Posted in bloggers, Medical, Politics, Reviews

Book Review: This Is Going To Hurt – Adam Kay (and also, A Love Letter to the NHS)

As someone who will officially become British in the next 6 months (after dropping a whopping Β£5000 on residency and naturalisation fees of course), I now feel like I have the authority to list some of the things from my adopted country that I’m most proud of.

1. Harry Potter

2. The very commendable ability to insult someone while still managing to sound polite

3. Scones, clotted cream and jam (yum!)

4. Intermediate rent for key workers

5. The Tube (believe me, I’ve travelled a lot and I’ve yet to find a more extensive or well-run transportation service)

6. That damned accent that makes everything sound like a Shakespearean play, even when someone is telling you to sod off

7. The NHS

This post, and this book review, is really an ode to number 7. I freakin’ love the NHS. Call me naive, but I think its a modern miracle. And I say this both from the perspective of working in it, and from having been a patient needing its services.

I arrived in London seven years ago, and within the first four months I managed to get myself bitten by my landlady’s dog to such an extent that it necessitated actual surgery.

Up to this point I had never been admitted to a hospital, never had a cannula put in and have never had to take anything more serious than the occasional antibiotic. Unless you count the cholesterol-lowering medications but hey, I blame genetics for that.

ANYWAY. I was totally unfamiliar with the country’s health system. Heck, I didn’t even know where or what my nearest hospital was. I had to take a bus to a certain hospital in North London and hoped someone there would know what the hell needed to be done with me and my gaping leg wound.

I arrived at the A and E and was seen within the hour (I was later to learn that this was an exception rather than the rule). I had a line put in for the first time in my life, was given antibiotics and was asked, quite stupidly in my opinion, if I cared about the appearance of the leg.

Being somewhat vain about my legs, I said of course with an admirably controlled level of incredulity that such a thing needed to even be asked. I was then informed that in that case I would need to head to another hospital which specialised in plastics and that I would most likely need surgery.

Off I go, taking the Victoria Line and changing at Green Park to take the Jubilee line, stopping somewhere in the general vicinity of Hampstead before taking the bus to get to where I needed to go. I got to the hospital and was scheduled for a day surgery procedure the next day.

On the day of the surgery I was seen by a very lovely and good-looking plastic registrar. I would have given him consent to do anything and everything but all he wanted was my ok to do a washout +/- skin graft procedure. I was wheeled into the anaesthetic room and asked to count backwards from 10. And that was the last thing I remembered before waking up in the recovery room an hour later.

After a couple of hours, I was discharged with take-home meds, dressing instructions and a smile. I then took my very stressed mother and aunt (who were supposed to be on holiday to visit me in London) to eat some peri-peri chicken at Nando’s.

I did all these without having to pay a single penny, and without having to worry about insurance, or my lack thereof.

I don’t know any other country where anxious patients, especially those new to the country like myself, would be able to expect this kind of service. Its a privilege that we take for granted everyday because we are so immersed in it, but that’s exactly what it is: a privilege.

Its a privilege to have the services that the NHS provides, and its a privilege to be a part of those services.

I haven’t read other reviews of Adam Kay’s book and I don’t give a fig what other people say. To me, what I got from it was a love for the NHS, despite the stress, the understaffing, the unbelievable pressure to meet somewhat unrealistic targets and the perpetual financial crises that meant you rely on the goodwill of the staff most of the time.

This Is Going to Hurt is in turns funny, poignant, frustrating, touching, and above all things, wonderfully and painfully accurate. I laughed at the bits I recognised (because I experience it day in and day out) and teared up over the things that, despite our best efforts, we health professionals can’t do anything about.

There were moments that seemed so absurd that non-medics would think its fiction. But believe me, the number of times I’ve gone to work and been in a situation where I’ve said after “You cannot make this shit up” cannot be counted on both hands.

I bitch and moan about work as much as the next person, but it only takes me 5 minutes to remember that without the NHS I will not have a career, nor would I have had the experiences, opportunities and relationships that I’m blessed with today.

The NHS is neither good or bad. It simply IS. At the end of the day, one learns to suck it up during the bad days because inevitably, there will be good days that make all the effort worth it.

Like when someone is walking pain free for the first time in their life because of a well-done knee replacement. Or when you help deliver a couple’s firstborn after they’ve experienced more than one miscarriage.

These moments are everything. And for the cynics who say that the NHS provides sub-par services and that I’m idealising the whole situation, believe me, I’M NOT.

I’ve had days where, just like Adam, I felt like throwing in the towel and maybe moving to the private sector where I will at least be paid more. But something keeps me staying and sticking with the NHS. I really truly believe we get it right more times than we get it wrong.

I, for one, am glad that someone finally made the effort to make the general public more aware of what really goes on within the four walls of the hospital.

Once, someone I knew who worked in a different country shared an article written by a nurse who used to work for the NHS, and who had quit because she had gotten traumatised over the deteriorating quality of services in her hospital.

This nurse highlighted a lot of things that are true in most hospitals in the country. Its a tale of a health system that’s on its knees and a government that continues to be ignorant about its plight.

We get daily updates about Brexit negotiations but no one thinks it important to point out that patients with serious health conditions are delayed in seeing a doctor because of an A and E that’s full to bursting? Ridiculous.

Anyway, this person sharing the article erroneously thought that the nurse didn’t have the right to complain because third-world countries have the same problems and the nurses get paid even less, the message being that NHS nurses should just suck it up and get on with it like the rest of the world do.

While I acknowledge that the UK still have it better than, say, the Philippines, the fact is that the point of the article was not about salary or any kind of compensation. The article made an effort to bring to light some of the very real issues the NHS faces, and to bring it the level of something as crude as money is to take away the power of the message it was trying to get across.

What can we do to help?

That’s a question Adam Kay got asked a lot during his book tour apparently. The answer is as varied as the medical field itself.

Maybe next time you see a junior doctor who’s spent more than 24 hours on shift answering bleep after bleep after bleep, or a nurse at the end of the operating list who cannot decide whether she’s more tired or hungry, you’ll find it in your heart to offer them a KitKat.

Maybe during the next election think long and hard about who you’re voting for and ask yourself whether they are the once in a lifetime politicians that will actually care about our health services. (Something to keep in mind now that I can actually vote).

Or if you are part of the noble majority of the population that work for the NHS, maybe be a bit kinder to your colleagues. We are all on this (sinking) boat together, and we’ll hold on to it until they tell us we need to jump ship and swim.

I am extremely proud to work for the NHS, and I am extremely overjoyed that books like these exist.

5 stars.

Posted in Careers, london, Medical, Nursing

Chronicles of a theatre nurse: Chapter Two – Periacetabular Osteotomy and Hip Preservation

I was researching some images and videos over the weekend for a presentation that I had to do at work when I came across this video. Watching it and hearing testimonials from patients that have had their quality of life improved by this procedure really highlights everything about my work that I’m proud of. I also have a blink-and-you’ll-miss appearance on it!Β 

I’ve worked with Mr. Witt since I started at UCLH . I did his list twice a week every week during my first 18 months and I can really say that he’s one of the best surgeons I’ve ever met. He’s very precise and meticulous about his work. As his nurse, I find his list a challenge to manage because there are so many things to organise. Surgeons are also creatures of habit; they like consistency in the people they work with and they like their tools about them when they do their work. And you can’t really blame them because what they do is so complex, the best ones just make it look easy.

I remember when we did this video and others like it. There are usually surgeons from other hospitals watching, as Mr Witt is one of the few surgeons in London to do this kind of procedure. They called him an actor’s actor because even those surgeons aim to learn from him to improve their own technique. I have to say that I often forget that because of the stress of running his list. I forget how much of a privilege it is to see him in action. This video has reminded me why, even though I do a lot of admin now, I still make it a point to scrub for him when I can.

The procedure itself is incredibly amazing. Watch the video for a better understanding but essentially it aims to help people with developmental dysplasia, a condition in which the ball of your hip does not fully fit into the socket (acetabulum) causing it to displace; eventually these abnormal movements will cause arthritis, pain and later on, the need for a hip replacement using a prostheses.

A hip replacement, as I understand it, is not the best option for young people and that’s where PAO has helped a lot. I think the idea is to prevent the need for a THR later on in life by correcting the problem with the socket. It really is an amazing surgery. Pause it at the part where the scrub nurse is passing instruments and you’ll see me in action!Β 

This video has filled me with inspiration to tackle the work week again. I will remind myself of this feeling the next time I have to scramble for sets or wear a heavy lead gown for 8 hours. Or the next time someone asks me to call Interserve to turn down temperature in theatres. πŸ˜‰

For more information about some of the surgeries we do, visit Mr. Witt’s website.

Posted in Careers, Medical, Nursing

Chronicles of a theatre nurse: Chapter One – A day in the life

Ok, so anyone who knows me knows that I have an aversion to seeing myself on film. Photo? Sure. I’ll jump in front of a camera and strike a pose. But live action video? Aghhh. I can’t.

About 2 years ago, one of our anaesthetists asked if I could be in this short film they were doing so that people would know what its like working in our operating theatres – the highs, the lows, the challenges we face and ultimately, why we love it so much. I have to say I’ve never seen this video in its entirety. My boss recently re-posted it as part of a recruitment drive. I cringed at the thought of watching it but its actually quite good. My part in it was “engaging” and you could apparently tell I really enjoy what I do.

If I had to do this video now, would my answers be any different? Probably. Being in education poses a whole new challenge but it also comes with the sweetest rewards. One of my students just got her pin last week making her a qualified practitioner after three long years of hard work. I have another three graduating in October. Two of the staff I helped train for orthopaedics are now doing really well. There’s so much that we’ve achieved as a team and I’m so proud of the work that we do. I have that now on top of the clinical aspects which I do still love. 

Working in theatres is exciting. You never really know what your day is going to be like. You depend a lot on other people because surgery is a team effort. And I like that, I like the camarederie and rapport that comes when team members work regularly with each other. I love that I can have a laugh even when its a stressful day; I love that I’m not facing the challenges alone because I always have a team with me, both clinical- and education-wise.
Enjoy this video, blabbaholics! 

Posted in Fundraising, Medical, Nursing

Raising Money For Prostate Cancer Research: A Personal Story

A few months ago, I found out that one of the most important person (if not the most important) in my life had elevated prostate specific antigen (PSA) levels. Being a nurse, my mind immediately leapt to the worst possible conclusion. For those of you who are non-medical, this antigen is usually elevated in people with an enlarged prostate. And the reason for such an enlargement may be benign or it may be indicative of prostate cancer.

I still remember that sinking feeling in my stomach when I found out. I felt like the edges of the world had suddenly gone grey. I could not wrap my head around the idea that this person, who always seemed infallible to me, could be afflicted with the dreaded C word. Yep, 4 years of studying nursing and nearly 10 years of experience and I can’t even bring myself to say the word out loud in relation to someone I love.

The worst thing is being so far away and not being able to be personally involved in caring for him. I wanted to go to every medical check-up (to make sure he actually goes, as he is stubbornly resistant to the idea), to oversee each medication dose and to just know for sure, one way or another, so that we can deal with it. Rationally, I know that it could well be harmless; I mean elevated PSA levels are normal as a man advances in age. But I have always been something of a hypochondriac. Whenever I have a stomachache, I immediately think I’m having appendicitis. My mind just goes there. So I am now living with a certain level of anxiety until someone can tell me for sure that it is not cancer.

Look, I know that things happen. Things change. Nothing lasts forever, everyone has to go some time. But I am not ashamed to say that I’m not ready to live without this person yet okay? We don’t see each other all the time, but knowing he’s there for me to come home to, it keeps me going. Its the reason why I’m able to explore the world, go on adventures, reach for my dreams, because I know that anytime I want I have that to come home to.

This is why when my friend Dengei asked me to help him raise money for his Berlin marathon, I immediately thought of sharing my story. Its deeply personal, and I’m getting emotional writing it. But I also know that I’m able to reach more people if I write from the heart. So, here it is. My friend Dengei is running in Berlin to raise money for Prostate Cancer Research. And knowing that there are people out there who are making strides in looking for a cure, its what keeps me going. The thought that maybe, by raising enough money for research, I could be potentially helping someone I love dearly…its everything.

I wish I could run for it myself, but I’ll probably expire before I get to the finish line. But I’ll hopefully be there to cheer him on when he gets to the finish line. Thank you for doing this denj. I don’t tell you enough how proud I am of the things you do, but I know you know that I am.

If you guys want to help, follow this link. Every little bit helps. Together, we can beat this.