Editors’ Letter 2016 No. 2 – Puppet on a String

[box] Our Editor-in-Chief returns from exams to a situation that is yet to change [/box]

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When exams approach I tend to let things get a little on top of me and weigh me down, not that I’ve ever really understood those expressions. Things, those pesky things, they tend to get swept aside, brushed under cabinets and stacked in lofty heights on top of wardrobes rather than above me, the puppet master to my marionette, as the sayings suggest.

Having just tackled the robust and impenetrable fortress that is Finals I am once again returned, refreshed (allegedly) and marching back into the world of medicine. For those of you still fighting the good fight, The Unofficial Guide to Medicine have some absolutely fabulous books for you to get hold of here. For me, the next three weeks or so find me back in the world of psychiatry, a world that I find myself returning to again and again. This time it is to the diocese of psychotherapy that I venture to, in order to fit the final piece in my wholesome medical school education.

Despite being away from the wards for some time I return to the same problems. Still, junior doctors are not listened to or valued by our Government. This isn’t a surprise of course for a band of brothers already well known for their empathic and all-inclusive nature. They’d never try to make thousands of disabled people worse off would they? They’d never forego animal welfare legislation would they?

I reiterate again that doctors are not striking because they want time off or want more money, however nice that would be. They are striking because the Government has, despite endless spinning of broken-record scientific fact, ignored calls for a safe and fair contract for doctors and patients. They want to fulfil an empty election promise. The BMA has shown itself to be strong in its leadership and its conviction; something that, with the recent resignation of resident battle axe Ian Duncan Smith, the Government apparently is lacking.

Jeremy Hunt is, as ever slithering serpentine around the topic of the strike. He refuses to engage with the BMA or with doctors who wish to talk to him directly about the matter. He’s closed a door that should never have even been on its hinges. In a case discussion meeting this morning, we talked about the roles of the medical professional and the patient during a psychodynamic psychotherapy consultation. There is often an elephant in the room, a third party, not present but nonetheless important, pressing down, getting on top of, the patient. In this model, Jeremy Hunt, the absent, neglectful parent, is the issue that ties the two parties together. A body that previously had been the source of scorn from large swathes of doctors, the BMA, would be the psychiatrist, there without judgement when the patient needs them. Finally, the thousands of junior doctors furious over their maltreatment would be the patient. Perhaps then it would be fitting to have discussion between the BMA and the doctors, where the crux of the issue is discussed, namely the negative effect that Tory Government and Jeremy Hunt has had on the morale of so many, and then lifted from their shoulders with tact and out of the conversation entirely. From there the other issues, the crises of underemployment, overspending and underfunding in the NHS, could be tackled with reason and with a real hope of progress. Perhaps I’m overanalysing.

What I do know is that so many of my colleagues are demoralised. This is as unsurprising as it is unsavoury. We shouldn’t have an entire generation of doctors that feel this way; a workforce of highly trained, highly qualified individuals who, despite all of the problems that the NHS faces, still want to help the general public. We should talk about the contract to anyone who lingers long enough to listen. Enthusiasm is infectious, a contagion of positivity.

However easy it is to cave in and become, as our glorious leaders do, Machiavelli’s Il Principe we needn’t use deceit or devilishness to win the argument. We can win with enthusiasm and determination. Now those are personality traits in doctors that must weigh oh so very heavily on the minds of government and their marionettes.

Rob

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