Act 1: At the Surgery
My visits to the surgery feel as though I’m an actor in a long-running play. I’m one of the crowd who has a few lines; my doctor is the lead.
Every time I climb these stairs, I tell myself that there’s no need to knock. You know she’s expecting you. I looked up with everyone else as my name chimed onto the long, narrow screen in red LED: Mr Nigel Rumsey, Dr X, Room Seven.
But I knock anyway, and then hesitate before I open the door. The doctor looks up with no sign of recognition. It’s 5:15 pm on an August Thursday afternoon; the we’ll fit you in at the end of the surgery performance, and she’s played this part many times already today.
There was a time when I hadn’t been to the surgery for a few years; now I’m doing my best to make up for it. I had assumed that my regular visits, combined with my natural charm, would mean my problems stayed at the front of the doctor’s mind. That if she were unfortunate enough to be troubled by a case as she went to sleep, it would be mine. I was confident that this woman would put her years of medical training and experience to bear on this problem. Between us, we’d get to the bottom of it, and I could get back on with my life.
Her usual ‘How can I help you today?’ puts a damper on those dreams. But I know my part; I slump into the wipe-clean grey plastic chair alongside her desk and recite the potted history I’ve been through so many times before.
When I was young, I remember doctors sitting behind imposing wooden desks — furniture as a symbol of authority. But that was thought of as a barrier between them and us. So now the patient sits alongside the desk, which is designed to encourage the feeling that we’re all in this together!
Act 2: The Call with Rachel
I’ve got ahead of myself; this particular performance was prompted by a call I’d had with another doctor (I’d been planning on calling her ‘GP 2’, but that sounds like a weight-loss drug. So, we’ll go with Rachel*) a couple of weeks before. The pain in my legs had been getting noticeably worse for a few weeks, and after three nights with almost no sleep, I needed to do something, anything.
I filled in the e-consult form on the surgery website. It’s tedious, but the system does work. The next day, the NHS app on my phone pings to tell me that my submission has been successfully received. Thank you. However, they go on to say that today they have switched to a new, better system: Anima. ‘Please resubmit your request, and we’ll deal with it as quickly as possible’.
The brevity of the Anima form catches me out. Whereas e-consult was an exercise in repetition, I reach the end of Anima before I realise that I haven’t had a chance to say what I wanted to say, mainly that I’d like to speak to my usual GP, face-to-face. I’m not a fan of telephone consultations.
There’s a world of difference between ‘I can’t carry on’ and ‘I CAN’T CARRY ON!’
A few hours later, another ping: ‘The doctor (that we’ve come to know as Rachel) will call you on Wednesday.’ That’s far quicker than I’ve ever been offered with my usual GP, so I go with it. Rachel has a caring voice; I like the sound of her; I pick up my script, imagine I’m sitting on a grey plastic chair, and I begin.
My dad’s sister drove a London ambulance, back when they had big silver bells mounted on the front. This made her a hero in my eyes, and so I have an almost reverential respect for anyone who works for the NHS.
But the tiredness and the frustration get the better of me. I politely say that I feel abandoned by the surgery, that they got me into this mess and are doing very little to help me out. Nothing I said was incorrect or unreasonable, but it probably wasn’t helpful when I was asking for help.
Rachel apologised that I felt that way, but there was a noticeable change of tone. She wisely didn’t want to get between a sleep-deprived patient and a senior partner. She assured me that she would ask my doctor to call me as soon as possible.
Back With Dr X
The call with my usual GP had none of our usual conversational warmth – but maybe that’s my perception. I got the impression Rachel had left a note indicating that I was less than happy.
However, a few more days of pain and very little sleep had passed since I’d spoken to her. If I needed help before, now I was feeling desperate. ‘I need help. I can’t carry!’ That didn’t come out as I had intended, with all that it implied; it had just slipped out. I waited, hoping that she wouldn’t ask the question I didn’t want to answer.
I had suggested something that I didn’t intend. That I knew I wasn’t going to follow through with. There’s a world of difference between ‘I can’t carry on’ and ‘I CAN’T CARRY ON!’
She paused. ‘Come to see me next … er … Thursday.’ I can fit you in at the end of surgery.’ Another six days, it seemed like an eternity!
All this flashed through my mind as I finished my opening lines and tried to get comfortable on a grey plastic chair designed so that you don’t want to hang around.
‘I spoke to your colleague…’ I didn’t want to go into my conversation with Rachel, so I trail off. Dr X picks up on my hesitation, ‘Oh yes, I remember.’
I remind myself that I’ve been waiting for this moment and I must make the most of it. So, I explain about the pain, the lack of sleep, the desperation. I remind her that when I was taken off of Amitriptyline, I had a job, and a social life; I was riding my bike; I had a life!
Act 3: The Consultant Referral
There is a knock on the he door; it opens, and a head pops around. The young doctor smiles at me. For a moment, I’m thrown. There’s someone else on stage! This hasn’t happened before, and it certainly isn’t in the script! ‘I’m ready when you are’, he says. ‘Okay, I’ll see you later’, says Dr X.
She looks back at me, and it’s as though she sees me with fresh eyes. ‘I can see that you’re far worse than you’ve been before. I’ll refer you to a specialist and I’ll fast-track it. They’ll be in touch in a few days.’ At this point, I couldn’t be more surprised if a marching band entered the room playing the Stars and Stripes – this isn’t the show I was expecting.
I say my grateful thank-yous and I exit stage left.
At the bottom of the stairs, the waiting room is unusually quiet. The only person there is an attractive young woman reading a newspaper. The screen chimes; we both look up: Miss Allie Burns, Dr X, Room Seven. She gets to her feet, the next performance starts shortly.
Epilogue
I don’t hear about my appointment with the consultant for ten days. I’m not sure what to expect from a fast-track, so I get the phone number from the GP’s surgery and leave a message for the consultant’s secretary. She calls back later that afternoon. They had received my referral, but unfortunately I’d been referred to the wrong clinic. So they sent it back to Dr X.
NHS 1: Patient 0
Further Help
If you need to talk to someone and you’re in the UK or the Republic of Ireland, The Samaritans are there for you. If you’re outside of the UK, at a look at Befrienders Worldwide. Be kind to yourself.
Dr Mark Horowitz offers the most practical, professional antidepressant withdrawal advice I’ve found online. The academic papers are impenetrable to the nonprofessional. But he has useful links to newspaper articles which explain things in layman’s terms. The UK mental health charity, Mind, is also a good resource.
* ‘Rachel’ had a soft Indian accent.
W Eugene Smith: I couldn’t pass up the opportunity to include a couple of shots from the documentary photography master that is W. Eugene Smith. You can see more of his wonderful work on the Magnum website.
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