By Dr Katie Rogerson
*Trigger warning*
I have so many of these memories. Too many to document, of ‘simple cases’ expanding, like a fan. Each fold seemingly more complex.
I remember having four minutes until the end of my shift in A&E. I had already cancelled personal plans all that week, last minute, because of work overrunning. But here I was, in a glorious state just minutes before the end of my shift. I had sorted all my patients and was ready to pick up the next. Or not!
Four minutes. Wow. I could even finish on time if I stopped now! Whoop whoop!
We pick A&E patients up in order. I knew I didn’t have time to see a ‘complex case’. I was still holding onto distant dreams of seeing my other half at least once in the week before he went to bed. And I was already knackered from the unpaid overtime I had already done that week.
I looked to my right and saw my backpack and coat shoved under a chair (many jobs don’t give us places to put them). It looked like a delicious potential escape route. I imagined it for a moment. Out into the fresh air. The wind blowing in my face. A cold fizzy water. Maybe even a lollipop (work dehydration and heating systems make me dream of lollipops, even in the dead of winter).
Then I looked to my left. I saw a full waiting room, and another ‘bus load’ arrived (a busload is ED slang for another burst of people arriving to ED at specific times, like when school ends, or the pub closes, and they all head to get mended by us). I looked up at my colleagues. I knew some hadn’t eaten or drunk despite being here for hours. They looked tired.
To hell with it. The early finish was tantalisingly close, like a desert mirage.
But I decided I would pick up another patient, who cares about finishing ‘exactly’ on time. An overrated treat I am sure. I only had a few minutes so I didn’t pick up a ‘major’ i.e. likely more complex. And I saw that at the top of the pile there was a ‘minor head injury’.
Perfect, a quick history. Make sure there are no red flags or need for a brain scan. Quick exam of brain and nerves around head and neck. Maybe painkillers. Maybe glue or stitches (if glue nurses would be kindly doing at that hospital). Good safety netting advice. Then home with a leaflet.
It was a kid who bumped their head relatively inoffensively bouncing on a trampoline. As soon as they walked in I knew they were fine from a head injury perspective. But I went to do due diligence. But there was something about the answers. The dad. Their rapport.
The dad gave me the heebie geebies. When he nipped out I asked a couple of other questions. The answers made me feel uneasy. I didn’t know what I was dealing with but I knew the kid needed help. I knew something was very off. Long story short, I fought to get a very well child admitted. And unusually, without that parent being allowed to join.
I had to fight, fight, fight for the last of the beds. I had to justify to everyone why I was doing it. And a great team. they trusted me (although that itself took about one hour of different phone calls). It became a barrage of work. And paper work. And phone calls. It was hours later when I went home.
It turned out the kid was in serious trouble. They were being raped regularly by their dad. They were the centre of a child sex ring suffering serious exploitation.
Doctors work hard everywhere (as do all NHS staff). But the government don’t trust us. Instead of acknowledging they don’t invest in us, they try to shift the blame onto us. Very clever. If they tell you the system is broken, they can dismantle it and replace it with something that suits them. Not you.
You need good doctors. Who can redirect when they realise someone needs them. I mean really needs them. You need someone who can pull out all the stops when they recognise there is something going deeply wrong.
Don’t clip our wings. Don’t fall for this nonsense.
Because one day it will be you sitting there. Scared. Trying to look someone in the eye and tell them there is something wrong without saying it. And they need to be able to do their jobs enough to pick up on this. Without fear of recrimination. Or, let’s face it, bullying.
Remember that poem… first they came for…
Well, this is pretty much that moment. Choose wisely who you support. What you support.
The focus needs to be on better funding. More doctors. Not on bullying. Right now Javid is trying to target GPs. But not in a way that will make it better.