06 June 2011

A Threesome on the NHS

Three books on special offer — perhaps a ‘3 for 2’ sort of deal, but if it was, I’ve removed the stickers; I don’t want casual visitors thinking I’m cheap.
The three books all about working in the NHS; two of them are blogs or diaries, the life of a very junior doctor and life as an Accident and Emergency doctor. These are accurate enough, though the A&E doctor does rant on a bit about the inefficiencies of the NHS. There is nothing particularly literary about them — and there do seem to be lots of similar titles in the ‘Confessions’ style. A way to waste a couple of hours reading them, but I didn’t get much out of them.
The third is quite different. Direct Red by Gabriel Weston is a short book of short stories, fictionalised things that happened to her during her training to become an ENT surgeon. I heard it on the radio, but didn’t realise that Gabriel is female — I thought that it was a boys’ name. Anyhow, she’s taken an unusual route to medicine; she studied English Literature at Edinburgh, then qualified in medicine through a ‘fast track’ programme for arts graduates. She does seem to have gone through this rather slowly.
There’s no doubting the accuracy of her medical descriptions (I didn’t find any errors!), but operations etc aren’t the point; she describes feelings of how it is to be involved with procedures, operations and people, and how she reacts to them. Medicine sets a scene, but doesn’t overwhelm. It’s not an autobiography, more a series of vignettes, related only by her passage through the ranks.
I can empathise with a lot of her descriptions; the consultant who asks the same questions during every operation — yes, I plead guilty, though I like to think I caught myself on, and changed the questions — at least when I realised that the chaps had the answers off pat.
I did think that some descriptions of other female surgeons were if not harsh, then critical. Not critical of their abilities, but of their personalities — though this is as much a cultural thing. I have the feeling that English surgeons are much more arrogant than people I’ve known in Ireland, though perhaps we are more sexist. I didn’t recognise some of the bitchy things that both male and female surgeons said to her; then again, perhaps my anima isn’t well enough developed for me to be able to appreciate them.
There’s a wonderful description of ‘JFDI’. We’ve all been there, we know how it feels, and she captures the feeling exactly. What she doesn’t (yet) capture is the feeling that ‘Sir’ or ‘Miss’ waiting outside has, on the one hand having to let the trainee proceed unaided, but on the other the awful wondering if help should be offered, and if so, would it be psychologically damaging. And only getting second-hand descriptions from the nurses about how things are going, and not being sure just who is being reassured.
I have wondered for quite a while if the way we ‘educate’ medical students is as good as it’s supposed to be. Much of it seems more a test of memory, recall of largely irrelevant facts for the examinations — and I’ve also wondered why it was necessary to have to relearn all this for the post-graduate examinations. I used to try to provoke people by describing medical training as being no better than learning brick laying at a FE college. You get to know lots of facts, you get to see lots of people, but what you don’t get is educated in the sense of constructing an argument or of having to write an essay. I’d never heard of the ‘necessary of sufficient’ type of argument during my training, and I’ve never met any other consultant who has. To my mind, university is where you go to be educated (and socialised, and to find yourself — you know exactly what I mean) — it’s not a crammers. Doctors, I feel, have missed out on this in general, yet have the concept that because they know a lot more about how people work this entitles them to pronounce as authority figures. It’s common enough to see this thinking in presentations from people who ought to know better, but don’t seem to. The ability to think is something that wasn’t emphasised when I was a student, and I guess it still isn’t. You could call it the difference between education and training.
If I were to study medicine again, I’d start with an arts degree in something unrelated, and then ‘fast track’. And I’d combine this with a better idea of what speciality I’d choose long before I’d chosen it. More processed in this choice you might say, but I’d respond by saying that I’d be more balanced when I qualified, more mature and more capable of making a reasoned choice.
Back to Ms Weston; she’s taken the advice to write about what she knows, in her case herself and her profession. Hers is a literary work, from someone involved who can still stand back and think.
So, get the finger out and JFDI. Read it.

No comments:

Post a Comment