This article is from the source 'guardian' and was first published or seen on . It last changed over 40 days ago and won't be checked again for changes.
You can find the current article at its original source at https://www.theguardian.com/books/2017/aug/03/rachel-clarke-your-life-in-my-hands-interview
The article has changed 9 times. There is an RSS feed of changes available.
| Version 1 | Version 2 |
|---|---|
| Rachel Clarke: 'Right Mr Hunt, you’re coming with me' | Rachel Clarke: 'Right Mr Hunt, you’re coming with me' |
| (6 days later) | |
| It was Christmas Eve 2009, and Rachel Clarke was desperate to leave on time. She had only been working as doctor in the NHS for four months and had two small children at home so she worked hard, aiming to make a rare exit on time at 5pm. Then a scan revealed one woman’s cancer had spread and Clarke had to tell her that she was going to die. A former nurse, the patient asked Clarke not to sugarcoat the news. She didn’t. At the end of a long conversation, the woman asked if Clarke would come back later to speak to her husband. Clarke said yes. | It was Christmas Eve 2009, and Rachel Clarke was desperate to leave on time. She had only been working as doctor in the NHS for four months and had two small children at home so she worked hard, aiming to make a rare exit on time at 5pm. Then a scan revealed one woman’s cancer had spread and Clarke had to tell her that she was going to die. A former nurse, the patient asked Clarke not to sugarcoat the news. She didn’t. At the end of a long conversation, the woman asked if Clarke would come back later to speak to her husband. Clarke said yes. |
| Five came and went. Part of Clarke was impatient to go home, but instead she went to the patient’s room and spoke to her and her husband. Both were crying. The woman’s family was coming for Christmas and she wanted to know if Clarke thought she could wait to tell them, so they could enjoy the holiday. Rachel shared her thoughts and when she went to leave, an hour later, the woman asked her to lean over the bed. She kissed Clarke on the cheek and said: “Thank you. This has been my Christmas present.” | Five came and went. Part of Clarke was impatient to go home, but instead she went to the patient’s room and spoke to her and her husband. Both were crying. The woman’s family was coming for Christmas and she wanted to know if Clarke thought she could wait to tell them, so they could enjoy the holiday. Rachel shared her thoughts and when she went to leave, an hour later, the woman asked her to lean over the bed. She kissed Clarke on the cheek and said: “Thank you. This has been my Christmas present.” |
| “It was obviously a horrendous Christmas, but it was good that she had that conversation. I’ll never forget it,” Clarke says, eight years later. “I wanted to cry. But she needed it. Anyone who is hospital might be facing the most frightening, humiliating, hopeless situation ever. It’s not always bad, sometimes they’re having babies or getting an all-clear. But it is always a moment out of time for that patient. And it is a total privilege to be part of it.” | “It was obviously a horrendous Christmas, but it was good that she had that conversation. I’ll never forget it,” Clarke says, eight years later. “I wanted to cry. But she needed it. Anyone who is hospital might be facing the most frightening, humiliating, hopeless situation ever. It’s not always bad, sometimes they’re having babies or getting an all-clear. But it is always a moment out of time for that patient. And it is a total privilege to be part of it.” |
| While Clarke’s enthusiasm for her work is infectious, her polemical memoir Your Life in My Hands reveals the gap between those who dream of being a doctor and the real life experience. The book follows Clarke through eight bruising years of working in the NHS, witnessing systemic degradation of Britain’s most valued public service firsthand. She tells the story of 17-hour days and 70-hour weeks, complete with fountains of blood, Kafkaesque bureaucracy, and the constant struggle with limited resources (one ward is referred to by colleagues as “Beirut” due to its condition). | While Clarke’s enthusiasm for her work is infectious, her polemical memoir Your Life in My Hands reveals the gap between those who dream of being a doctor and the real life experience. The book follows Clarke through eight bruising years of working in the NHS, witnessing systemic degradation of Britain’s most valued public service firsthand. She tells the story of 17-hour days and 70-hour weeks, complete with fountains of blood, Kafkaesque bureaucracy, and the constant struggle with limited resources (one ward is referred to by colleagues as “Beirut” due to its condition). |
| At one point, Clarke and her husband calculate the financial cost of her job – by working, she is losing the family £5,000 a year (in childcare and transport). But Clarke unashamedly loves her work, while refusing what she calls “the notion of medical vocation as self aggrandising clap-trap.” It’s still hard not to wonder why anyone would want to be a doctor after reading her book. “Yes,” she says soberly, then flashes a sudden smile. “Maybe it should be compulsory for any sixth formers thinking about medical school?” | At one point, Clarke and her husband calculate the financial cost of her job – by working, she is losing the family £5,000 a year (in childcare and transport). But Clarke unashamedly loves her work, while refusing what she calls “the notion of medical vocation as self aggrandising clap-trap.” It’s still hard not to wonder why anyone would want to be a doctor after reading her book. “Yes,” she says soberly, then flashes a sudden smile. “Maybe it should be compulsory for any sixth formers thinking about medical school?” |
| Descended from four generations of doctors, Clarke is gentle and friendly, with sudden bursts of assertive eloquence – evidence of a well-honed bedside manner. An ex-journalist who reported from danger areas around the world, she shows flashes of being an adrenaline junky. After telling me a story about another terminal patient thanking her for her help, she says: “I mean, it’s not exciting, it’s not like restarting a heart.” She admits she’s “addicted” to saving lives: “It is a class-A drug type of reward. It is like skiing down a black run or jumping out of a helicopter, [but] it is not sustainable in the long term. It is the smaller, less dramatic moments in medicine that sustain the soul.” | Descended from four generations of doctors, Clarke is gentle and friendly, with sudden bursts of assertive eloquence – evidence of a well-honed bedside manner. An ex-journalist who reported from danger areas around the world, she shows flashes of being an adrenaline junky. After telling me a story about another terminal patient thanking her for her help, she says: “I mean, it’s not exciting, it’s not like restarting a heart.” She admits she’s “addicted” to saving lives: “It is a class-A drug type of reward. It is like skiing down a black run or jumping out of a helicopter, [but] it is not sustainable in the long term. It is the smaller, less dramatic moments in medicine that sustain the soul.” |
| Why does our health secretary care so much about the deaths that suit his agenda, and not a jot about the others? | Why does our health secretary care so much about the deaths that suit his agenda, and not a jot about the others? |
| Which brings us back to kindness, of which Clarke has a seemingly endless stock. Her story of the woman on Christmas Eve is not in the book, because she worried it would seem like boasting (“Any doctor and nurse would do the same thing.”) But there are others that made the cut: fighting to get a terminal patient a space in a hospice, then buying whisky for the hospice’s drinks trolley in his memory; breaking bad news with striking tenderness. | Which brings us back to kindness, of which Clarke has a seemingly endless stock. Her story of the woman on Christmas Eve is not in the book, because she worried it would seem like boasting (“Any doctor and nurse would do the same thing.”) But there are others that made the cut: fighting to get a terminal patient a space in a hospice, then buying whisky for the hospice’s drinks trolley in his memory; breaking bad news with striking tenderness. |
| But ever present in Your Life in My Hands is Clarke’s fear that if the NHS is stretched any more, doctors will no longer be able to maintain the compassion and empathy that, on the whole, drew them to medicine. And stretched it is: with £22bn “efficiency savings” demanded by 2020, the NHS is not going to get the estimated 6,000 doctors and 40,000 nurses it needs to run safely any time soon. | But ever present in Your Life in My Hands is Clarke’s fear that if the NHS is stretched any more, doctors will no longer be able to maintain the compassion and empathy that, on the whole, drew them to medicine. And stretched it is: with £22bn “efficiency savings” demanded by 2020, the NHS is not going to get the estimated 6,000 doctors and 40,000 nurses it needs to run safely any time soon. |
| The spark behind the book came in 2015, when health secretary Jeremy Hunt announced his decision to impose new terms and conditions on the NHS’s 53,000 junior doctors in England. His plan to introduce a seven-day NHS service was to spread existing resources further without investing in new staff – putting huge pressure on the current workforce. Angry protests sparked across the country, with 98% of junior doctors supporting the eight strikes that followed. | The spark behind the book came in 2015, when health secretary Jeremy Hunt announced his decision to impose new terms and conditions on the NHS’s 53,000 junior doctors in England. His plan to introduce a seven-day NHS service was to spread existing resources further without investing in new staff – putting huge pressure on the current workforce. Angry protests sparked across the country, with 98% of junior doctors supporting the eight strikes that followed. |
| For Clarke, she was “acutely politicised overnight”. “It hurt so badly because I would have been better off if I quit my job completely,” she says. “I could see the government spin machine was running rings around doctors and [doctors’ union] the BMA, dictating this narrative about overtime with no relation to what we were upset about. I felt duty bound to help.” So she became a public face for the strikers: conducting TV interviews from her living room, balancing appearances on the news with medical shifts, staging a 24-hour sit-in outside the Department of Health in London to protest against plans for tough new contracts for junior doctors. | For Clarke, she was “acutely politicised overnight”. “It hurt so badly because I would have been better off if I quit my job completely,” she says. “I could see the government spin machine was running rings around doctors and [doctors’ union] the BMA, dictating this narrative about overtime with no relation to what we were upset about. I felt duty bound to help.” So she became a public face for the strikers: conducting TV interviews from her living room, balancing appearances on the news with medical shifts, staging a 24-hour sit-in outside the Department of Health in London to protest against plans for tough new contracts for junior doctors. |
| “We have a duty of candour in the NHS, we have to speak about mistakes and dangers,” she says, of her decision to go to the media. “I found it breathtakingly cynical that the government said stretching five days of the NHS over seven was safe. It was never party politics. I don’t care what party Jeremy Hunt is from. I care profoundly about protecting my patients. And people are being failed by the NHS because the NHS is being failed by the government.” | “We have a duty of candour in the NHS, we have to speak about mistakes and dangers,” she says, of her decision to go to the media. “I found it breathtakingly cynical that the government said stretching five days of the NHS over seven was safe. It was never party politics. I don’t care what party Jeremy Hunt is from. I care profoundly about protecting my patients. And people are being failed by the NHS because the NHS is being failed by the government.” |
| Despite the strikes, in February 2016 Hunt announced he would impose the contract. Clarke believes that the public mostly sides with the doctors, despite the strikes, “as many of them are NHS patients and see how hard we work”. | Despite the strikes, in February 2016 Hunt announced he would impose the contract. Clarke believes that the public mostly sides with the doctors, despite the strikes, “as many of them are NHS patients and see how hard we work”. |
| “And crucially, after the strike was over,” she says darkly, “subsequent events proved we were right.” | “And crucially, after the strike was over,” she says darkly, “subsequent events proved we were right.” |
| Over the winter, the NHS almost collapsed under a larger than expected increase in patient numbers, with some being left for hours in corridors; at least two patients are known to have died there. The Red Cross declared a “humanitarian crisis” in England’s hospitals and the chair of the House of Commons health select committee Sarah Wollaston – a former GP – responded: “This is not equivalent to Syria or Yemen.”) Clarke says it is proof that Hunt’s strategy – to increase service without increasing spending – will never work. “You can’t magic up a seven-day service from an NHS only funded for five. You need to resource it and staff it. And nowhere in Hunt’s plan was there a single pound of funding or a single extra doctor or nurse. It was all rhetoric.” | Over the winter, the NHS almost collapsed under a larger than expected increase in patient numbers, with some being left for hours in corridors; at least two patients are known to have died there. The Red Cross declared a “humanitarian crisis” in England’s hospitals and the chair of the House of Commons health select committee Sarah Wollaston – a former GP – responded: “This is not equivalent to Syria or Yemen.”) Clarke says it is proof that Hunt’s strategy – to increase service without increasing spending – will never work. “You can’t magic up a seven-day service from an NHS only funded for five. You need to resource it and staff it. And nowhere in Hunt’s plan was there a single pound of funding or a single extra doctor or nurse. It was all rhetoric.” |
| During his campaign, Hunt alleged that poor care on weekends resulted in 11,000 “excess deaths” a year. “There are avoidable deaths every day of the week, because of underfunding,” Clarke says incredulously. “Those people died on those trolleys in January because they were languishing. Why does our health secretary care so much about the deaths that suit his agenda, and not a jot about the others happening on other days?” | During his campaign, Hunt alleged that poor care on weekends resulted in 11,000 “excess deaths” a year. “There are avoidable deaths every day of the week, because of underfunding,” Clarke says incredulously. “Those people died on those trolleys in January because they were languishing. Why does our health secretary care so much about the deaths that suit his agenda, and not a jot about the others happening on other days?” |
| The book ends with Hunt and Clarke meeting in a tiny parliamentary office; he tells her: “I have totally failed to communicate with junior doctors and I have torn my hair out trying to think how I could have done it differently and better.” But, while they have the same goal – more staff across the NHS – their prescriptions are polar opposites: spending more, versus spending nothing. | The book ends with Hunt and Clarke meeting in a tiny parliamentary office; he tells her: “I have totally failed to communicate with junior doctors and I have torn my hair out trying to think how I could have done it differently and better.” But, while they have the same goal – more staff across the NHS – their prescriptions are polar opposites: spending more, versus spending nothing. |
| She says: “I almost want to take him by the scruff of the neck and say, ‘Right Mr Hunt, you’re coming with me and you’re going to A&E to spend the night with a registrar and you will watch what it is like, the faces of the paramedics who are trapped outside the hospital because they can’t hand over their sick patients without a bed’.” | She says: “I almost want to take him by the scruff of the neck and say, ‘Right Mr Hunt, you’re coming with me and you’re going to A&E to spend the night with a registrar and you will watch what it is like, the faces of the paramedics who are trapped outside the hospital because they can’t hand over their sick patients without a bed’.” |
| Has she sent him her book yet? She laughs. “I haven’t, but I imagine he preordered a copy.” | Has she sent him her book yet? She laughs. “I haven’t, but I imagine he preordered a copy.” |
| Your Life in my Hands is published by John Blake Publishing | Your Life in my Hands is published by John Blake Publishing |