One of the stages of grief is anger. Maybe I am angry, maybe I am.
It is difficult to know really, I think frustrated is a better word, working in psychiatry doesn’t necessarily help this, but then I’m not sure A&E would too. I say A&E as this is what I swapped from, but actually it could be almost any speciality in the NHS, apart from perhaps pathology.
A psych letter tends to have quotes from patients in for example, John told me he was hearing voices telling him “to steal from Lidl” as well as more innocent quotes john described his mood as “all over the place” today. The rationale for doing this as opposed to just writing John gets command hallucinations (“go on steal that”) or John has an erratic mood. Is that the way they describe it can be suggestive of different mental health diseases, for example an erratic irritable mood that varies quickly over short periods is more likely to be Emotionally Unstable Personality Disorder (formerly called Borderline) but over longer periods is more likely to be bipolar affective disorder (historically called manic depression). As this is quite subtle quoting makes sense it also highlights what risks they have for example it might be best to encourage John to stay away from Lidl.
The reason for telling you this was in a recent letter that I read the patient said “I feel like I’m wasting your time” he actually went on to say “I feel like you’re wasting resources which could be better spent on other people” . The problem I was tempted to agree with him for half a second. But I wasn’t I’ll explain. Emphasising that in bold. He, like me, is perfectly entitled to NHS treatment actually, unlike me, he’s worked for most of his life, therefore has paid for his treatment, if I survive I doubt I’ll ever pay enough tax to cover it. Then it got me thinking actually he’s in the minority actually thinking that as there are tons and tons of patients who waste NHS money everyday. Those who spring to the GP when they cough once. The bed blockers… Typically “older persons” (historically called elderly until that was banned), an idiosyncratic term, because for me this incorporates anyone 28 and above. Anyway these older people who stick in bed for months and months not because they are having medical help, but that their package of social care, be that a nursing home or carers at home has not been arranged. I used to think this was typically because of obstructive families that want to keep their inheritance. Although in the case of my grandad recently leaving hospital I realised that it was mostly delays from the NHS, for example asking my mum and auntie to look around nursing homes, to see if they were suitable, which were full.
What I’m trying to say is that I am now much more wary of NHS inefficiencies, and I don’t like seeing money wasted, as my treatment depends on the NHS being able to pay for it. A recent audit by Lord Carter suggested that we’re £5 billion worth of efficiency savings that could be made. That could be accurate I’m not sure, but £5 billion is a lot of immunotherapy. For that perhaps I’d be able to consider cryotherapy and wait five years when the research has matured and the guidelines have a clearer idea of what to do. Remember it’s our NHS don’t go out of your way to abuse it, it’s inefficient enough!
The patient I’m actually talking about responded well and is getting on with his life now. However I’ve seen patients who are so wrapped up in their own paranoid delusions and hallucinations from schizophrenia they’re unable to embrace reality.
I guess what I find the hardest is seeing people waste the thing I want most of all… And that’s life. I love my life, I’ve got a job that’s secure and although my colleagues moan, well paid, and I actually enjoy it most of the time too. I’ve been a best man now! thanks Gav. Lastly, to mention her for the first time I’m well into a new relationship!!! To be fair it wasn’t what I expected when I woke up that morning. I don’t want to be too soppy on here but be assured she’s wonderful. So life can be great even when it looked so bleak. If you’re ever in this position just keep on going!!!
By the way I’ll be on Iplayer on the 21st of july 10.35pm it’s BBC one Wales so you’ll have to stream it if you want to watch it live or obviously you can catch up. The programme is called “Before I Kick the Bucket”.