As a whistleblower and a doctor, in order to survive financially, you have to be ready to do any kind of dirtbag medical work. I worked in Prisons to raise capital for the case against the GMC in 2004. I decided that I disliked the GMC more than I disliked crimimals. Actually, criminals are quite pleasant when you get to know them. The GMC aren't pleasant even when you do get to know them. Large numbers of GMC officials should be locked up and others wrongly imprisoned should be let out. This is the idea I had when I met a asylum seeker who was given a 2 year prison sentence for stealing food.
I have probably had a phenomenally varied amount of medical experience simply because I have worked many hours, in many places and under extremely bad circumstances.
Prison medicine is always dire. I only did it when I needed to raise capital. It always made me feel terrible. Healthcare is generally bad in prisons. It depends on the doctors available of course. I think prisoners deserve a better deal myself.
If male prisoners know there is a woman doctor around [ you may look like a large butch whale], they line up with one common problem " testicular pain". Of course, I am a little cleverer than your average prisoner so I managed to get away with taking a history and recalling them to a male doctor. I have worked in a number of prisons during the weekend shifts. I must say it taxed me quite badly because you honesty have to work under quite bad situations where your safety may well be compromised. Your ability to do your best for the patient is always met with obstruction by El Governor and his merry men. Healthcare is variable in many prisons. One thing is for sure, getting an emergency out of a prison and into a hospital is a feat in itself.
Prison Medicine can be quite careless. My friend Geoff Monks experienced this quite sometime ago. Geoff credits me with saving his life. His partner at the time had come running to me and begged me to write to the Prison requesting that they immediately administer medication. Without it, he would have gone into a cardiac arrest. They finally did do so after I faxed the letter.
In 2007, this letter was used by the General Medical Council to investigate me. Apparently, it wasn't good enough to save the patient, the debate was whether I should have written the word " Psychiatrist" under my name. After losing me my job during the 2007 GMC investigation, the GMC cleared me. Apparently, I could call myself a psychiatrist because I was working as one at the time. It took 6 months for the GMC to come to this conclusion. A four year old could have done it in three minutes. Geoff in the meantime was livid about the GMC abusing his data. He had told the GMC that he never wanted a complaint against me, there was no question I was a psychiatrist and that was irrelevant anyway since I acted to save him. The GMC wrote to Geoff unconcerned about the entire affair. Geoff had nothing good to say about the General Medical Council and still huffs about the manner in which he was treated.
So thats Geoff's experience of the prison service healthcare and my experience of saving a patient but then falling foul of a vexatious complaint. This is akin to the Good Samaritan Act. No good deed goes unpunished as they say.
Another tale terror commenced when I was called to the medical block of a well known prison on a cold winters night. The man was listed as a murderer and therefore on high security. You can read all about prisons here.
The patient also had substantial problems. It is a sad fact of life that no one had read his blood results for weeks. They kept coming and being filed. His renal function had been deteriorating considerably. He needed to be in hospital. Just by looking at him and examining him, you could tell his blood gases were not going to be normal at all. He was deteriorating, had a raging Urinary Tract infection and was just left. I was called because he insisted on seeing a doctor. He had been insisting on seeing a doctor for 7 hours.
I suspect the prison was just hoping he would die. The next issue was trying to get him to an accident emergency. El Governor was not a happy man when I requested a transfer. He moaned about shortages of staff and how he didn't have the manpower to allow this patient to go to the hospital. He then wanted me to jusfify why he had to be sent. So, being a polite kind of person during workhours, I told him this
The patient in the meantime was smirking to himself while I got him ready for the ambulance. Trying to find his darned slippers was a feat. I wrapped him up in various bits of clothes and told him that at his age, he didn't want to get pneumonia. By the time I finished, he looked like a large ball. Well, at least I knew he wouldn't get cold in the journey and then in Accident Emergency while he was waiting to be seen.
He told me :-
It was a surreal experience having a murderer have a fairly normal conversation with you and then waving good bye.
So for a murderer, he was fairly polite and rather more amenable than El Governor. The El Governor just required a little nudge. Not really sure why governors tend to be gruffingly large creatures with a howling booming voice but there we go. HMP must train them that way on some kind of super marmite diet supplied by the Home Office.
I have probably had a phenomenally varied amount of medical experience simply because I have worked many hours, in many places and under extremely bad circumstances.
Prison medicine is always dire. I only did it when I needed to raise capital. It always made me feel terrible. Healthcare is generally bad in prisons. It depends on the doctors available of course. I think prisoners deserve a better deal myself.
If male prisoners know there is a woman doctor around [ you may look like a large butch whale], they line up with one common problem " testicular pain". Of course, I am a little cleverer than your average prisoner so I managed to get away with taking a history and recalling them to a male doctor. I have worked in a number of prisons during the weekend shifts. I must say it taxed me quite badly because you honesty have to work under quite bad situations where your safety may well be compromised. Your ability to do your best for the patient is always met with obstruction by El Governor and his merry men. Healthcare is variable in many prisons. One thing is for sure, getting an emergency out of a prison and into a hospital is a feat in itself.
Prison Medicine can be quite careless. My friend Geoff Monks experienced this quite sometime ago. Geoff credits me with saving his life. His partner at the time had come running to me and begged me to write to the Prison requesting that they immediately administer medication. Without it, he would have gone into a cardiac arrest. They finally did do so after I faxed the letter.
In 2007, this letter was used by the General Medical Council to investigate me. Apparently, it wasn't good enough to save the patient, the debate was whether I should have written the word " Psychiatrist" under my name. After losing me my job during the 2007 GMC investigation, the GMC cleared me. Apparently, I could call myself a psychiatrist because I was working as one at the time. It took 6 months for the GMC to come to this conclusion. A four year old could have done it in three minutes. Geoff in the meantime was livid about the GMC abusing his data. He had told the GMC that he never wanted a complaint against me, there was no question I was a psychiatrist and that was irrelevant anyway since I acted to save him. The GMC wrote to Geoff unconcerned about the entire affair. Geoff had nothing good to say about the General Medical Council and still huffs about the manner in which he was treated.
So thats Geoff's experience of the prison service healthcare and my experience of saving a patient but then falling foul of a vexatious complaint. This is akin to the Good Samaritan Act. No good deed goes unpunished as they say.
Another tale terror commenced when I was called to the medical block of a well known prison on a cold winters night. The man was listed as a murderer and therefore on high security. You can read all about prisons here.
The patient also had substantial problems. It is a sad fact of life that no one had read his blood results for weeks. They kept coming and being filed. His renal function had been deteriorating considerably. He needed to be in hospital. Just by looking at him and examining him, you could tell his blood gases were not going to be normal at all. He was deteriorating, had a raging Urinary Tract infection and was just left. I was called because he insisted on seeing a doctor. He had been insisting on seeing a doctor for 7 hours.
I suspect the prison was just hoping he would die. The next issue was trying to get him to an accident emergency. El Governor was not a happy man when I requested a transfer. He moaned about shortages of staff and how he didn't have the manpower to allow this patient to go to the hospital. He then wanted me to jusfify why he had to be sent. So, being a polite kind of person during workhours, I told him this
" Mr X, this patient has been deteriorating for 4 weeks. The blood results have gone unnoticed. He has a urinary track infection with phenomenally high urea and creatinine. His potassium is rising and is already abnormal. If this man is not taken to accident emergency within the next hour, he will be dead. This will increase the death rate in this prison. You will recall the recent suicide death criticised by the newspapers last week. According to the records, 7 people have died in the last 5 days. I look forward to an officer to escort this gentleman and I am just about to call 999. Do I assume I have your permission sir?
"How did you know all about all that?," said El Governor
"I read the paper with the prisoners his morning and they told me about it," I calmly told him.
He shouts down to his colleague
"John get the Prisoner 415 an escort for accident emergency".
I then said " Thankyou El Governor. I am most appreciative of your assistance".
The patient in the meantime was smirking to himself while I got him ready for the ambulance. Trying to find his darned slippers was a feat. I wrapped him up in various bits of clothes and told him that at his age, he didn't want to get pneumonia. By the time I finished, he looked like a large ball. Well, at least I knew he wouldn't get cold in the journey and then in Accident Emergency while he was waiting to be seen.
He told me :-
"You told him didn't ya". Bet he ain't had a woman talk like that to him for years. Thanks doc, you saved my bacon".I waited until the ambulance came. Paramedics are always great. I gave them my detailed summary letter, listing his millions of drugs, his allergies and his blood test results. I then had to summarise the issue for them. I told them that he already had IV access because I had done it for them with a green venflon. He needed some fluid infused slowly and his main risk was high potassium. It needed to be reduced immediately in Accident Emergency to prevent a cardiac arrest. His ECG done with the paramedics showed the usual findings in someone with hyperkalaemia. These peaked T waves and widening QRS complexes were not looking good. Luckily, he was an asthmatic who was wheezing. I thought, great, Salbutamol nebuliser will temporarily lower his potassium until the doctors get to him. So, we fixed him up and wrapped the paramedics blanket around him. The strapping tall paramedics took him in the ambulance and I followed. He was finally looking a little better despite the wait while there was paperwork clearance. In that period, the monitor showed the peaked T waves decreasing slowly while the nebuliser was at work for a while. This was one of those tricks you learn while trying to sort emergencies out. At least this was a temporary fix for a few hours while they got him a more permanent solution.
It was a surreal experience having a murderer have a fairly normal conversation with you and then waving good bye.
So for a murderer, he was fairly polite and rather more amenable than El Governor. The El Governor just required a little nudge. Not really sure why governors tend to be gruffingly large creatures with a howling booming voice but there we go. HMP must train them that way on some kind of super marmite diet supplied by the Home Office.
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