GOING BACK TO MY ROOTS
Dr Michael Mosley returns to the NHS front line
THE A&E department in London’s King’s College Hospital is one of the busiest and most hectic in the country.
As paramedics rush in through swinging doors and patients in wheelchairs are hurried along corridors, I stand in a small side bay, helping to set a woman’s broken leg back into place. Clare slipped when getting off a bus, landed with her leg bent backwards and now needs it ‘clicked’ back into position, along with a hefty dose of pain relief.
I’m in the hospital to lend a helping hand as part of a new BBC documentary to be broadcast on Thursday that marks the 70th anniversary of Britain’s National Health Service. Celebrities On The Frontline sees myself, former Shadow Health Secretary Ann Widdecombe, paralympian Jonnie Peacock and television presenter Stacey Dooley work alongside the dedicated staff of King’s College gaining valuable first- hand experience of what working life is really like in a modern NHS hospital.
Jonnie, who underwent a belowthe-knee amputation as a result of meningitis aged five, and Stacey, who suffered from a heart condition when young, were particularly keen to compare their childhood experiences to that of patients now.
As the only medically trained member of the team, I was immediately thrown in at the deep end. My first assigned ‘patch’ was resus – the front line when it comes to treating trauma victims and those in need of life- saving medical attention. Straight away I was struck by the pace and energy of the unit – it’s busier and more demanding than it was when I trained to be a doctor in a London teaching hospital some 30 years ago.
The unit, led by Clinical Director Dr Malcolm Tunnicliff, is almost always running at full- patient capacity. I seem to remember that time was allocated for afternoon tea, which certainly wouldn’t be possible nowadays – not with the estimated staff shortage of more than 50,000 doctors and nurses and ever tighter budgets. Emergencies involve a lot more than broken limbs and chip-fryer burns; some have attempted suicide, some are suffering a suspected drug overdose and others are riding the wave of a long-term, chronic illness.
Overall, my three days in A&E were just as fascinating as they were in the 1980s, only this time it was far more sobering.
I can remember treating my first-ever A&E patient like it was yesterday. I was a nervous young medical student, eager to learn and do my best.
My patient was an old man who had been brought in unconscious, having fallen and cut his skull. After checking that he was OK (it was alcohol, not the fall, that had put him into a deep slumber), I was asked to stitch him up. I
THE UNIT IS ALMOST ALWAYS RUNNING AT FULL CAPACITY
was slow and careful, proud of my work.
But when I’d finished and I tried to take my hand away, I quickly realised that I’d stitched my glove to the top of his head.
Along with a fair share of alcohol-related problems, King’s also treat a lot of drug addicts.
It’s estimated that drugs and alcohol put more than a million people in hospital every year. During a late- night shift, I’m called to help restrain Rocco, a 40-year-old who has been wheeled into the ward after suffering a suspected drug overdose.
He arrives on a stretcher, thrashing around and screaming. The consultant I am workign alongside tries to inject him with a sedative, but he is very strong and finding a suitable vein is almost impossible. Years of drug abuse means most of his blood vessels are blocked, so I am forced to hold him down by lying on his legs while the consultant desperately searches his body, looking for any vein he can stick the needle in.
The consultant finally gets the needle into Rocco.
The trouble is, with a cocktail of prescription and non-prescription drugs increasingly available online, there could be any number of unfamiliar substances running through his system.
When Rocco regains consciousness many hours later, we have a chat – a conversation that really challenged my assumptions.
Rocco is not the street- wise junkie I’d imagined, but a successful businessman who is shortly scheduled to board a first-class flight to the Far East. But, as Dr Tunnicliff points out, this has no relevance to his staff. ‘We treat everyone, no matter their personal situation,’ he told me. ‘It’s important not to judge.’
If I stepped off the kerb and got hit by a car because I wasn’t paying attention, does that mean I shouldn’t be treated? Obviously not.
The following few days were particularly hectic, as I ran around trying to keep up with senior nurse Carole Olding, a key member of the trauma team.
King’s is the centre of a major trauma hospital network serving more than four-and-a-half million people across the South East, which for Carole and her team, means constant, intense pressure.
There weren’t Major Trauma Centres back in the 1980s, and we used to talk of the ‘golden hour’ – the vital period during which you needed to act if you are to save a patient’s life.
These days, paramedics are often on the scene and delivering treatment within ten minutes of a code-red 999 call.
When the patient makes it to hospital, thanks to medical techniques learned from battlefield doctors in war zones such as Afghanistan, they are far more likely to survive.
By the end of a week in A&E, I felt completely wiped out – but also elated. Still, the idea of coming in and doing it all over again felt a little daunting. God knows how Carole and her colleagues manage to keep themselves so motivated after years on the job.
My second week at Kings was spent with junior doctor Amreeta Autain, who was t raining to become a maxillofacial surgeon, treating injuries and diseases of the head and neck.
During my time with Dr Autain, she was working a 12-hour, oncall shift, arriving early and leaving late. She was constantly on the move, constantly being bleeped.
I helped out in a number of procedures, including one operation which involved putting a metal plate into a broken jaw. But the most dramatic and moving
I HAD STITCHED MY GLOVE TO THE TOP OF A PATIENT’S HEAD
moment came during an operation on a sweet little boy called Ben who had developed a misshapen forehead that the surgeons felt needed correcting.
The complex procedure took many hours and involved several maxillofacial surgeons and a neurosurgeon. They needed to work together to reshape his skull while protecting the brain.
Ben’s parents were, understandably, incredibly nervous – and I felt almost unbearably tense watching the whole thing.
Once the operation was finished, he was transformed. I don’t know whether it was just exhaustion, or the fact that as a father I couldn’t help but think of how I would feel if this was my own child, but I was close to tears. Witnessing the operation and the reaction of Ben’s parents, I understood how Dr Autain and so many like her find the strength and enthusiasm to work exceptionally long hours over so many years. To become a maxillofacial surgeon you must have two qualifications. Amreeta has first qualified as a dentist, before training as a doctor. It is a huge commitment. As a young, vibrant medic with so many years of training behind her, Dr Autain i s of huge value – it is obviously important that the NHS find ways to hold on t o doc- tors like her. When I left medicine, it was seen as an unusual career move, but nowadays leaving the medical profession and deciding to do something else is not uncommon.
With limited prospects, long working days and strained working conditions, increasing numbers of medics are choosing to take career breaks or go and work abroad.
The good news for junior doctors is that, thanks to the 2004 European Working Time directive, it is now illegal for junior doctors to work the 100-hour weeks that were standard in the 1980s.
The bad news is that when they are on the job, most junior doctors are working harder than ever.
To be able to make a difference, and to change lives in that way, is truly remarkable.
The NHS is a huge, unwieldy and enormously frustrating organisation to work for.
Yet in the two weeks I was at King’s I saw so much wonderful work, often under intense pressure. She may be 70 years old but this old dame still inspires her army of loyal workers.