Monthly Archives: November 2015

The Fable Of The Expensive Table by Minesh Karia

“Dear Juniors,

I get paid an extortionate amount

image

of tax payers money to ensure that I care about the NHS.

Let me be absolutely clear. I don’t want to give across the impression I don’t care, even if I don’t actually care.

Of course I care and I would urge you to listen to my rehearsed rhetoric rather than focusing on my actions.

The fact of the matter is that I think we face difficulties in our communication.

Repeatedly, I have asked for you to “get around the table”.

You have been understandably clear that if I drop the threat of an imposition of a dangerous contract, I can stop the biggest doctors strikes in NHS history and we can then restart negotiations around the table.

Repeatedly, I have ignored this and have continued to ask for you to “get around the table”.

Once again, you have pleaded and begged me quite rationally to drop the imposition of a dangerous contract.

Instead of approaching this maturely, I have labelled you as militant, accused the British Medical Association of misleading doctors and have continued to ignore your plea, instead responding through various media outlets imploring you to “get around the table”.

This table is truly a magical table. You can get around my table anytime on a weekday during normal social working hours, be it at my office or at your office. I’ll even bring the table to a militant doctors office if I have to, so long as there is no media present. 

In fact, we don’t even need an actual physical table. What really matters is that the public believe that you don’t want to get around the table and that I do. We can talk about whatever you like over the table- it doesn’t matter to me, for I’m going to impose the dangerous contract anyway.

After many months back and forth on this matter, I think it is quite clear that I don’t really understand what 98% of you junior doctors are trying to say.

Are you saying that if I drop the threat of the dangerous contract then we can actually have meaningful negotiations? Are you saying that when I said “no preconditions” I was misleading because I have a massive precondition of imposing a dangerous contract anyway? Are you Implying that because I spin, I’m a spin doctor?

I fully understand that with a simple written guarantee that I will not impose a dangerous contract, I can potentially stop this strike.

Instead, I want us to focus on the table. Im sure there has been some research somewhere showing that 11 percent of tables come with one extra chair if bought on the weekend. Therefore, it is clear that this research proves that it is all the junior doctors fault.

Finally, I hope you have recently read my latest letter where I have, a few days before you strike, decided that I will send some people to speak to ACAS at some point and that whilst this all sounds like a step in the right direction, essentially I’m still planning to press on and impose the dangerous contract anyway. I’d just like to let you know that my enormous delay in making this decision public was not because I am lazy like you doctors, but it was tactfully planned in the hope that a) it will divide you last minute so that I can conquer you and b) to try and get the public back on my side who are dramatically losing faith in my spin strategies.

Time is in my hands. You have till August to stop me and after that it’ll be too late.

I look foreword to imposing a dangerous contract on you shortly. Once i’m finished with you, I’ll be coming after the rest of the NHS.

Yours,

An expensive table owner.”

#unitedwestand #dividedwefall

Advertisements

The Cycle of Life Part 3

I could write and write about the many lives I knew that were cut short in their prime but I will complete the cycle with this last blog about one of my oldest friends. His name was Nabil. We probably met as babies but the first meeting I remember was when I was 15 years old. We had moved to London the summer before and were getting settled in still. My mama came home one day and announced we had been invited to have dinner the Ibrahim’s on Saturday. Who were they? I asked. She explained that they were old family friends. The parents were my grandparents’ friends and although their children were younger than my mother and siblings, they knew them well as children. I am told one of the kids had even stayed periodically with my grandparents in Lagos when they were going to school there. She told me that the oldest daughter had 2 sons, one my age and I was going to meet them.

Although we both lived in North London, it was quite a trek as there was no direct tube route and we had to go on 2 (or was it 3?) buses. By the time we got there, my nose, fingers and toes were frozen and all I wanted to do was curl up into a ball and sleep by a fire. I needn’t have worried. As soon as we stepped into their house, I felt my frozen cells begin to stir. It was always tropical in that house. Mum and Baba (the grandparents) like it very warm so there was never any danger of being cold once you got in there. I was introduced to the many adults, face after smiling face. It was like a mini-Northern Nigeria. All the warmth, the noise, everyone speaking Hausa. The boys were called down, Nabil and his little brother. They were instructed to take me upstairs until it was time for dinner. Although Nabil was friendly, he was definitely the quiet one. His little brother made up for it. He was very chatty, still pre-adolescent and full of excitement about life. Back then, he was quite small too. Very cute!

Nabil played us some music and told me about how they had only been in London for a year so were new to town too. He explained who was who in the family and we made general chitchat with his little brother telling us his fantastical half made up tales. We were in the same year of school and I was older by 2 months. By the time we got called down to dinner, we were friends. Over the delicious dinner cooked by Mum (his grandmother) and his mum, we talked some more. We exchanged numbers when I left. We stayed good friends over the years. We went to visit every so often and they made the trip across North London a few times too. We text occasionally in between visits. The next year, we talked about finishing year 11 and applying for colleges. I told him I was doing all the sciences and Maths because I would be applying to do Medicine. He said he wasn’t sure yet what he wanted to be so he was still thinking about which subjects to choose. We talked about where to go and I must have been convincing because I suggested for him to join me in Barnet College and he promised to consider it. He wrote down his address on a teddy bear notepad I had so I could sent him information when I had a confirmed place.

Common sense prevailed and he went to a college more local whilst I went to Barnet College. We went to see movies together and we even ate out at this stage, being all grown up at the ripe old age of 17 and 18 years. Every time we went out, he would insist on paying for everything and I would argue him down so we went halves. His little brother had grown into pre-adolescence by then and would irritate Nabil endlessly. His patience was great and he would repeatedly ask him to butt out of our conversations. I didn’t mind. I had a sister too and as the younger sister, I knew what it was like to be the little one. When we applied through UCAS for universities, he finally had a plan. He was going to study Maths. I was shocked. I mean, I was a straight A student and I got my A in Mathematics, an A* even in AS. I was no slouch when it came to it but to do a whole degree in Maths? I was agog! Why would anyone in their right minds do such a thing? He took my teasing in his stride. He said he didn’t have a profession in mind like I did and he knew he could use his generic Maths degree to do a wide range of things. I accepted this but I still thought him mad. He gave me that calm smile of his. ‘You’ll see’, he said.

As is the norm, we saw each other less when we went off to different universities. I went to Birmingham and he stayed in London. We probably saw each other once a year but when we did, it was like no time had passed at all. Ours was a very easy friendship. He would tell me about his ‘crazy’ Maths course. He seemed happy. I would tell him about Medicine and how much of it there was. How I realised more and more that what I knew was only a small fraction of how much I needed to know. He was openly impressed by how well I coped with it. His support and belief in my abilities were unwavering. Just like his friendship. I knew he was there somewhere should I ever need a friend. We text and Facebooked more than we spoke face to face. I can count the number of times we spoke on the phone in all the years.

Over the years, I would tease him gently about his girlfriend, or lack of. As the Fulani girl, I should have been more embarrassed to talk about such things but he was so shy about it. It became part of our friendships. I would needle him about ‘her’ and he would counter by asking me about my many boyfriends. I wasn’t shy about it. I had very little in the way of boyfriends but I told him of every encounter and how I preferred not having a boyfriend. He never admitted to any love interests but his brother was a more open book and I know there was somebody special at some point. He graduated and started an online sales platform. Next thing, he was talking about going back to Nigeria for his NYSC (mandatory youth service). He settled in Lagos. I happened to go the Lagos route once in his time there so I got to see him. He looked way too skinny and I was worried. As a newly-qualified doctor, I saw ill-health everywhere and was concerned he wasn’t sharing. He reassured me that he was fine. I didn’t need to doctor him. I believed him because youth corpers do tend to look the worse for wear during their year’s tenure.

The last time I saw Nabil was in Life Camp, Abuja in 2011. He happened to be visiting Abuja whilst I was there on a 10-day holiday. He was staying with a friend who brought him over. Again, I thought he was too skinny and he laughed it off. ‘Maybe I was always meant to be skinny like you’, he said. We chatted for an hour and he had to go. As we hugged goodbye, I felt how bony he had become. Life in Lagos was a hard one for a young man trying to start a business. My parting words were ‘You need to eat more. You should look after yourself better.’ His reply was a laugh and a ‘Yes doc!’ I stood at the door and waved until the car was out of sight. Not for a second did I imagine I was saying goodbye for the last time. The fuel subsidy crisis in Nigeria was the last thing we ever chatted online about. He became very involved in the demonstrations. I worried about his safety and he sent photos of himself and his friends at Lagos marches, looking happy and less skinny. He had found a cause to believe in. I was proud he was making a stand for a cause.

News that he was ill came out of the blue. I was in Yola, having taken a year out from working in the NHS to see the world. My mama got a call from one of his relatives saying that he was in hospital with a bleeding illness, cause still unknown. It was pretty serious and they were considering transferring him abroad as the healthcare available in Lagos was deemed inadequate. When my mother related the facts, I wanted to know more. What sort of bleeding? Was it related to a fever? Was Lassa fever the suspected cause? When my spoke to them again later, she was given more details. He had woken up that morning and told the friend he was living with that he wasn’t feeling too well. I think there was mention of a headache. He had been well the night before going to bed. His friend had gone with him to hospital and he either vomited or peed blood. The exact sequence is hazy but the gist of the story was that he had become sick rather quickly and what started out as an isolated bleed was now bleeding from multiple sources. He had been given a transfusion, we were told. He was conscious but seemed to be deteriorating.

When my mama related all of that news, I immediately thought the worst. When I burst into tears, she was alarmed. ‘He is alive,’ she said to me. ‘Don’t write him off.’ I tried to explain what I was thinking. I didn’t want to be a pessimist but unexplained severe generalised bleeding had a poor prognosis even with the best medical care. And he was not getting that. Not yet anyway. I had 2 professional experiences to draw on, both rather negative. My first experience of a patient with uncontrollable bleeding was in Malaysia on my medical elective in the 4th year of medical school. He was brought in by his heavily pregnant wife and a male relative to the A&E where I was working. He was very quickly diagnosed with Dengue Haemorrhagic fever. However, before any real treatment could be commenced, he went into cardiac arrest. With the medical students and his wife watching, the doctors performed CPR. It was horrific. He began to bleed from every orifice imaginable. His ears, nostrils, mouth. The blood was coming up the tube he had inserted into his lungs to ventilate him. The only part visible with no blood streaming out of it were his closed eyes. It was over as quickly as it began. It was obvious to everyone that he was far too ill to be saved. His wife was led away with the news.

The second experience was indirect. I was working in FMC Yola (Federal Medical Centre) and although Yola was ‘free’ from Lassa fever at the time, there were new cases being reported further south of the country. In fact, about 6 months before I had started working at FMC, there had been a patient with Lassa fever there and 2 of the doctors had contracted it from him. Unfortunately, 1 had died and the second had got to the Lassa Centre down south in time to be treated. He was one of the registrars on the paediatric team I was working with. So although he was okay, it seemed that mortality was quite high and only those who were diagnosed early and treated before they started actively started to haemorrhage (to bleed) were salvageable. Nabil’s story didn’t quite fit the bill because he had not complained of a fever and indeed had no fever in hospital. But it was my best guess with the facts I had and I feared the worst.

I pulled myself together eventually and prayed and waited with my mama. Next time we got an update, it was to say he was worse still, I suspect barely conscious at this stage. He was still bleeding despite all efforts and his parents were with him (they don’t live in Lagos). An air ambulance had been organised and he would be transferred abroad as soon as possible. We even heard he was being placed in the ambulance and I thought maybe there is some hope after all. That hope was short-lived. We got a call a few hours later to say that although his parents were in a flight to London, his air ambulance had never taken off. There were complications and unfortunately, he had not made it. I was so upset! All I could think is how his parents had no idea he had died and how they would have to make the return trip with that news weighing on them. To be honest, I have not asked them what happened exactly but it could only have been a terrible day.

I think the initial reaction of tears had taken the edge of my grief. I had started my grieving process before he was gone. I sat around in disbelief as my mama asked if I would be okay. As we made arrangements to go and visit his family, I could not stop thinking about how final death was. That was it for him, in this life anyway. I have no brothers so I whilst growing up, I found a handful of boys/young men to be my shining examples of decency in the male sex, my torch bearers when I felt dark about men in general. Nabil was one of them. Here was a gentle, calm, positive young man who believed in doing what was right, what was decent. He was respectful of God, his parents and our culture. He was a great friend and it was clear from the few times that I spent with him in the company of his family and friends that he was an all-round good guy. Losing Nabil was losing a little of the light in the darkness that sometimes surround men for me. Nabil was a good guy. Now he is no more. It took just over 2 days for a healthy young man in his mid-20s to sicken and die. Muslims would say it was time to go. I accept that but did it have to be such a horrible death? What did he ever do to deserve such an end? Why him?

The Cycle of Life Part 2

Mamie, my late grandmother, was from Mubi and Ribadu. Mubi is a large town in Adamawa State, even in the old days a thriving commercial town with good links to many other towns (that is until Boko Haram decided to move in). I understand that Mamie’s father was one of the successful merchants there and her home in Michika only came about long after her father died because Grannie, her mother was from Michika. Anyway, through one of her parents, she is partly from Ribadu too. My memory of Ribadu is of a little diversion on the road to nowhere, little more than a collection of huts that we got to by using dusty dirt roads off the main highways. Most Nigerians will recognise the name though because of the famous Nuhu Ribadu, arguable Ribadu’s most successful son. He was EFCC’s first executive chairman – Nigeria’s anti-corruption agency and suffice it to say, he went about his business fearlessly, bringing those previously seen as untouchable to account. He was loved by the masses and detested by the ‘elite’ who had enjoyed incredible daylight lootery for so long in Nigeria. He had to go on exile when he left office because of fears for his life. I digress, Nuhu Ribadu is a relative. Of course he is I hear the Nigerians cry. Everyone in Ribadu is related so therefore, he is definitely a cousin of some sort. My point is that before Nuhu Ribadu, Ribadu would have been a name no one except its indigenes noticed on the map of Nigeria. Now it is one of the household names in the country and no Nigerian should wonder about its origins.

The girl I want to write about was called Aishatu Mohammadu Ribadu. We called her A’i for short (pronounced Ah-ee). I don’t know how the arrangement came about but I remember vividly when she moved in with us. She was about to start secondary school. I suspect my mother offered to bring her cousin to Yola where there were more education opportunities. She was the oldest girl and named after Mamie so who better? She was as you would expect a little village girl to be at first. Timid and as quiet as a mouse. Pretty Fulani girl with her long curly natural hair. She was soon enrolled into GGSS Yola (Girls Government Secondary School) and on the first day, we lugged all the usual paraphernalia to the boarding school to check her in. I remember us walking around the dorms trying to find her allocated one. We did and when we had her things moved in, we said our goodbyes and left. I was in primary school then so it didn’t occur to me how hard it would have been for her. Not only to leave the shelter of her little village and move in with us but to then go straight into boarding school with girls from all corners of the State. She never complained about it.

She remained quiet for the first year or so and then by JS2, she came into herself. She joined the cultural club in JS3 or SS1 and flourished more with it. She came back after the first term of being part of the group and started to sing us their songs in her lovely voice. One chorus went:

Sai mu ‘yan Hausa cultural,

Daga makarantar Geeeee Geeeee (GG).

Mun zo ne muyi maku wasa,

Wasan mu ta Hausa.

Mun zo ne muyi maku wasa,

Wasan mu ta Hausa.’

(Translates roughly into: We are the Hausa cultural girls from the school of GG. We are here to entertain you, in the Hausa cultural way).

We particularly loved the bit where they introduced themselves and when she got to Aisha Mohammed (the Hausa-nised version of her actual name), we would grin out loud. Over the next year or 2, we learnt many of her songs (some by Sa’adu Bori, very X-rated for our age but who knew?). In the evenings when there was no electricity, we would lie on mats out under the stars and moon. She’d tell us stories about boarding school and we’d sing her songs. Her love for music grew and the first album she absolutely loved was Brandy’s Never Say Never in 1998. We all loved it to be fair but she learnt the words to the songs ‘Never Say Never’ and ‘Have You Ever’ early and would sing those songs so hauntingly that I can’t hear now even today without thinking about A’i. Just hearing someone utter the words ‘never say never’ evokes memories of A’i to me. I suspect looking back she was going through puberty and probably was in love for the first time. Being a shy Fulani girl, we never heard or saw the object of her affections. In fact, in all of her time, I only knew of one ‘boyfriend’ before she met the man who would be her husband. I cannot for the life of me remember him but I know she suddenly relaxed her hair, started to wear makeup and took extra care when getting dressed to go out.

When she graduated, she met Hamma Z (his nickname) and we all knew this was different. She would light up when his name was mentioned and although she was shy about it, she never hid that she liked him. I barely knew him then because I was in boarding school in Lagos myself and he wasn’t resident in Yola but visited periodically. I heard she was getting married shortly before the event and as it was the middle of school term and we had moved to London then, I could not be there. I spoke to her though and she told me how excited she was. She sounded it. After the wedding, they moved to Ashaka where her husband worked. It is a little removed so it wasn’t on the road to anywhere we would normally go when we visited. I never made it to her marital home (this I am still sad about). One summer holiday, I contacted her to say I was coming. She promised we would see each other as she was planning a visit to Yola and Ribadu in that summer.

One day, there she was. I think this was in 2002. She looked beautiful. She was always pretty but she was glowing that visit. When she spoke of her marriage and her new home, her eyes shone. I was very happy. I wondered if she was pregnant and asked her the question. A little bit of the light dimmed. She clearly wanted a baby and it had been over a year. She was worried. I remember telling her not to worry. ‘These things are written,’ I said. Her baby would come when it was meant. She smiled and said ‘You are so grown up Diya’ in Fulani. I hugged her and we sat by the car parking bays at home in Yola, sharing a private moment. Once again, the two Aishas reunited under the stars and moonlight. Before she left, she told me about how quiet it was in Ashaka but that she had made a few friends. She told me about her small business venture and how she was now making some money for herself and her plans to make it more than a hobby. She told me about her husband and how he was kind and worked very hard for them. When she left, I promised when I came next time, I would make the trip to Ashaka especially.

That next visit never came. I saw her when she came for Mamie’s death. Then I got a call from A’i a few months later excitedly telling me that she was pregnant and to tell my mother. Her voice was exuberant and I was ecstatic for her. We rejoiced briefly before she had to go. Call charges to the UK in those days were astronomical but she clearly wanted us to know because she was over the moon. It was very un-Fulani of her to call and talk about her pregnancy so early. Traditionally, Fulani girls would normally never say a word until their pregnancy was obvious to everyone. I guess she knew with us being abroad, we had to be told to know. It was the last time we ever spoke on the phone. We texted from time to time and she let me know everything was progressing fine. She said she had never been happier.

One morning, I got a call from my mama who had moved back to Yola. She said ‘A’i has a son’. Her voice sounded sombre so I immediately asked ‘and how is A’i?’ Mamie had died the year before and since then, we had lost a few other people. I suspected the worst as soon as my mama began to speak. She said Hamma Z had been informed that A’i was taking a little longer than expected to recover from her general anaesthetic. You see, she had had complications which meant they had taken her into an emergency caesarean section. Although my heart was still heavy, I was a little relieved. I was a medical student then so I looked it all up and was a little reassured. Chances of dying from a general anaesthetic are slim in a healthy young woman. Looking back, I think she had pre-eclampsia or something like that but as usual, in the Nigerian healthcare system, information is restricted so all we heard was that she hadn’t quite woken up. My mama promised to call when there was news.

I sat by my phone and waited. When the call came, it was what I didn’t want to hear. She had died. We found out later that actually she had died pretty much straight after the baby was born but that was kept from her family. In a panic, they pretended she was still alive but unconscious. I was in the UK and she was buried according to Islamic rites so I never got to see her. My mama went for the ‘funeral’ and reported Hamma Z was devastated but their son was healthy and beautiful. When the next summer came, I went to Yola and asked to be taken to him. He was living with his grandmother then and was nearly 18 months I think. He was beautiful, like my mama had told me. Quiet like A’i was at first. His aunties and cousins told me how he didn’t talk much or take to strangers. He came to me and sat by my side all visit, leaning into me when I wrapped one arm around him, despite not saying a word to me. They looked at me in wonder and said ‘he must know his blood’. I smiled and agreed. Yes, he must. I felt an intense love for him at that moment and I wanted to steal him away. I also wanted to burst into tears. I knew how proud his mum would have been of her little boy and was devastated she never got to meet him.

His father remarried after many years and A’i’s son was reunited with his father for good. Although I have only seen him a few times over the years because they do not live where I go on my short visits to Nigeria, his father and I keep in touch and I am told he is happy. He is an adolescent now and he is so much his mother’s son. I looked at the most recent picture of him I have and saw his smile. A’i’s smile. He has her eyes, her nose and her mouth. His colouring and demeanour is very reminiscent of her. I still well up at the thought he will never know her just as she never got to meet him but I am comforted by the fact that she lives on in him. If I ever get a chance when he is older, I will tell him his mother wanted nothing more than to bring him into this world. That I have never seen her so happy than when she was with his father. Nor heard her so excited than when she announced he was in the making. That he would have been the centre of her world. That she would have done anything for him. That he would have been the most loved little boy, the apple of her eye. I hope I get the chance to tell him all that. Life!

The Cycle of Life Part 1

As I said in the bit about me, I am a realist with a healthy dose of optimism. Apologies that I am again going to write about death. It may seem morbid to my blog followers but I do not always find talking about death negative. I dwell so much on it because it is my way of not forgetting those who have left footprints in my heart. Also because unfortunately, for someone who has been fortunate not to be from areas where death is a daily occurrence, I have seen more than my fair share. In the old and in the young. If you are squeamish, this may not be the blog for you.

I write this in the living room of my sister’s flat in Abuja and this was prompted by another blog I just read and also by a conversation I had with my sister. It was a long conversation but it ultimately lead us to discuss our mortality and how death can strike unexpectedly, about being a parent and planning for that eventuality to ensure your children are taken of and about writing wills etcetera. Despite the gravity of the conversation, it was quite an uplifting one. The words to follow are snippets of memories centred mainly around 3 deaths that have literally changed my life. These are young people who no one expected to die and their manner of death changed the way I think about death.

The first was of a classmate from Queen’s College, Lagos. It happened in 1999. She (I will call her Eve here) was not a girl I was particularly close to or even fond of. But I had known her for nearly 3 years when tragedy befell her. Eve was the daughter of a quiet unassuming teacher who I will call Mr Brown here. Mr Brown was the complete opposite of his daughter. Where he was quiet, she was loud. Where he was always serious, she was always laughing, finding the humour in things even when it wasn’t appropriate. She was tall for a 12-13 year old and he was a short man. She was fair where he was dark skinned. The comparisons were striking being that they were father and child. Anyway, Eve was the class joker. She was always loudly laughing or telling a joke. She was always planning the next prank or calling out funny witticisms from the back of the class. Sometimes, it was distracting so I wasn’t always laughing with her but I never thought her to be malicious.

We came back for the 3rd trimester of JSS3 and Eve didn’t. Soon rumours began to circulate about her being unwell. Then we heard that she was in fact really quite sick and was admitted in hospital. Then we heard that she had been victim of an acid burn. The extent was unclear but we did not expect how grave it was. Why we asked? And we kept asking. She was only a young girl. Why would anyone do this to her? I was pretty sheltered so I had never heard of acid attacks nor did I know the usual motives behind them. My more streetwise classmates told me that normally jilted or scorned (adult) men were the perpetrators were and the victims the poor unfortunate girls/women of their affections. It was mainly a Southern thing back then so I had never come across this despite my mother’s job.

This was the perplexing issue to us, her classmates. Why would a girl so young attract such affection? Soon, we again heard that the attack was aimed at her older sister (also in our school but nearer 16 or maybe 17 year old). We were told that Eve opened the door to their home unsuspectingly and she had acid thrown in her face. We were told that she was badly burnt and had been admitted to the hospital weeks before we were hearing of it and was in a serious condition. We talked about her non-stop for a week. There was a sombre mood in the class. It was as if no one felt right to take over her role. So there was no joking or pranking in those days. We all feared the worst as the news we heard was comprised solely of rumours. Like Chinese whispers, we were unsure who to believe.

One morning, the Day students (as opposed to us Boarders) came in talking about the 9 o’clock news on NTA (Nigerian Television Authority channel, national news broadcast). Eve had been mentioned as there was an appeal for funds. The attack on her and the resulting serious injuries were so serious that the doctors in Lagos could do no more and I think the thrust of the news was that her family was appealing for donations to take her abroad. This was when we realised just how bad things were. We sat around in silence, praying for some news. Mr Brown turned up in our class that morning. For once, no one needed to ask for silence. We all sat in our seats and looked at him expectantly. He spoke to us in his quiet voice. His eyes were red…from exhaustion or from tears – it was hard to tell which. He confirmed the rumours. Eve had been the unintended victim of an acid attack. She had been home alone when the men called and as she was so sick, she could not identify her attackers. She was in hospital in a stable but critical condition. He left. For the next few weeks, we continued to whisper about Eve. What did critical mean exactly? More rumours about who the intended victim was and the suspected attackers. About the extent of her injuries. Some adults had been to visit and they all agreed it didn’t look good. Despite all our fears, she remained alive but in a ‘stable condition’.

End of term for us JSS3 students came early and on our last day, some kind soul had organised a bus for those of us who felt up to visiting to go and see Eve. Most of the Northern girls declined to come. I was the only Northerner to get on the bus. In total, out of 90+ classmates, the bus held less than a dozen of us plus a couple of adults. The bus ride was made in total silence. You could smell our fear and the tension was palpable. I mouthed prayers, praying that I could handle whatever condition she was in. I don’t remember much of the usual Friday traffic and the heat. I remember walking off the bus in a single file and how much I was dreading what I was about to see. The smell hit me first and I felt my gut roll. My nostrils curled inwards, as if to block off my nose and the smell with it. I thought I would faint. It was the smell of decaying human flesh reaching the corridor outside her room. I could hear someone whimper and start to sob within our group. We all marched on following the adult leading us in. We stopped by the door as she announced our entrance. When she opened the door, the smell hit us harder followed closely by the sound of Eve taking breath after painful breath. My knees locked and a part of me wanted to bolt. I remember telling myself sternly that I could face anything. If she had to be here, I could visit her. Even if only for a minute.

On wobbly legs, I followed. I inhaled and held my breath. The bedside cabinet was groaning under the weight of medication. Mostly topical and oral stuff with cotton wool and forceps in a metal tray. She was barely visible. Her head was uncovered and there was a lady (her mother?) whispering in her ear. Asking her to be brave, not to scream in pain as she had begun to do. ‘Your classmates have come to visit’ the lady whispered into the hole where her outer air should have been. She seemed to hear her and she lapsed into her painful breathing again. The rest of her body was covered. It was beneath a metal cage over which a sheet was draped. I could not see underneath but I was certain she had burns all over her body, which was why she was lying so. To prevent clothing coming in contact with her skin. We all took turns to step up next to her and tell her who we were. Her eyes were covered, she clearly could not see. The hair on her head was badly singed and what was left of it was in a clump, stuck to her skull. All of her skin was badly damaged. You could see bits of colour imbedded in the skin of her face and neck, clothes melted into her skin. Her nose was gone…there were holes for breathing but no nostrils. Her ears like I already mentioned were missing too. All that was left were holes leading to her middle ears. Her lips were also damaged and her mouth was hanging upon as she struggled to get air in. Through her open mouth, you could see her blackened shrivelled tongue.

She grunted when each girl said her name. We retreated to the back of the room and stood silently for some time. Her carer took a bottle from the cabinet and dropped it onto some part of her face when she started to complain of pain again. Soon, her bravery was unable to contain her pain any longer and she began to whimper. This very quickly turned into screams of anguish. She was clearly in unbearable pain. We all had tears in our eyes as we were ushered out. Her carer came to us and said ‘thank you so much for coming. I know Eve appreciates it’. None of us replied, we were too busy crying. We got back on the bus and gave way to emotion. I remember staring unseeingly out of my window as tears coursed down my cheeks. I wept for nearly an hour, until we got back to school. When I got off the bus, my face was dry. It was obvious I had been crying but the tears stopped. I had to be brave. I got my things and I went home. I did not speak much of it over the next few days except my family would ask how I was doing whenever the appeal for help with medical costs was broadcast. Her death was announced on the Tuesday after we visited. Although I didn’t say it out, I sent a word of thanks to God for answering my prayer. My prayers on the bus after we left was that He put her out of her misery. I was sad but life went on.

About a month later, 2 of my older male cousins, my foster sister, my sister and I had one of our late nights of playing cards by the light of a lantern on the veranda whilst most of Yola slept. It was around midnight and Yola was definitely in bed by then. We were suddenly famished and we rooted around in the kitchen to no avail. We decided to go out and buy some food. We walked in the quiet to the night market (‘kasuwan dare’), fearless in those days of anything untoward happening. Yola was that kind of town. Despite the fact that 3 of us were young girls, we felt safe enough in the company of 2 older boys. We bought food and came home, had a merry little feast and were in the middle of telling jokes and laughing when it suddenly dawned on me that Eve was dead. Just like that. She would have no more holidays, no more jokes, no more laughs. She was gone. Forever. The enormity of it hit me. The pain she was in, the senselessness of her death (her murder come to think of it) and the grief her family must be going through. How had she felt just before the attack happened and when she had the acid thrown at her? How had she borne the pain for so long? Could she smell her own flesh decaying? Did she realise how badly she had been hurt? Did she know she was dying?

From laughter, I dissolved into tears and I could not stop. The more I thought about her, the more I wept. The others were concerned. I told them through my tears not to worry. I was just remembering Eve. They were worried I could see but also understanding. This carried on for maybe half an hour. Eventually, my sister suggested that the boys go home. My sisters would look after me. I smiled through my hysteria and tried desperately to compose myself. I remember rocking as I sat on the ground, hugging my knees and trying not to hyperventilate. I was sobbing out loud, my eyes closed as I got flashbacks of Eve in her eventual death bed.

My sisters asked what the matter was when I did not show signs of stopping. I said ‘I will be fine. I don’t know why I can’t stop crying.’ Actually I did know. I could not stop imagining myself as her. Going through that ordeal, surviving for over 3 months with all the pain. Unable to talk, unable to move, unable to ask why. I thought mostly of her mother, who had to watch her daughter go through this. I thought about the inadequacy of treatment, how she was clearly in pain but there were no painkillers strong enough to control her pain. I thought of her sister, who was rumoured to be the intended victim. How did she feel? Did she feel bad her little sister had taken her place? Did she feel guilty by association? I thought of Mr Brown and his wife. I knew they would be devastated. I had seen it in their eyes. How were they carrying on? How could they bear the pain? If the pain I was feeling was so deep and I wasn’t even that close to her, how must they feel? How could they bear to be alive?

It took over an hour for me to calm down and stop the sobbing. I still cried. Until dawn that day but silently as my sisters lay next to me and went to sleep. I got it all out then and not once since have I shed a tear over Eve but I remember her whenever I think about life and death. The details are unclear to me now but I think her attackers were caught. Her sister was a witness in the case. I don’t know if they were convicted and what happened to them afterwards. We never got to go to the funeral because it happened over the summer holidays.

Life moved on when we returned to SS1. Without Eve. She had never made it out of her pinafore and into the skirt we were now wearing as senior students. Whenever someone said someone funny, we would refer back to what Eve would say. Mr Brown, bless him, looked devastated whenever we saw him, which wasn’t often. He did come to say thank you to all of us for our prayers and our parents’ donations. He especially wanted to say thank you to those of us who visited. He said we helped Eve. I hoped so. As the days turned into weeks and weeks into months, we gradually moved onto other topics. Other girls soon took up the mantle of class clown and the laughter returned. Still, I never forgot and I know at least within my circle of friends at least, none of us will forget her. She lives on in our hearts. What a senseless loss!

The Taboo of Domestic Violence

One of the great privileges of being a paediatric doctor is the frontline seat we have on humanity. Of course we only see this great variety of human life and get to share in their stories because the NHS is still at the point of need free. We get to see how the very poor live their lives and also how the more affluent live theirs. Stereotypes abound within medicine and on the whole they ring true but we doctors and other frontline staff are constantly amazed and shocked by the unexpected. Life is certainly unpredictable as a doctor in the NHS. This is one of the reasons why I love the NHS so.

One of the greatest sorrows I have faced is when I come across a mother and or child who is being abused by the man who is supposed to love her and protect her from the rest of the world. One of our babies has been taken into foster care recently because the mother is being abused and has chosen that option for herself and her baby. I wanted to weep (still do) because I cannot imagine the horror that the mother has gone through and must be going through to carry a baby to term, labour to deliver her beautiful baby and then feel she must give that baby up. Heart breaking! In this case, the abuse is on-going and the father of the child not only threatened the mother with further abuse, he has threatened to kill the baby if she takes it home. Isn’t there something we can do for her I hear you ask? Of course there are ways in which we can help her. We have offered her every viable option including the one she has taken: giving up her child for fostering or adoption. She weighed up her options and came to a decision to give up the baby. Some of us are worried this is not a rational decision but unfortunately, within the law as she is an adult without any mental illness to cloud her judgement, we have to accept her decision whether it appears rational or wise or not.

Unfortunately, this case is not unique. In my 4 years of paediatrics, I have seen far too many cases of domestic violence and its many victims. 1 is too many but there have been dozens in my short time in the NHS. Bearing in mind that I have only worked in 7 NHS Hospitals and have seen but a tiny snippet of what is going on out there, this is a massive problem that is rarely talked about. Even within paediatrics and obstetrics where this is a major concern, we only talk about it when we get a case. Then it gets filed in the back of our minds until the next unfortunate case. Today I want to highlight the evil that is domestic violence and in my little way encourage anyone directly or indirectly affected to do something about it. What we need is more awareness and everyone who can do something to do a little bit so we can get some change happening.

As you may know, my mother is a feminist so I have always been aware of domestic violence in its many guises and how ugly it can get. As a young feminist, it was always one of those issues I was passionate about and I even wrote a radio drama aged 14 on the topic which got aired in Lagos in 2000. From a very early age, my mother taught me to have zero tolerance to domestic violence. I have always said that the minute a man raises his hand to hit me, unless it is in retaliation after I hit him first, that relationship is done and dusted. Some of you may think this is extreme but if you knew what I know, you would understand that zero tolerance is the best way to go about snuffing out domestic violence.

In medical school (here in Birmingham), I opted to do a module on Domestic Violence in my 4th year of study. It was a short module but the quality of teaching delivered voluntarily by the staff from the local Women’s Aid was fantastic. It was sobering to realise that the knowledge I had from what was happening in my hometown in Yola was mirrored in Britain. Britain may proclaim how forward thinking it is but just the same with Yola in Nigeria, their response to domestic violence is still inadequate and there is very little actual protection for the victims. Majority of the work is done by the voluntary sector trying to safeguard those who seek for help. By the very nature of this service provision, victims do not have access to help and unfortunately, many will continue to be victims until they end up in intensive care or even worse in early graves.

Here are some facts and statistics from Women’s Aid (http://www.womensaid.org.uk/domestic_violence_topic.asp?section=0001000100220041&sectionTitle=Domestic+violence+%28general%29) by way of introduction:

  • Domestic violence is any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. It is not just physical violence. It can be verbal, sexual or neglect. It can be against a partner, a child or an older relative.
  • The vast majority of the victims of domestic violence are women and children, and women are also considerably more likely to experience repeated and severe forms of violence, and sexual abuse.
  • Women may experience domestic violence regardless of ethnicity, religion, class, age, sexuality, disability or lifestyle.  Domestic violence can also occur in a range of relationships including heterosexual, gay, lesbian, bisexual and transgender relationships, and also within extended families.
  • The majority of abusers are men, but in other respects, they vary: abusers come from all walks of life, from any ethnic group, religion, class or neighbourhood, and of any age.
  • Abusers choose to behave violently to get what they want and gain control. Their behaviour may originate from a sense of entitlement which is often supported by sexist, racist, homophobic and other discriminatory attitudes.
  • The estimated total cost of domestic violence to society in monetary terms is £23 billion per annum. This figure includes an estimated £3.1 billion as the cost to the state and £1.3 billion as the cost to employers and human suffering cost of £17 billion.
  • The first incident of domestic violence occurred after one year or more for 51% of the women surveyed and between three months and one year for 30%.
  • Amongst a group of pregnant women attending primary care in East London, 15% reported violence during their pregnancy. Nearly 40% reported that violence started whilst they were pregnant, whilst 30% who reported violence during pregnancy also reported they had at some time suffered a miscarriage as a result (Coid, 2000).

The commonest question people who have not been victims ask is ‘why doesn’t she leave?’ To understand the answer, you have to try to understand how they become victims in the first place. The typical victim starts out as a happy vivacious young woman, often pretty with very social personalities. They meet and fall in love with a man who at first glance is perfect. Often these men are older, more experienced who charm the girl with their confidence and assertiveness. Once the young woman/girl is ‘in love’ and moves in with the abuser, he (often he but not always) will begin to isolate the girl from her friends and family. It often starts innocently but becomes more pervasive. Often the man will complain about some character flaw in one friend and systematically will find a way of making her cut ties with majority if not all of her social support network. He will often start with small acts of violence like physical restraint if she wants to go out and he doesn’t approve, seizing her shoes so cannot leave the house or calling her ugly when she dresses in a way that she would normally and in the way he would have previously approved. Then once he starts to isolate her, he will chip away at her confidence and withhold praise so that she begins to modify her behaviour to please him and to get approval. To please him, she often has to isolate herself from her friends and family and cater to his every whim. Despite that, he will find fault with all she does and he will start by criticising her. Eventually, he will physically punish her for not doing what she should. Mentally, because of the slow insidious way of grooming her into becoming a victim, she starts to believe that whenever he abuses her verbally or physically it is because she has failed to do something.

Eventually, she is truly a victim and she stops to see herself as a victim and him as an abuser. She begins to blame herself for everything that befalls her and see him as her saviour. Most will come to believe their abuse is an act of love. What it often takes for her to begin to see her thinking is faulty is either when she ends up in hospital because he has lost control and beaten her so badly that he ‘allows’ her to seek medical help or she has children or other family members she feels responsible for and they get harmed. Even then, these victims will often go back time and time again. Sadly, some will go back one too many time and end up dead. Or their child will end up dead or permanently damaged. Here are some statistics to back that fact:

  • Women are at greatest risk of homicide at the point of separation or after leaving a violent partner. (Lees, 2000)
  • 60% of the women in one study left the abuser because they feared that they would be killed if they stayed. A further 54% of women left the abuser because they said that they could see that the abuse was affecting their children and 25% of the women said that they feared for their children’s lives. (Humphreys & Thiara, 2002).
  • The British Crime Survey found that, while for the majority of women leaving the violent partner stopped the violence, 37% said it did not. 18% of those that had left their partner were further victimised by stalkingand other forms of harassment. 7% who left said that the worst incident of domestic violence took place after they had stopped living with their partner. (Walby & Allen, 2004).
  • 76% of separated women reported suffering post-separation violence (Humphreys & Thiara, 2002). Of these women:

– 76% were subjected to continued verbal and emotional abuse.

– 41% were subjected to serious threats towards themselves or their children.

– 23% were subjected to physical violence.

– 6% were subjected to sexual violence.

– 36% stated that this violence was ongoing.

Lest I forget, I will mention the even more invisible group: male victims of domestic violence. I was heartened to see a poster the other day in a public toilet (female) offering male victims some help. This is just as important because we know that many perpetrators of (domestic) violence were once victims their selves. The man might be the victim in some cases. Learn to expect the unexpected.

So what do I suggest? For anyone who reads this, please share so that we can raise some awareness. If you suspect anyone you know might be a victim, please talk to them and point them towards the Women’s Aid website for help. Do not allow your friend or sister or mother to isolate herself. If you feel you are being pushed away and this is out of character for your friend, please persevere and remain friends with them even if it is only from a distance. Do not cut all ties as you may be tempted to do. Lastly, be watchful. Personally and for everyone you love. If you suspect something is amiss, draw them closer and be there so that if they need help, you might be that link that keeps them real and potentially saves their lives. If you are with a partner who is exhibiting some of the behaviours above, talk to someone you trust about it and ask for help. This help could come from Women’s Aid or even a trusted friend. If you are in a place where Women’s Aid or similar do not exist, turn to friends and family and seek for help early. No man is worth losing your dignity, sanity, health or life for.

Happily Ever After: a Disney concept or reality?

I am a huge Disney fan. My late grandmother Mamie introduced Disney to both my sister and I early. Every time she travelled abroad, she would return to Yola bearing delicious large variety boxes of chocolate and Disney Videos. She would watch the animation movies with us and being an adult, she got some of the more subtle humour and would chuckle away to herself. For us, it was about the songs and the princesses, about the girl finding her prince against all odds and getting that happily ever after. My sister and I knew all the songs and when we drew pictures, it was always of the beautiful Disney princesses with their tiny waists, long hair and dainty feet. It is not hard to see why I wholly believed then that every little girl would grow into a beauty, find her soul mate, fall in love and live happily ever after with lots of happy children. To make it worse, I was also an avid reader and there was nothing I loved more than fairy tales, all with their happily-ever-afters and when I became a teenager, I read numerous paperback romances.

Unfortunately for me, reality intruded at some point during adolescence. I was witness to women who had been beaten by their husbands, those who were practically enslaved and could not leave their homes on their husband’s say so and those who were in forced marriages, mostly young girls like me. I went from thinking that every little girl was destined to be happy to believing it was all a fairy tale and that there was no such thing as a happy relationship between a man and a woman. I still believed in romance but I believed that romance didn’t tend to last beyond the ‘honeymoon’ period of a relationship. I also learnt about the widespread deceit being enacted by adults who seemed blissfully happy in their marriages.

I could not find any aunties who could say to me that their marriages were truly happy. Even those who at face-value were living a fairy tale. I found out that many came to be content with their lot having gone through a lot of heartache and choosing to put up with the husband they got as opposed to looking for Mr Right. Most had considered leaving their marriages but on balance thought the security of a marriage outweighed their hurt and betrayal. Many had been cheated on, more than once. A good proportion were the main breadwinners in their household yet were still treated as secondary to their husband. They took the lion share of responsibility, financially and socially. They fed and clothed their children, they made sure the children attended school and did their homework. They sent the children to Quranic School and made sure they learnt to say their prayers and how to fast when the time came. They were the nurturers and disciplinarians. They did it all for little appreciation in many cases.

Unsurprising, I was quite cynical when it came to love. I had very few relationships that lasted longer than a flirtation over a week or maybe one date. Before I met my husband, I had two ‘significant’ boyfriends. I think it is pretty telling that both of those are guys I met on holiday and only gave them a chance because I was on holiday and in the mood to have some fun. The first one lasted about 7 months but the last 2 months wasn’t really a relationship. The second lasted about a year and I really did consider a real relationship with him but I had my rational hat on throughout and I could see how bad he would be as a potential life mate. It was clear to me that we were not in the same place in our lives so I broke it off, difficult though it was.

I was single for 4 years before I met George. By the time I met him, I was happy being single. Loving my space and the freedom to do what I wanted when I wanted, unlike many of my friends. I was happily alone and not at all lonely. The only thing missing in my life was children – I had always been sure that I would one day be a mother. I even had a plan for that. I wanted to take a year out to see the world then come home and work on my career for a few years. Then when I was comfortable, I would find myself a gay bestie who wanted children without the ties of a relationship and we would have a couple of children raised in harmony. Plan B was to go to a sperm bank and find myself some quality swimmers. The only concern I had was explaining to my extended family back in Nigeria who the father of my children was.

Of course, best laid plans and all. I was making plans and God had plans for me. Just before my year of travel, I met George and I was suddenly in a real relationship. George says he knew within a few days he wanted to marry me. It took me a little longer to be sure but I was pretty sure within 3 months that this was the man I would risk getting my heart broken for. We have been together for over 4 years now. We have, like everyone else, had some ups and downs. Some of the best times in my life have been in the past 4 years. Some of my worst too. Some of them because of the relationship, a good proportion nothing to do with personal life but for which I was glad I had George to lean on. I have grown up and learnt a lot about myself. I have found that I have infinite patience I could have sworn I didn’t possess. I am capable of much love despite hardship. I am capable of trusting a man. I still can get really angry but yet my capacity for forgiveness has grown immensely.

Question is: does happily ever after exist? I don’t have an answer. I wish I did. I know there are couples out there who give me hope. My grandmother and grandfather were not a perfect couple. I know Mamie (my grandmother) had to put up with a lot through the years and her patience had to have been great but I also know that Baba (my grandad) loved her and that she knew he did. He never forgot her birthday or their anniversary. He never passed on a chance to show her off. He loves all of his grandchildren lots but he has a special spot for the 3 of us named Aisha, after my grandmother. When she died, it was clear he was lost without her. She died just before their 50th wedding anniversary. He went into deep mourning and we were all worried for the first year after that he would self-destruct. He couldn’t bring himself to mention her name or talk about her for many months. When the raw wound finally began to heal, he would mention her with reverence and such love that it made me well up. Theirs was definitely a till death do us part affair. I cannot attest to how happy they were but I like to think it was happily ever after, at least for Mamie who died secure in her husband’s love.

As a relative newly-wed, of course I want to believe it will be a happily ever after affair. I only agreed to say I do because I had hope that it would be forever. No one goes into a marriage wanting it to fail. However, the facts speak for themselves a bit here. These are from the Marriage Foundation and the Office of National Statistics:

‘The Social Justice Outcomes Framework reports that 45% of children already see their parents separate. Unless trends change dramatically, nearly half of all children born today will not still be living with both natural parents on their sixteenth birthday.’

‘34% of marriages are expected to end in divorce by the 20th wedding anniversary.’

‘There were 241,000 marriages in 2010, near a 100 year low. Cohabitation rose from 2.1 million couples in 2001 to 2.9 million in 2010.’ Maybe because divorce rates are so high, people are opting more and more not to say I do?

There is a lot of good news though:

‘Those who marry have a far greater chance of survival as a couple than those who cohabit. 93% of parents who are still together when their children complete their GCSEs are married.’ In other words, couples that choose to marry as opposed to just living together are much more likely to stay together, have children and watch them grow to the age of 16 or older.

60% of marriages are expected to survive to the 20th anniversary.’ Isn’t that an amazing statistic?

‘16% of marriages reach the 60th wedding anniversary’ and ‘the average marriage is expected to last for 32 years.’ I think those are awesome stats, don’t you?

‘Among natural parents, 31% of those couples who were cohabiting at nine months had separated when the children were seven compared to only 12% of married parents.’ Meaning that married parents are nearly 3 times as likely to stay together for 7 years or more compared to those just living together.

‘Cohabiting couples make up only 19% of parents but account for half of all family breakdown.’ In other words, married couples tend to stay together more than couples who have chosen just to live together.

I will end with this quote:

‘Quite clearly getting married does make a difference to your life chances and your children’s outcomes.’ It has been shown to be socially advantageous. Married people are more likely to be happy than their co-habiting or single or divorced counterparts, despite the shocking divorce statistics. So let us look beyond those stats and go into marriage putting our best foot forward. Sure it is hard work but we all know that anything worth doing is worth doing well. So I remain a realistic optimist. I will work hard at my marriage and I will pray for my happily ever after. I think I deserve it.

Champion the Truth

If you don’t live in the UK, you may have missed the junior doctor contract row that has been brewing for a few years but has escalated over the last couple of months. If you live in the UK and rely on major media outlets to keep you informed, you may think the dispute is about junior doctors asking for more money. I would suggest you turn to social media for more accurate information from doctors, other NHS staff and more importantly their families. Long and short of it is that the dispute is about our Government deciding we junior doctors need to work longer hours whilst our pay is cut and refusing to do the simple arithmetic that would show that if you want more junior doctors working around the clock, you need to recruit more of them because we are already working long hours and we absolutely will not do me as it would put our lives and the lives of patients that we hold so importantly at risk. I mean, how is it fair that the Government has voted to pay its MPs more and they can still claim vast amounts on expenses yet the very same Government says we have no money in the coffers to pay for more junior doctors? Isn’t that ridiculous???

I digress, please read up on Facebook, twitter and blogs writing on the issue. Plenty of truth out there is you care. The baseline is that at least half of the junior doctors who have voiced their opinions have stated either that they have made up their minds to quit the NHS or are at the very least, looking into alternate careers or going abroad. The simple truth is we as a group of junior doctors think the bottom line is that the Tories have vested interest to tear down the NHS and privatise our healthcare and hence line their pockets. There is also strong evidence out there that the current fool we call our Health Secretary has been a champion of NHS privatisation for many years and probably owns share in private health insurance conglomerates like Virgin Health.

This blog is actually about the one good thing that has come from this attack on junior doctors. We now have an online Facebook forum called Junior Doctors Forum which is by invitation only. It has 63,000 members and counting. Not all of them are junior doctors. We have consultants, medical students, nurses, midwives, paramedics and other allied healthcare professionals plus a few lawyers, journalists and even politicians about the forum. What I want to do is big up the passion of those on the forum and champion them sticking to their guns and being honest about how they feel and what this is doing to us as a group. Never has there been so much unity within the profession. Medicine is a very hierarchical and competitive profession and although we all start as one, we generally sub-divide as we become more senior and choose specialisation programmes. Our world then shrinks even further so all we know is related to the one field eventually. Our only contact with the outside specialities is if they are part of the multi-disciplinary team that we need to make sure each patient’s care is optimal with the inclusion of all relevant expertise.

So it is all good news though? No. Unfortunately when you get 63,000 opinionated voices with the top 1% in terms of IQ and ability to rationalise, debate and analyse, you get varying opinions. I am all for freedom of speech and embracing our differences. However, as with all other aspects of life, some are excessively worried about how other people interpret our opinions. An article was published based around a discussion we had on the forum and people are getting all uppity about all coming across professional and un-emotional. Why? If this was about professionalism only, we would all continue our stony silence whilst we get attacked as we give our all for the greater good. This time, we have stood up and shouted NO because not only have they attacked us (we have thick skin because of the nature of being medics who take enormous responsibilities day in, day out) but they are threatening the very fabric of the health of our nation. Their proposals are not only ensuring that many of us want to leave because we choose life and living than putting ourselves in danger from physical and mental exhaustion, they are also meaning that we are now less willing to carry on doing extra unpaid hours for no thanks.

The NHS has been running on the goodwill of its junior doctors for a very long time and things have been in a steady decline for the past decade yet this is the first year that doctors have threatened to strike. We love the NHS and have been carrying its weight to the detriment of our mental, physical and psychosocial health for far too long. This is the straw that will break the camel’s veritable back. It is because we are passionate that we are fighting the proposed changes which may start with junior doctors but we all know will extend to the rest of the hardworking staff the NHS is lucky to have as its employees. How then can anyone ask that we lie about how angry and betrayed we feel? How upset we are that we are being made to reconsider our futures? Whether we can afford to have children and continue to be there for our patients? How the lies of Hunt et al are demoralising us? How we don’t feel it is worth it anymore to carry on in the NHS when all we get for breaking our backs for a pittance (£11/hr 6 years after graduating for me compared to a plumber who can earn up to £50/hr) is abuse and an Etonian ignoramus vilifying us for caring.

Well, I am here to say that no. I will not be unemotional. If I didn’t care for the NHS, I would have quit after my first foundation year when I became a fully licenced medical practitioner. If all I care for was the money, I would be abroad today with a private clinic, dictating my hours and pay. If I didn’t care, I would not be attending protests and spending what little I have left over after my living expenses and medicolegal expenses on supportive merchandise. I care and I am not afraid to show it.

Hunt is only the face of the Tory campaign to break the NHS and leave privatisation as its only viable option. The Tory Government is libellous, dishonest, spineless and un-democratic. If the general public continues to buy the bullshit the Government is peddling, it will be the British public who will pay the price in the next few years. So unless you are all dying with something that will kill you with certainty in the next couple of years, wake up and realise facts. Fact is the NHS as we know it will be no more unless the whole of the British public fights this. Just google how much it’d cost you to pay for your health insurance in the US and imagine the UK going the same. Doctors are in hot demand the world over. We can and will be forced to leave the UK and the NHS is this horror continues and we will be fine. I assure you. So the fact that I am getting emotional is not because I am a greedy lazy overpaid privileged posh kid as Hunt and co would have you believe. It is because I care and I am not afraid to show it. Fact!

Open Letter to David Cameron – Our Silent PM

This was written by the father of a UK doctor. He lives in Sweden but is speaking out to save our NHS. If you share his sentiments. Reblog or share my link. Please.

Sir,
Your silence in the matter of the NHS and Junior doctors is conspicuous and indicates your silent approval of the Health Secretary and his policies.

This is not a matter only between Mr. Jeremy Hunt, the NHS, and junior doctors. In fact, this concerns everyone, from a child yet to be born to the elderly person counting the last breath and every one in between. Therefore your intervention is of vital importance to the national interest.

It is also very painful to see how ruthlessly and insensitively you treat the elite youth of your society. The youth who have chosen to indulge in the service of people of your nation, day and night, ignoring their own comfort and social life. They are the foundation of health and wellbeing of your nation of which, I am sure, you are proud of.

I have seen the plight of junior doctors. They are working day and night, have no control over their week-ends or holidays, when on call they have to be available for up to 48 hours. They cannot think of taking leave irrespective of personal urgency. In spite of all this they are single-mindedly devoted to their duties and responsibilities and have never asked for a pay rise. They are just short of being slave driven. To add ridicule and insult to their calibre, Mr. Jeremy Hunt wants to reduce their pay and increase their working hours (while informing the public he is doing the opposite). All the while he has been projecting them as greedy and an unwilling work-force. You are watching all this silently.

The fact is that junior doctors are tired, fatigued, exhausted, demoralised and yet they stand erect and defend the health system of your nation.

I will spare myself the energy and assume that you know more than I can ever explain. You will be well versed on the internal workings of your own government, therefore, I will draw your attention to a few things which might have escaped your attention. I do not think that this has escaped the attention of Jeremy Hunt because it appears his is a well calculated mission.

First, all signs suggest that you want to privatize the NHS. If that is so, you should come out boldly and declare to the public that you want to do so. Firing the gun from the shoulders of the junior doctors and blaming them is not graceful nor is it worthy of a strong Government. The public who have placed you in the high office have the right to know your plans rather than manipulations. If your Government succeeds, cutting the pay of junior doctors and increasing their working hours, junior doctors will survive in one way or another. However, the entire population of your country will suffer. I do not think that they will forget nor forgive. Therefore, before you dismantle the NHS, it is imperative that you rethink your plans because the health and wellbeing of your country depends on it, and for this, you are directly answerable – even in the future.

Second, the Health Secretary has succeeded in downgrading and vilifying the medical profession as much as possible. Once again, you are a silent witness to this. He has taken away all the motivation and incentive from bright and elite students of your schools and colleges to choose the medical profession. If he is allowed to succeed further, you might find medical colleges left wanting for students. That would create an enormous shortage of qualified and quality doctors in the long run and an ever increasing burden on the health service.

Thirdly, if you and Mr. Jeremy Hunt succeed in privatising the NHS – I can see how this could be the interest of Mr. Jeremy Hunt. Your previous health secretary Mr. Lansley, has recently take a role in a company who is promoting privatisation of The NHS.

If The NHS is short of funds (and we know it is, through systematic underfunding by the government), it is not the fault of junior doctors. On the contrary they have to work even harder without adequate machines, equipment and staff. It is a simple case of mismanagement of finances and mismanagement of administration. Instead of pointing the gun toward the junior doctors – who are the weakest link in the chain of NHS hierarchy – aim your guns at cleaning and pruning the financial management of NHS. Look deeply into it as to why The NHS is in this position.

There are 53000 junior doctors. They are working for at least double that number. Each doctor is giving you output for at least two doctors. Instead of motivating them, patting them on the back, and incentivising them, you want to pull the carpet from under their feet so that all of them tumble down. More worryingly, you are willing to do this on the whims of a few people who may not think beyond their own interests at the cost of the health of your entire nation.

Your junior doctors are dedicated, hardworking and responsible. They are the future specialists, researchers and innovators. They are the backbone of the health system of your country. Give them the respect they deserve. Give them the motivation and sense of worth. Applaud them for having chosen the medical profession.

I have seen them working with dedication and without complaining in spite of all the hardships they face as my son is one of 53000 junior doctors.

This letter is the voice of 106000 parents who are proud of their children and their devotion to the service of people.

Best regards,
Anil Bhatnagar