Sunday, October 20, 2013

Time and patience

Time. A commodity which seems to pass us by at a frightening pace. Maybe never more poignant than when I see my daughter..seems like it was yesterday I held her in my arms gingerly taking her from the midwife...and today as I see her taking that extra minute in front of that mirror flicking her hair...time passes us all by, doesn't it? And another week went past in my work life and I am trying to make everyone count...take it in small silos...small steps ahead..adds up to perhaps a bigger change..we shall see, won't we?

Being physician on the wards is always a fascinating experience...interacting with juniors, taking time to do some teaching..sometimes we Consultants forget what a smile, what a arm around the shoulders mean to all those folks working so hard. I had one of the best Consultants ever and never ever did he have anything but a smile for us as juniors- however hard the day was. And I try..sometimes its difficult but I always know that translates into your juniors putting that extra bit in. And you struggle to see anyone who shouldn't be there..primary care are taking more risks, the front door deflects more...resultant folks on wards are genuinely ill or have nowhere to go to. Either their health or the system has failed them, not individuals.

In between a travel to the BMA House for the parliamentary think-tank for diabetes care. Listen to the government and opposition lay out their vision, the challenges..listen to the National Clinical Director for diabetes outline his priorities, listen to Barbara Young asking all to "get on with it", listen to a primary care champion argue the case for QoF...too many challenges, too many problems? The world seems to be too preoccupied in colourful power points, too engaged in outlining the challenges..the same ones I heard about 5 years ago...I attempt to inject some positive thoughts in..."Stop mulling over the problems, ladies and gentlemen...its time to do..and its possible". Patients in the audience nod, an elderly patient who happens to be from Portsmouth says she knows me...places a hand on my shoulder and says.."Don't stop. Show them the art of what's possible"...makes taking those extra tablets to help in the journey worthwhile.

Another drive later in the week to London meeting an umbrella organisation dealing with musculoskeletal pathologies...what could I possibly contribute as a diabetologist? No idea but outlined what we had done for diabetes a chronic disease but always a pleasure to see patients, doctor leaders etc around a table trying to improve care. They weren't just sitting and moaning..they were trying. Hope springs eternal, right?
Finally, a 2 day meeting bringing primary care and specialists together discussing diabetes care, discussing the way forward, discussing what social media could bring to the party, how engagement of patients could help build services, discussing working within existing financial margins, listening and challenging Martin McShane...once again, an event where the art of possibility was spread, the ethos of can do was hopefully cascaded. My parting shot to all? may not work all the time...but you got to try. Life's too point in looking back and thinking what if...when you have the opportunity to try now.
The week then finally ends...with a beautiful and touching email from the mum of one of my patients who I had seen struggle every day and now is a mum herself of a lovely baby.It taught me what parents go through with their kids and the unstinting and nonjudgemental love mums have for their daughters. Makes every single day of this worthwhile, every bit that national award or accolade can replace that warm feeling you get when an email like that. 

Finally,a request to all patients with diabetes. On social media, I read, listen and appreciate the frustration with the system. But like me, there are several who are trying. I know them, I talk to them, I met some of them this weekend too. The reason you don't hear about them is because they are less flashy than me, more humble and like to progress their work without making a show about it. Each are trying..using a comic book analogy, Iron Man's approach maybe different to that of Captain America but they are trying to do the same thing. But as with all things, these things need time. There are years of inertia, institutionally held beliefs, mistrust between primary care and specialist care, financial restrictions, organisations, continually changing goalposts which takes time to negotiate and cut through. 

So all we ask for is a bit of patience. We will, together, with your support, change it. But give us some time..I know the past has not been great....but we can't account for that..but we are certainly trying to make a difference to the present and future.
In the words of the Christian author from Carnage Titullian.."Hope is patience with the lamp lit". We are trying to make sure this isn't another false dawn, another false hope...time and patience is what we ask for in return.

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