may work and I’d have the tourniquet on, arm (or foot) laid over the edge of the bed to try and get the veins up, and then come back and give it a go. She had so much work to do, yet she never complained about the fact she was trying (and failing every time except once or twice) to cannulate me every day, sometimes 3/4 times in one shift.
To the many junior doctors who have spent hours with me learning about Ehlers-Danlos, POTS, Chronic Intestinal Pseudo Obstruction, Intestinal Failure etc., about TPN, Hickman lines, PEGs, Ileostomies and Urostomies, who don’t fear asking questions, and who take the time to learn from me to help the next patient who comes along with any number of my conditions or interventions. The ones who remember me from their medical student days when they’d come up and practise examinations, try to work out what’s going on with me, whose professors would quiz them on my conditions and tubes/bags and who would get to see my scans and test results, and who thank me for allowing them to do that.
Thank you to the ones who share their lives with me to make me feel at ease, who show me pictures of their children and tell me stories about themselves, as they might be the only people outside the nurses and my consultants who I will see that day. The ones who’ve laughed and joked with me, and the ones who’ve fought to keep me alive. The junior doctor who was visibly upset when I fell out of bed and broke my hip, waited 5 hours for a doctor, 4 days for the surgery to pin and plate it, and had to choose between pain relief and my nutrition and IV medications. He commended me for choosing nutrition over pain relief since the femur is the most painful bone to break, and I coped with no extra pain relief before or after the surgery. He actually made me feel like I’d achieved something when I couldn’t see any good in what I’d been through. He said this with tears in his eyes; not tears of sympathy, but of empathy. To the young lady who spent 3 hours cannulating me, us both laughing at the fact that she was apologising for stabbing me over and over again (with me insisting she keep trying way beyond the “two tries and get someone else” rule) and that I was apologising for having such useless veins after years of cannulas with harsh medications like Cyclizine, Potassium and corrosive antibiotics such as Clarithromycin being pumped through them. The ones who’ve become more like friends in the inevitable long admissions. To the junior doctor who cannulated me 12 times in 24 hours, never complaining when no cannula lasted more than 30 minutes.
Thank you to each and every junior doctor who has treated me, put me at ease, laughed with me, shared their lives with me, taken time to help me outside their shift, and appreciated me spending time explaining things to them which might help the next patient. The ones who work with me, not against me. The ones who give their all for their job, make sacrifices for their patients, and who never lose compassion, empathy or lose sight of the fact that patients are people with feelings, emotions, families and lives of their own. The ones who truly embody what it means to be a junior doctor – and this applies to each and every junior doctor out there, especially each and every one who has entered my life at some point or another. My gratitude extends to you all.
I could go on and on about junior doctors, because I am so grateful to the [I don’t know how many] junior doctors who have treated me in the 8 years that I’ve been ill. I’ve had many deep chats, shared many stories, had many laughs and also cried with many junior doctors over the years. They need to get the recognition they deserve, they need to be nurtured and respected, for they are the consultants and professors of the future. They are the future of medicine. And we need to treat them how they deserve to be treated. They need the recognition they so badly deserve.
Please support our junior doctors. David Cameron, Jeremy Hunt: please pay doctors a respectable amount for their work, for the sacrifices they make, for the debts they’ve incurred over the extremely long and gruelling training they undertook at university, and will continue to undertake through their medical career. To provide for all the extra costs, such as GMC membership, training courses and exams, professional development and more. To respect the fact that we already have a 7 day NHS, and see that what you’re doing will be detrimental to junior doctors, to patients and to our beloved NHS. Life is already tough for junior doctors, and what’s happening is demoralising and will ruin the camaraderie between junior doctors and will threaten the love for their job. Please don’t cut their pay, pay them a decent wage for all their training, hard work, dedication and sacrifices, and don’t make them work longer hours, especially in light of the cuts. They already give their all to the NHS, please don’t take away their dedication and their passion for their job.