Bad Case of Loving You

Andrew was sitting at a table of doctors, all of them involved in an intense conversation, with their heads pressed close together, when I walked past at lunch time, but he looked up and smiled at me. “Blake,” he said, and he nodded at an empty chair.

I sat down, papers, empty pear tin and olive jar in my hand, and wondered if he’d recognise them as being from his cupboards. Hopefully I’d get a chance to ask him about the assignment. Evidence-based medicine struck me as something else that Andrew would have opinions on. I suspected he was actually composed almost entirely of opinions. And submission.

Everyone else ignored me and went back to their conversation, apart from Dr. Seagate, who I recognised from the BMA meeting. He stared at me for a moment, until someone in scrubs threw a marshmallow at him to get his attention.

“…wider responsibility,” the man in scrubs said. “As members of the profession, we’re looking at a question of the greater good.”

“Greater good is shit,” Andrew said. “Our primary responsibility is to our patients right this moment. Not to the ones that will come later, not to other people’s patients.”

“If this is an NHS-wide crisis, then aren’t we compelled to take action?” a woman asked.

“Given that I trained in a system where there was minimal free healthcare, I’m probably not the best person to speak on this,” Andrew said. “Hell, I can’t even vote here. In the short term we need to voice our support for F, who was after all just doing what any of us would do, and to keep caring for our patients. Long term, we need a broad-based community response. Someone who is a citizen needs to actually do something, run for parliament or seize control of their local Labour party branch.”

“Are you advocating that we don’t stop work?” the woman asked Andrew, and I could feel my jaw dropping open. They were going to strike?

“No,” Andrew said. “I think that we have to give the hospital enough notice to staff the wards with locums. I think we can quite reasonably stop non-essential work.”

“Monday?” Dr. Seagate asked.

Andrew nodded. “That should be long enough for admin to get back-ups in. It’ll cost them a fortune to staff the wards for eight hours, which will get their attention.”

I couldn’t believe what I was hearing. Doctors didn’t strike.

“Will it harm the patients?” I asked, making everyone look at me for the first time. Hell, I was going to be a doctor soon; I wanted to know about this shit.

Dr. Seagate said, “I was a medical student at the time of the Irish strike of ‘87. There was no increased morbidity or mortality from the strike, but that was only the junior doctors who were on strike that time. Registrars and consultants remained on the wards. Unlike then, we’re just one hospital; we’re not taking the entire profession out with us.”

“So we need to notify Homerton and St. Andrews. They get our emergency cases; we maintain skeleton staffing on the wards. As long as we don’t remain on strike, we can be pretty sure that the only people we’ll inconvenience will be the admin and God.”

God? Andrew was worrying about inconveniencing God?

The man in scrubs said, “Andrew, you’re confusing your med student.”

Andrew chuckled. “Relax, Blake, God is the director of medical services.”

“Are you really all going to strike? Has it happened before?” I asked, still trying to get my head around the idea.

“Looks like it,” Andrew said. “It has happened. Canadian doctors went on strike in 2002, Los Angeles doctors in ‘76.

Israel had a major countrywide strike that lasted for four months in ‘83. British doctors went on strike in the 70s.” He tapped my stack of printouts. “If you research the issue, you’ll find plenty of references to mortality and morbidity falling during a strike. The figures are crap, don’t believe them. There is a temporary drop because of no elective surgery, but as soon as surgery restarts, the figures come back up, and nobody is prepared to talk about the overall impact on quality of life of that delay.”

I nodded, and he looked at the papers in front of me.

“Hospital policy statements?” he asked, taking the stack off me, and I tried hard not to colour. It was hard to match the way he intimidated me like this with the man who had given himself so completely the night before.

“Yeah. I was, um, looking at the, um, policy of using evidence-based medicine. I went looking for journal articles and they weren’t in the database because they were anecdotal.”

Andrew was nodding approvingly when I looked up again.

“Excellent. This is instead of the presentation I asked you to prepare?”

I nodded. I was in the shit, no way around it.

“Tie it to the topic I gave you, and that’ll be fine.” He handed the printouts back to me. “I’ve got a copy of Callahan in my office if you want to borrow it now.” He checked his watch. “I’ve got a few minutes before I’m due at outpatients.”

I gathered up my papers, jar, and tin, and waited while Andrew said a round of ‘goodbyes’ to the doctors and Dr.