Tuesday, July 17, 2012
Don't ask me why
Tired. Really tired...and just genuinely happy that am just about to go on holidays for a few days. Long journeys do tend to take a lot out of you, however comfortable they are and I am writing this blog while travelling back home..all the way from Liverpool. Been part of a roadshow, asked to talk about our local model of care and as part of that been to Manchester, Birmingham, then to Newcastle, followed by London and finally finishing in Liverpool. Just to clarify, all done on my own time by taking out annual leave or by making sure clinics were not cancelled. Not on my high horse, but whenever you do these sort of things, people tend to assume that the rich, spoilt Consultant is skiving from the NHS to do personal "gigs". Some sense of morality still runs deep, so for the doubting Thomases put that in your pipe and smoke that.
GPs, Clinical Commissioners, Managers, Practice Nurses, Consultants...they were all there..in all the cities and it was a fascinating group of people..some disgruntled, some willing to engage...and in front of all of them, the roadshow unfolded. There were sessions on discussing the patient with complex diabetes, there were sessions on the pitfalls of clinical commissioning, there was discussions about public health engagement...all in all, an interesting day of discussions.There was a debate about appropriate treatment of patients with diabetes..about how it was beyond simple rules and algorithms...but about the patient in front of you. "Horses for courses"..."fit the drug to the patient"...all of these were discussed and debated...and somewhere during the day, the healthcare professional bound by rules and guidelines stood down..and the clinician who had time to look up from his prescription pad, and resist the urge to fill out a computer screen..emerged.
In my session,I tried to showcase what we had done locally. The usual caveat was added about this not being a session to "tell anyone what to do"...but this was our story...the story of the Portsmouth Diabetes centre, the journey of ours from 2009...and this was an interesting story to tell. It was the story of a tight knit team, the band of Four Consultants...the old 3 musketeers who took the young D'Artagnan under their wing...it was fun to relate a "heroic" story, a story laced with intrigue, mystery and triumph....but mostly this was about paying homage to the nurses who made this happen, respect to the colleagues who stood firm, the managers who understood and formed an amazing ally..but foremost there was a genuine sense of pride to say..."We come from Portsmouth".
And during the course of this meeting, there were the others. Beyond the organising company...there was Emma Carroll...bouncy, vivacious...but beyond all, a project manager par excellence.When you have 5 such events on the trot, and have speakers to manage, their travels, delegates attending, not turning up, catering etc to handle...and that goes without a hitch..well..you must be pretty darned good! Throw in a few other good eggs (Danielle, Bradley)..a trip to Pizza Express, a discussion about Gary Barlow ( don't ask) and they were good folks to hang out with. The professional side of it never goes away..I was there to do the talk...they were there to make sure the event went well...but when you are scoffing down a pizza and sharing a joke about who can get how many Take That references in a sentence....it just makes such meetings just that bit more fun.
I made new friends..Stuart, Sailen...bumped into old colleagues, Richard, Fiona, Brian...and heck you know you are among people who speak the same lingo as you. Folks who are keen to make a change, but also who knew not to take themselves too seriously. You hear from Stuart, a healthcare professional on an insulin pump mentioning about how rarely his doctor has discussed a hypo with him...and you know how much you have to travel yet.
And finally there was the Pharma folk...and the dichotomy creeps in. Do we see them as Pharma...or do you see them as colleagues in the same industry trying to do their job...and perhaps forge friendships with them beyond their employer? Do I genuinely believe that being friends with a folk who works in the Pharma industry will make me prescribe his drugs...or do I take that as an insult to my intelligence? Heres an analogy....I have a good friend who flies planes for British Airways...I am not sure that has made me fly ONLY British Airways...on the contrary I tend to use the airline which suits me best for the travel and/or gets the job done, is safe and a lower cost does help too...heck that nearly sounds like how a level headed professionals uses pharmaceutical drugs too....doesn't it?? So there was Christian, there was Hannah, Sophie, Susie...a group of folks who are...what can I say...good fun. Is it an act to con me into prescribing their drugs..am I being lulled into some sort of Vulcan mind melt so I forget all forms of evidence based medicine...well I darned well hope not.You know what they say...don't piss off Partha Kar....he holds the longest memory in town....I may come from the land of Gandhi...doesn't mean I believe in his "forgive and forget" motto :-)
To end, I would like to finish with a little story. My talks as usual was delivered with the usual passion...the usual "Come on guys and girls..we can do it"...and after each talk, I was greeted with "keep it up/can I contact you/don't let anyone get to you/inspiring" etc etc which was just so...lovely. Not a single person criticised it, not a single specialist held their head in anger or disbelief. This was an audience away from the usual politics of diabetes, who had never heard of me, senior folk who had seen so much of the NHS..and yet were with free with their praises for this young gun. Swelled the ego? Betcha...who doesn't like platitudes and appreciation?
And then......an elderly lady who introduced herself as a GP for 36 years, of Pakistani descent...walked up to me in Birmingham. I turned around and extended my hand to accept her thanks...to which she asked me to bow my head. Slightly apprehensive..I did. She placed her hand on my head ( where I come from, it's a sign of blessing from your elders) and murmured in Hindi " your parents must be so proud of you...all my good wishes are with you, my son". I straightened up...and she was gone...slowly mingling into the crowd milling for coffee.
I am not one to show emotions, lower my guard..but at that moment, I had this solid lump in my throat. Every single accolade I have won so far melted into insignificance, every single criticism lobbed by cowards from the undergrowth didn't matter any more...In a flash, I remembered those hard days when my parents worked so hard to give me that education I needed, stood by me during my rebellious teenage years, those late nights when my dad used to struggle back from work..or those long evenings when my mum waited patiently for me to finish my muddy football game...heck, they made me who I am...and this elderly lady had crystallised that in one small gesture.
I had to lower my head, smile, while clenching my jaw...there was this speck of dust which had just landed in my eye...and I just had to clear it away.....next time, I see you,mum and dad..I give you a hug. Just don't ask why..it's just one way of saying..."thank you...for everything".