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Yes We Can


Posted by Dr No on 24 February 2015

yes_we_can_3.jpgThe wonderfully uplifting and generally obstetrically sound BBC series Call the Midwife has got Dr No worried. Playing catch up on the current series, he worries about the way the plots are getting more extreme, as if the writers, lacking the discipline of Jennifer Worth’s now expended memoirs, have decided to go commando. We’ve already had outbreaks of diphtheria, syphilis and rats: will bubonic plague be next? Or will it be World War Three? Dr Turner is burning out and booze has crept up on Trixie: when will the sponge-o-cidal Sister Monica Joan’s magic mushroom habit be exposed? Is unflappable Sister Julienne unflappable because she smokes cheroots behind the bicycle shed? Having put her back in a nurse’s uniform, will Dr Turner’s wife Shelagh now be transformed, Dennis Potter style, into a Singing Receptionist, complete with leather crop and corset? Will Dr Turner's stress trigger a bout of crippling psoriasis? Such are the possible alarming developments on which Dr No frets.

Some of the snootier upmarket broadsheet reviewers – the ones the get the wood on Wood Hall, the black screen adaptation of a Booker Prize winner where much of the acting is limited to Cromwell’s eyebrows going up and down, like the channel bars on a stereo recorder with the speaker muted - tend to look down on Call the Midwife’s cockle warming - in the musical Oliver! way – spirit. When will the nuns start singing Food Glorious Food at Compline? Why not welcome new staff – and on new staff, where the hell is Honeysuckle Weeks when you most want her - with Consider Yourself (one of us)? Come to think of it, the whole thing could be reinvented as a musical: The Sound of Midwifery. Sixteen Weeks Going on Seventeen, Climb Every Contraction, it’s all already there. No reviewer, though, has yet gone as far as to borrow Clive James’ 1976 take on Demis Roussos, with talk of ‘immense reserves of inner warmth, as in a compost heap’, but it may yet come it, as for some time Vanessa Redgrave’s opening and closing homilies have been revealing worrying signals of vast reserves of inner warmth; but for now Dr No is content to have his winter cockles warmed.

There are many levels on which Call the Midwife works. On one level it is an iron fist in a latex glove, hard-hitting social commentary on post war Britain wrapped up in Sunday evening fluff. On another, it is about convent-fever, the condition caused by housing a bunch of feisty same sex characters under one roof. On yet another, it is about stoicism in the face of adversity. Long before Barack Obama borrowed the phrase, the nuns and nurses of Nonnatus embodied the spirit of yes we can. And it is because they do that our cockles get warmed.

The NHS of Call the Midwife is the NHS Dr No was born into. The NHS Dr No trained in is closer to Call the Midwife than today’s NHS. We knew the NHS cost money, but the shadow of the market had not yet fallen. Commissioning was for the Armed Services, not the health service, and pathways were for walkers. The perfidies of purchaser-provider splits, and the flummeries of bean count flannel were as yet unimagined. Instead, we just got on with it, and did what we could, because we could.

Some but not all of Dr No’s own recent experience of the NHS, and tales he has heard from others, suggest the yes-we-can NHS has become too often a no-we-can’t NHS. A few years back Dr No had to give a talking protocol disguised as a radiographer a poke in the eye to get a chest x-ray he was due. He has described elsewhere on Bad Medicine some of the NHS misfortunes that befell his mother in the last weeks of her life. The internet is awash with dossiers of NHS despair, too many with a common theme of no we can’t. The freedoms of professional practice – yes we can - have given way to the prisons of protocol, the world of no we can’t, the computer says no.

But yes we can is still very alive. Earlier this week, Dr No attended an annual review appointment at his local hospital. In the weeks before the appointment, he had developed unrelated symptoms of concern, in so far as cancer was an unlikely but possible diagnosis, that came under the same specialty. Being new, the protocol pathway – or it may have been the pathway protocol – mandated a new separate referral. Still, here was Dr No, in the right clinic, at the right time. He decided to ask, despite fearing a no we can’t, you need a new referral reply, whether the doctor would consider the new symptoms. The answer? Yes we can! And quicker than one can say local anaesthetic, Dr No got the necessary examination, which he is pleased to report was clear.

This is superb service, an agile smart and supple health service doing what it does best, looking after patients. Dr No suspects he crashed a pathway, and may even have caused somewhere in the bowels of the hospital a protocol pile-up. But so what? The patient got looked after, mountains of paperwork and aeons of delay were avoided, and both doctor and patient were content. All because one doctor took the old line: yes we can.

7 comments:

Dr No's writing is getting better and better.

As Dr No may recall, Simon had cancer in 2010. I was very worried because of what I know goes on in parts of the National Death Service.

After the shock, I got on the blower and within a couple of hours had established that the service in Soton is excellent and there is a surgeon of international reputation in Basingstoke.

All went well.

Other parts of the Death Service are dreadful. We have had multiple high profile suicides in Soton.

Yesterday I spoke to Dr Timmins. What a fantastic chap. My initial impression is that he is a dream doctor after more than thirty years.

Incidentally dx with lung cancer in 2010, had all tests required promptly and a thoracotomy in Guys. No further treatment needed thankfully. Since then I have had an MRI and bone scan besides the regular follow up appts. having a chest infection recently I was immediately sent for an x ray and in the second year after surgery when I had a series of bad colds I had an extra CT scan and saw a lung doctor at the request of my surgeon. Maybe I have been lucky but I can't fault the speed of my treatment and the care with which I am treated if there is the slightest concern. I too think Call The Midwife is how I remember the NHS, fondly. I am quite a strong character though and I sometimes think how you are treated depends on where you live and how you approach the medical staff, polite but firm.

Haha! You have a point! I really like this series and I've been following it ever since it came out, but I agree with you. Things are getting a bit crazy. I haven't read the memoirs on which it's based, but I have a feeling it's drifting away from them just a tad. I don't want this to turn into a worn out series. chrissy

It's a very good show but it is getting a bit side tracked. It was just fine, I don't know what they felt like they had to make it more exciting with these little twists and turns. And I don't like that characters are always coming and going. nicole

I hope that they realise that they are killing the show if they continue this. What they should do is leave this bad idea behind and continue the show from where they were. Anithing can be fixed, even this. Raducu

I love Call the Midwife. I always stand by the TV with a cupp of hot chocolate when it is on. The best show wver!

never watched an episode of this series. maybe I will give it a chance after I read you article :) Vlad Andrei


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