I recall those days because I wrote about it in the Student BMJ on many occasions. 6 years at medical school was tough on a student grant and multiple loans to survive. I am by no means the only person to experience this but I believe the public always has a preconceieved idea that doctors were born with a silver spoon in their mouth. They also believe that we do not have personal problems, that we have never experienced any disaster and that we are superhuman. This is also the falacy that exists within the media. Every journalists thinks that all doctors are rich. Infact, junior doctors are some of the poorest in the population.
As time as progressed, the government has ensured that only the well off manage through medical school now. Assistance has always been bad for people in poorer backgrounds. It is though important to understand that it is the students from working class backgrounds that make the better doctors. I say this because 90 percent of patients are from the poorer or working class backgrounds. Public Health studies show that disease is associated with poverty, social class etc etc. It would be natural to encourage a cross sectional medical profession that has some understanding of different people. It should also narrow the divide between doctor and patient and make it into a partnership to ensure wellbeing rather than a " them and us" culture.
The basic and fundamental problem relating to senior doctors is that they are mostly from very well off backgrounds and have no concept of the working class or the problems they experience. Most doctors like this have a "position to maintain" or believe in the " stiff upper lip". The problem with these two concepts is that it doesn't solve the practical problems on the floor. I am not critical of all doctors who are from well to do backgrounds. I can simply speak from experience and the fact that good medical care is achieved by good communication and information delivery. I never blow my own trumpet save to say that I like to think that the compliments recieved from all my patients during the 10 years I was in medicine was due to my background and the fact I was able to know instinctly what the patient required - I was reputed as a problem solver. It isn't enough for doctors just to dish the medication. Doctors should be there to solve the problems that affect their lives. I believe I have solved a lot of problems from financial, debt, divorce to problems with animal care that has distressed the patient. Small pieces of informations such as support groups or short pieces of advice on financial management is often useful and prevents relapses of a number of mental health conditions. And the good thing about the 3D management of patients is that the General Medical Council cannot pin a thing on you. The GMC doesn't like to admit this but in all the years they have tried to instigate procedures against me, develop their insane vendetta against me, collect what I write, they have never ever recieved a complaint from any of my patients. There is a reason for that of course, that is because my patients always felt I was good at my job. And that is an uncomfortable reality for both North Staffordshire NHS Trust and the General Medical Council.
As with most junior doctors in 1998, I passed my exams and ended up looking at my bank balance and having that " heart sinking effect". When I started in North Staffordshire NHS Trust, the pay was not that great considering you busted a gut on the 110 hour weeks. I had a £30,000 debt. I had family to support and every week I had about £50 spending money which is about the same as someone who is unemployed. When the Trust cut my finances over two three months following the whistleblowing episode, I had nothing. They tilted my debts into an emergency situation. The problem with financial disaster is that it causes worry for sometime.
This causes a great deal of distress in many junior doctors but its important to remember that "its only money". In the end, that is all it is and there are worst disasters in life. I came to a point where it became so bad that I gave up worrying. I just lived on day at a time. The thing about poverty is this - it becomes a way of life and even though it is concerning there is a certain happiness that is bourne out of simplicity. Money is one of those commodities that causes complexities.
After I returned to Birmingham in February 1998, I worked at my day job in Selly Oak Hospital, went off to Coventry to locum on some nights and returned back in the morning to the day job again. The weekends were spent on one locum or another. I actually cannot remember much of those months because all I did was function much like a robot earning money to survive, to make up for the hell North Staffordshire NHS Trust put me through.
Walsgrave Hospital in Coventry always treated me very well. I did their oncalls and they allowed me to sleep in the spare bed. The nurses made me breakfast and it was the highlight of my day. I do recall once completing a shift at Selly Oak Hospital, handing it over and walking towards my car only to find it clamped in the hospital car park. It was a Friday night and I was off duty. I had no energy, no money to catch the bus and no brain power to deal with the parking attendants and hospital management. At the time, Selly Oak had been abusing my good nature and my past and forcing me to do their pathetic surgical waiting list pre-op clerkings. Basically, I sat on the pavement next to my Renault clio and fell asleep. That was until my family came looking for me, bundled me up and took me home.
The good thing about North Staffordshire NHS Trust is this - it made me into a person who can actually work for hours and hours without any rest. It also made my brain function at a fairly high level despite staying away for hours on end. Stamina is important - it is important to train yourself to cope with anything the world hits you with. For that, you require determination, coping strategies and willpower. I found that of use when I was in financial trouble and had to work harder than the average doctor. I also found it useful when I fought the GMC. The GMC had its entourage of lawyers, against just me. During 2004, I didn't sleep. I worked, I earned money to pay for my litigation against the GMC and all night I wrote letters responding to the GMC lawyers while eating chocolate and playing loud music. Fighting the GMC is much like a race. They pull every trick in the book and basically if you aren't faster than them, you fail. As a doctor, you have to remain awake, astute and you have to act fast. The same principles apply to fighting the General Medical Council. Many people do ask me how I did manage to be the first doctor to beat the GMC in a civil application in 2004. Most people think I had the money, or I had the backup. In truth, I didn't have any of those things at the time. I simply had my brain, I had my ability to work hard and I had the principle I believed in. That is all I had when I issued the claim against them.
I still recall the cackling laughter of the GMC barrister Ms Collier who told the courts initially that I should be denied legal representation because as a mere junior doctor I could never afford counsel therefore should not have the opportunity to be allowed counsel. She was right, at that time, I couldn't but this did not mean I would never do so.
There was a few weeks between the first hearing and the last hearing. I have this motto " It ain't over till its over and it ain't over till the fat lady sings, and even when the fat lady sings there is always another fat lady waiting to sing" In that time, I decided Ms Collier required a taste of her own medicine. I called it "payback time". I didn't like her cackling, I didn't like her attitude and she may have been a barrister, but I was a doctor and as a doctor, I could make an emergency situation survive. We were in ITU territory case wise and we needed some good strong medicine. Ms Jane Collier needed to know that not everyone is a walkover.
So I set about earning money, I worked hard, sold what I had and obtained £30,000. Earning that sort of figure in a few short weeks is extremely difficult but I did. With the finances, I paid my solicitor and I paid for leading silk. Leading silk to you and me is Queens Counsel. I knew little about barristers during that phase of life. I though knew that Queens Counsel had the reputation of being excellent at their job, excellent in advocacy and often very good looking. The "good looking" part is useful in court believe me. Three days before the next hearing, Robert Jay QC unveiled himself to the other side. You could hear the squeals from here to eternity from the GMC. They may have had nice expensive folders and we may have had cheap Staple black folders but we had Silk. Money bought Robert Jay QC and Robert Jay purposely took his lectern and placed it one step in front of Jane because in his view, we all wanted to know who was boss. QCs advocate on the bench in front of junior barristers by the way. It was actually a joke between all of us but this court tactic amused us no end. In court, Jane Collier, stamped her feet, squealed at the judge and demanded an adjournment. It was all denied. Fate had reversed itself back onto Jane Collier and the General Medical Council. And that is what the GMC gets if they start being mean. The GMC are mean, very mean. Infact, no one will have met anyone just as mean as the GMC. They believe in the engagement of suffering. Infact, that is what they had hoped to engage against me. As I say, I am sure they would all laugh on my grave if I was dead. It would be convenient to them but not convenient to me. In my view, they may have made me fat, they may have driven me to chocolate, they may have taken all my money away, they may have taken away all I had worked for - but they were never going to take me away. That was my policy and that is why money although important is not all that important when it means crossing over to the dark side as the GMC clearly have.
Robert Jay QC was excellent in court. My bank balance at the time in 2004 was £500 overdrawn and no limit above that. My sister had to buy me my regular Hello and Now magazine which I hid under the court papers and secretly read while Jane Collier was crowing away about my typographical error on paper being "evidence of mental illness". Richard Price, my solicitor and I played hangman through the hearing. We sat there poking fun at Jane Collier all the way through. I whispered to my sister and partner " Damned stalinist regime they are, obviously didn't have their three shredded wheat today".
Right into that hearing, the judge started to call the GMC a " Totalitarian regime". Hangman stopped, the Now magazine fell off the table onto the floor [ With Richard Price saying " God, Rita, pick it up, you have to appear to be a well behaved doctor and not read about Paris Hilton"], we all sat up bolt upright and I choked on my jelly baby that Richard had stashed in my hand. And there it was, the judiciary had accused the GMC of everything I had done a week before and now. I didn't see anything wrong with reading "chick lit" myself. Chick lit was good because it reminded me that I was no odder than the rest of the 90 percent of the world. Anyway, Jade Goody made lots of typographical errors and still coped. In my view, money that day could have been useful because the only difference between me and Paris Hilton was the fact she had money and didn't have to be a doctor, I had no money and had to fight to keep my livelihood and worst still had to fight the GMC with large amounts of money justifying why a typographical error did not mean I was mentally ill. £30,000 for that. That's the reason I read Hello and Now. Making sense of the world in relation to the court hearing was important to me. Each of Paris' earrings cost £30,ooo so what was one typographical error and £30K? It was all about perspective after all.
60 percent of women read tat, besides having read medical books and worked so hard hadn't got me anywhere apart from in a court. In court, I realised that the world isn't a fair place and it certainly wasn't fair to me. Thats what happens to working class people - they go from one catastrophy to another and in the end they live within catastrophes and accept it. It is always the working class that have principles because the rich never need principles because they have money.
Robert Jay QC was worth the finances we paid him. He also happened to be good looking which helped a great deal. I cannot deny that Robert Jay QC had a good backside because both my sister and I commented on it while sitting behind him. Anatomy was important. It was important when there was nothing else to look forward to on that day. There was also nothing else to look forward to because the GMC had removed it all. We also have to say that he was debonair and dashing with all his paperwork. Robert floated in court and floated out again. Basically, Robert floated, period.
It was a fabulous day in court. One of the best and one we will never forget. Of course, the GMC is of the view that they would have won on appeal but they didn't appeal and neither did they win that day. They lost because in the end some people are losers, some people are lethargic and some people are winners. In the end, they had to face the fact that a very junior whistleblower had beaten them in court, had made them look a fool, had masterminded the entire tactical maneuvres in court and had the audacity to eat chocolate while doing so. In the end, it was the first win of that kind in the history of the General Medical Council. Ben Emmerson QC reputedly fell of his chair when he heard that the GMC had been sued. Then those were the days when you think " Well, I have nothing to lose, I am going to read the law books, come up with the claim and walk into court". As young people we are often daring, sometimes brave and sometimes reckless and brave. It is that one occasion that moves like that can be pulled off successfully.
That of course did not teach them the lesson that was vital - never abuse a junior doctor because one day they might just return and start a Punch and Judy show. This specific Punch and Judy show was over for now. It is though always interesting to study the fact that the General Medical Council had no sense of morality, humanity, courtesy, respect or sense of upholding the standards of the profession. It quite happily colluded and fought in support of North Staffordshire NHS Trust. I know at the time, the GMC loved to threaten me with "costs" each time the tough got going against them. Prior to the last hearing in 2004 they tried to make my legal team run by threatening "costs". I instructed my lawyers to take themselves into court and stop being "wussy". I like that word. It is true they all initially gibbered but some people stay on the side lines, some people procrastinate and some people take action. I was a doctor, I believed in action. Inaction for me meant patients could die, I took action, I made the decision and the buck stopped with me.
Money on that occasion bought the best. The best in the end won against the GMC that day. Even though litigation always concerns money, sometimes justice can be obtained. Sometimes, and very rarely miracles do happen. The important thing in life is not the actual winning but doing your best with the intention to win. So when people ask me whether money is important, I say, it is important to live, to win and to buy chocolate but when money becomes your prime focus in existence that is when you tread the path of the dark side and that is when you dissociate from the values that matter. The dark side is of course seen in North Staffordshire NHS Trust and the General Medical Council. Money, fame and reputation is all they value hence no one has any respect for them. The only respect that exists is the delusional belief in their own self importance. That in the end will result in their downfall because they have both lost all that is valued by people. One cannot blame them, after all it is an evolutionary adaptation in the tough financial driven world of the NHS. To them, money matters more than lives of patients. For me, money is indeed funny in a rich man's world.
Related Links
1. Doctors Supportline
2. Royal Medical Benevolent Fund
For my friends Andrea, Shom and all those in 1992 when we all played ABBA in Fitzroy Square in the Summer.
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