A timely reminder of what junior doctors actually do – and it's not pleasant

Plus: Timothy Garton Ash comes out fighting for free speech on Radio 4

16 April 2016

9:00 AM

16 April 2016

9:00 AM

All this week Radio Five Live has been giving us an insight into what it is like not just to confront death every day but also to know that a minor error on your part might end a person’s life. In Junior Doctors’ Diaries on Sunday night, Habiba, Andrew and Jeremy took us inside their daily round, followed by updates throughout the week on Phil Williams’s night-time show. It’s been a timely reminder (politically motivated or not) of how much we need good doctors, and how sad it is that so many of them have felt driven to go on strike. Sad because it’s actually a reflection of how undervalued they have become, and of how little we understand about what they do. Indeed, Habiba, a paediatrics specialist, told us she had been upset by some parents who, ‘rightly frustrated’ that their child was not improving as quickly as they had hoped, had questioned her experience. ‘It’s hard,’ she said, bleakly, before reassuring us that she loves her job and would do nothing else.

Andrew, meanwhile, was driving home at 9.07 a.m. after a weekend on call at a hospital in Suffolk. The hospital was absolutely full, he told us, just one or two empty beds, and some of his colleagues were making ‘awful and morbid comments about how people passing away frees up a bed’. He added, despairingly, ‘That’s the point we’ve got to.’

In Gwent Jeremy recorded his thoughts at two in the morning after spending two hours in theatre operating on a woman who was suffering from a hernia that was stuck. He was thirsty and tired, but there was now a new urgent patient waiting for him in A&E, who needed to go straight into theatre with a twisted testicle. ‘I need to have a quick drink,’ he told us, ‘and then get back on it.’ Quite apart from his workload, Jeremy also has to make, on an almost daily basis, decisions on whether to operate or not. One patient came in with infected pressure sores that were so bad she had become overwhelmed with infection. Surgery to remove all the dead tissue could make her better, he said, but she was very unlikely to survive. ‘Just because we can do surgery doesn’t make it the right thing to do.’

Andrew, too, also talked about difficult decisions. He wanted to change the resuscitation status of an old lady who had been found on her own at home suffering from hypothermia and who had no family or friends. Her next-of-kin was a neighbour who hadn’t spoken to her in two years. He didn’t want her to experience CPR if her heart stopped because there was little chance she would survive the trauma. ‘Three taps on the chest won’t bring people back,’ he said. ‘This isn’t Holby City.’

Will they, won’t they, get back together again? Debbie Tucker Green makes no promises at the end of her new play lament on Radio 4. A man and a woman are in a fancy restaurant, meeting up for the first time in years. It’s not a comfortable reunion. They speak across each other, interrupt each other, repeat what the other has said without taking in the meaning. But gradually their separate stories since they parted begin to unravel. How they appear might not be who they now are.

Tucker Green (who also directed her play, which was produced by Mary Peate) has said that when she begins a new project she doesn’t know whether she’s writing a poem or a play. She has a voice in her head that demands to be written down and it’s the words that count, not the format. As you listen you can see exactly what she means. She writes with such brilliant rhythm and economy that it could be poetry. She doesn’t explain but tells us all we need to know simply from the way her words are put together. The acting, too, was pause-perfect with Paterson Joseph as the man, Nadine Marshall as the woman and Cecilia Noble as a very noble but difficult mother.

How we use words, or give licence to others to use them, has become of vital importance, argues Timothy Garton Ash in his new Radio 4 lunchtime series, Free Speech (produced by Nina Robinson). ‘It’s the oxygen of freedom,’ he insists in the first programme. But he’s concerned that it’s being put under pressure by mass migration and the internet. The information giants such as Google and Facebook are crafting the rules for free speech without any recourse to courts or governments. We need, says Garton Ash, to establish a set of basic principles to combat the assassin’s veto (I will kill you if you say this), the heckler’s veto (we will stop you saying what we don’t like by shouting louder than you) and the offensiveness veto (I’m offended so you’re not allowed to say this). ‘We must fight for them,’ says Garton Ash, a new cogent voice on 4, with a vast hinterland of knowledge and understanding that he uses not to impress or confuse but to make sense of complex and crucial issues.

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Show comments
  • Fraser Bailey

    Well, yeeeeeeeeeees, but all these doctors believe in socialized medicine (with non-socialized salaries, of course), free at the point of service for anyone who wanders in from anywhere in the world. The demand for such a service will inevitably be infinite. Thus the doctors can’t really complain when they are very busy and tired.

    • kyle lynch

      Not true in the slightest. You can come in for emergency care only (which benefits all for obvious reasons) but any elective or on going care can and will be denied to those not eligible to them.
      What exactly do you mean by non socialised salaries because if you mean they are free market salaries that is not true. They have a set salary banding that all doctors adhere to regardless or their negotiation prowess.
      The doctors do not either decide on general healthcare policies so cannot be blamed for overworking.

    • Dacorum

      We need to support the NHS, we need to train enough of our own doctors, we need to offer them terms and conditions of service and pay levels sufficiently high enough to retain their services and we need to stop health tourism. The government is not doing any of that. Instead they are losing our own doctors overseas to places like Australia whilst the government is robbing places like Romania of doctors that they need to look after their own needs to fill gaps thegovernment have created here by treating our doctors so badly.

      We have to provide foreigners with emergency care in just the same way that we expect our citizens to be given emergency treatment in they fall seriously ill or have an accident when abroad.

  • Hippograd

    ‘We must fight for them,’ says Garton Ash, a new cogent voice on 4, with a vast hinterland of knowledge and understanding that he uses not to impress or confuse but to make sense of complex and crucial issues.

    Here’s T.G.A. applying his cogency to a recent controversy:

    After her finest hour, Merkel now needs help from all Europe

    Germany’s welcome to migrants was laudable. But their successful integration will be a huge challenge

    […] Merkel has simultaneously to reassure her people that she has immigration under control, and to lead German society in an unprecedented civic, economic and cultural integration of the newcomers who are already there. If she succeeds, she will not merely deserve to be Time’s person of the year. She will have earned the Nobel peace prize.

    Powerful stuff even by Guardianista standards. And it will be a huge challenge to integrate so many Persons of Vibrancy. Still, one thing remains certain: All those members of the Muslim and Black community will be nearly as good for free speech as they are for female rights.

    • sfin


      Here’s “free speech” in Mutti Merkel’s brave new Germany:

      Those recent negotiations with Erdogan have advanced the cause no end!

      • Dacorum

        I cannot help thinking that all those who have criticised Merkel for agreeing to the prosecution going ahead should themselves read out and post the exact words broadcast. It would then be interesting to see whether she then gives permission to prosecute fellow members of her cabinet!

  • Cyril Sneer

    Hospitals busy? Oh dear… well you keep voting for your parties of mass unchecked immigration and you’ll have a job for life as an overworked doctor.

    • Craig Leaper

      Average age on my ward is 70/80 odd…… these people don’t tend to be immigrants!!
      30% of them are medically fit, but can’t be discharged due to lack of social care.
      Interestingly, when we do have patients from an “immigrant” background, discharge to family care is RARELY a problem!

      Its UK born people getting older and lack of social care (both family and state provided) that is the problem, not immigrants!

  • trobrianders

    Socialist doctors love misery. All part of the sick narrative.

  • Craig Leaper

    When is someone actually going to explain where the manpower is going to come from to cover the additional shifts at the weekend, when it is very evident from the excessive locum budget, that there are not enough currently in place to cover the service given at present. Full 7 day working is a great ideal, but it is expensive, and a unattainable goal in the face of current financial pressures on the NHS; I’d like a hot tub on the roof, but unfortunately we have to be practical sometimes!!

  • congreve

    ‘Junior’ doctors who have been on strike have lost their professional status and joined the proletariat.

    And for the remainder of their lives they, and we, will know it.

  • They’re just doing what we’ve all done for years – and with shorter shifts usually. It’s a vocation. The cases described are part of that and are not intrinsically awful/sad/miserable/stressful. Really, a lousy article. There are plenty of docs in their 50’s doing much the same tasks, but as consultants.