Duck Tape - THE REFERENCE

I ought to carry on the tale of whistle blowing really. Of late I have been rather distracted with other matters namely the antics of the General Medical Council.

Times were tough in 1999. Selly Oak Hospital Birmingham caused me so much misery that I thought it would be too miserable to write about it today. I will though one day after consuming a large quantity of chocolate!

For now though I felt it was important to talk about fixing up references. By 1999, I had my GMC Registration but no references. The problem with a distinct lack of references is also the lack of jobs. Now, superglue doesn't work during these circumstances so you have to use your imagination and some duck tape. As usual, I was out of money. Money is always one of those things that drives you to do something about the circumstances you find yourself in. A locum agency had used some of my past references and offered me a job in the Isle of Wight. So, off I went, Renault Clio with tons of CDs, plus chocolate. The worst part was the fact I discovered I suffered from sea sickness on the ferry. It may have had something to do with the Maltesers I had scoffed in the car!

The job in the Isle of Wight was great. I did though discover how badly nursing homes treated their elderly folk. I also discovered the arrogance of indian doctors who didn't know the system but were too arrogant to learn about it. I recall one being repeatedly told by the consultant to check the patients blood sugars. He didn't. By nightfall, the patient was in ITU. That was something that could have been avoided had he taken just that little more care.

At the Isle of Wight, I was given a PRHO [Pre-Registration House Officer] to take care of. Much like me, she had her life made miserable by Southampton University. I forget her name but I gave her something that she thanked me for - that was the confidence to believe in herself. We worked well together - and over the two weeks she blossomed from a dithering doctor to someone who knew her stuff and was confident in her abilities. She told me that on the day I left.
I disliked what Southampton had done to her. She was typical of many junior doctors who fell under the pressure of victimisation. I suspect unlike me they did not have the attitude of " there is always chocolate".

The good thing about the Isle of Wight was that I ran into my friend at medical school Rami. Rami being the rebel he was had a skirmish with St Georges Hospital London, and had fought his way out of it. He had long hair, was an Egyptian and knew how to kick some ass. Rami I believe became a psychiatrist somewhere when he grew up.

I have fond memories of Rami who revised with me at medical school finals and whined away about how his long hair just didn't fit with the rest of the boring medics. Rami and I finally ran into each other again in the Isle of Wight. I was sitting in the doctor's mess reading the tabloid and waiting for the clock to turn 5 so I could run off to the sea. Rami came up to me and said" Hey Reets, Great to see you". We talked for a while while he rambled on as he did. The good thing about Rami was his old banger of a car. After hours, we all got in there and went off to the beach to watch the sea in the dark. Yes, we all sat there drinking Diet Coke and wondering what the hell we were doing watching the sea in the dark! Rami though was bohemian and pleasantly so. Rami was one of those boys who loved life and everything in it. Essentially, he didn't give a f*** about the world who criticised him, he simply loved adventure.

The Isle gave me back my lifeline. After the misery of Stoke on Trent, I discovered that there were finally normal people out there ie people who were not psychopaths. The consultant there was amazing. Actually, I adored him and he thought I was somewhat of a superwoman. Well, I was in those days because I got most things done in record time. I believed in completing the work and THEN going off and having some fun on top of a hill with Rami and his friends. Being young is a fine thing when you always believe the future is bright. The reference my consultant wrote is listed below. I like to keep these references because much is said about me [ usually all skewed] but DM probably got it just right. I know the GMC likes to tell the media a lot of things about me but I think we have to look more importantly at what a number of my bosses thought of me because we need yardsticks - proper yardsticks to measure ability by.

This is what he said

DM/PJS

To Whom It May Concern

This young lady carried out a two week locum with me in August 1999 as a SHO in xxxxxxxx. I remember that the time was very busy especially because of our coping with new house officers. I remember her as being very hardworking with a very pleasant manner with patients, their relatives, nursing and medical staff, She was very knowledgeable on the subject and conscientious in her work. I remember lively discussions about investigation and treatment on our ward rounds and she was always a very positive person. There was no problem with her written or verbal communication and her experience was adequate for the demands of the post. All the above and her personality would make me feel that she would have made a good Consultant Physician had she persisted with the speciality"

Yours Sincerely

DDM

Bowled Over

First Reference

Refusal

Dr Tim Bowling was someone I had always admired as a medical student. A dynamic consultant with an amazing bow tie. I spent sometime as a medical student at North Staffordshire NHS Trust in the late 1990s. Infact, I designed a helpful table for any other medical student who wanted to come to the ward for an attachment. In the first reference, Dr Bowling gave me an A grade so he must have had a generally high opinion of me. As the post whistle blowing letter shows, Dr Bowling was in somewhat of a dilemma. On one hand he had to support his medical colleagues and on the other hand there was me.

I suspect the biggest mistake I made was to really return there for my house jobs. Retrospective analysis though is a fine thing with hindsight. I though believed that all consultants would be as Dr Bowling was. I believed in many things that year. I believed in everything Tim Bowling had told me. As a fairly innocent medical student you often have faith in people, you have faith in them supporting you and everything you expect of seniors.

Now, it is an established fact that ALL consultants knew of the problems on Ward 87. That was one of the findings of the Creamer Report. Dr Creamer stated that everyone had overlooked these concerns. They knew of the fact that juniors had run into problems there in the past. Some had gone away traumatised. The problem with those who were supposed to be responsible for us was that they never took that responsibility seriously. This follows that it was unlikely that Dr Tim Bowling had no knowledge of the problems on Ward 87.

By February 1999, I was exhausted. The Trust had cut my pay. I was getting less that £500 per month. I had a disabled father to support. I barely had food in the fridge. My debts were building up. I had friends in Stoke on Trent but they all disappeared following this incident. Most of the Senior House Officers stated that they had always known of Ward 87 problems but they had not spoken out. I had been accused of a needle stick injury by the Trust three weeks after the whistleblowing incident. I had no references at all. The Medical Protection Society had been unhelpful. The British Medical Association were ineffective. The Trust had lied to me repeatedly as had Dr Monica Spitieri. They had all attempted to shift the problem onto me. Attempted to try and insinuate that I was not coping. During those periods, I often sat in my room and wondered why it was my fault that the ward had no equipment and everyone knew patients there died like flies. But as with any place, they were just patients to them. There were more where they came from. The fact that many were dying needlessly due to various failures was not acknowledged by anyone.

I needed to live, for that I needed money. For that, I needed to work and do a few locums. It was during that fateful time in desperation that I wrote to Dr Bowling for a reference so that I could work. I recall the conversation as if it was yesterday. I recall speaking to him on the telephone as well as receiving the letter. I realised what the medical profession had been like on that very day. Tim Bowling thought about himself. He didn't care that I was a penniless doctor and that I had worked myself through medical school through poverty. What did he know about living through hardship? They and Tim Bowling left me to effectively survive on my own. Tim Bowling had suddenly become inhuman. Everything he knew about my hard work had disappeared from his mind. He had believed his colleague's view of me and I am sure if I had killed myself at that point, they would have all laughed on my grave. The sort of raw wicked laughter that you find in people who are cold and have no heart. I discovered that is the sort of people they were. Tim Bowling was the turning point, he was the person who made me realise that people are never what they seem. To me, he may have been a complete success as a doctor, but he was a complete failure as a person. Leaving their junior doctors in the gutter to fend for themselves hoping they will just disappear and never return to challenge them.

But this only happened because I was a whistleblower, because I asked for more equipment. Prior to that, I had been the golden girl who could do nothing wrong. The medical profession at that time of the Bristol Inquiry was not ready for the whistleblower. Tim Bowling was not ready for the whistleblower. I wonder if he would treat his own children in the same way. Or whether he would appreciate other doctors treating his own children in the way he did.

It was very true that there were tears falling down my face as he spoke to me on the phone. I had to think about how I was going to support my disabled father and what I was going to do for money. I think its when you start counting all the pennies from the car floor is the time you understand the pain of poverty. The next day, I sold my clarinet, I sold my watch and I sold what I could to purchase food for the week. It is during these times that you understand the extent of wickedness that exists in the world.

I believe the public have a view of doctors, that view is that we are super human beings and that whistleblowers should walk into another job without any problems. Weakness is not an acceptable trait in doctors. This is illustrative of the fact that Tim Bowling is simply one consultant of many. He has forgotten all about me. I am not part of his conscience and never will be. I though remember him. He didn't have to give me a reference, he could have cared enough to ask whether I was coping or whether I needed support. These questions though escaped him. Doctors are supposed to be caring people but he certainly was not caring. Perhaps he is caring to the right people but clearly not when it should really count. Tim Bowling though is representative of many consultants view of whistleblowers. The vast majority of consultants will seek to ostracise their junior totally. The whistleblower is viewed as someone who has betrayed the profession in some way. In this way, the whistleblower is ostracized and isolated.

I believe though that people like Tim Bowling make you lose faith in human beings in general. My faith disintegrated from that day on. You learn to deal with characters like Tim Bowling in the way they should be dealt with - with complete contempt and indifference. I don't think they deserve any better.

This is written for the benefit of the public and junior doctors. I always find it important to narrate the experiences of whistleblowing because hardly anyone knows what it is like for a doctor to be in the middle of the backlash that follows the act of whistleblowing.