Trust Me, I’m A Doctor. Or Not…

A Crow

‘Well, I maybe trust you a little bit’.

Not too much of a compliment there, you might think.  Actually, you could be completely wrong.

Those were words I heard from a patient last weekend.  I’m a junior doctor working in mental health.  This patient was seriously unwell, showing signs of an acutely manic episode – his mood elated, the thoughts he was expressing jumping rapidly from one thing to another in a disordered manner; it was even a struggle to get him to sit on a seat for any part of the consultation.  It’s usual with that type of illness that if someone is unwell enough, they will lose their insight into the fact that they are unwell, so for example when they are questioned directly about how they feel, they may say that they are feeling fantastic, never better.

This was such a situation.  He was an unwell patient who clearly needed to be admitted to hospital for further assessment and treatment but due to his illness he could not recognise that he was unwell.  Understandably therefore, despite the best efforts of myself and the specialist psychiatric nurse with whom I was seeing him, he was not agreeable to coming into hospital voluntarily.  And yet just after I told him I had put him under a detention (an emergency detention certificate under the Scottish Mental Health Act, which any doctor is legally able to do under certain specific criteria), he came out with these surprising words to me shortly after: ‘Well, I maybe trust you a little bit.’

Not only as a healthcare professional but in general as a human being I tend to think about trustworthiness quite a lot. To hear those words from a patient whom I had just detained blew my mind a little bit.  I’ve just been working in mental health for a couple of months; he was only the third patient I’ve ever had to detain.  For someone to tell me they trusted me even a ‘little bit’ while they were unwell enough that they didn’t understand that they were unwell and I’d just told them I’d put them under legislation to keep them in hospital against their will seems pretty crazy to me.  In a strange way, it may perhaps the best compliment I’ve ever received from a patient.

In this day and age ‘well, I maybe trust you a little bit’ is probably about the best compliment most of our elected politicians could ever hope to receive.  Indeed, increasing numbers seem unlikely to do so. Corruption in the political establishment is rife – as revealed starkly by certain recent events, the Panama Papers as a prime example.  Prime Minister David Cameron’s behaviour in this situation cannot be described as anything other than blatantly dishonest, and this is but one example of many.  The Tories have a history of even removing pre-election commitments from their website after going ahead and doing exactly what they said they would not do – such as introduction of the 2012 Health and Social Care Act, a top-down reorganisation of the NHS carving it open for large scale privatisation, after they were elected in 2010 on a mandate of no significant NHS restructuring.

As a doctor, a human being and a member of the voting population, lack of trustworthiness in any context makes me very fucking angry.  Colleagues not taking responsibility for situations with patients where they could do more to help but at the expense of their own personal convenience.  When corruption is embedded so deeply in politics that politicians at the highest level can lie persistently, always putting their own interests before the common good and not be penalised for that whatsoever.  When trained professionals that could be me if I lived elsewhere are forced to take to the streets on strike over a threatened contract that at its core is a threat to patient safety, the safety of healthcare workers and the healthcare system as a whole.  Just today I read an article about a junior doctor in England who committed suicide, leaving a suicide note addressed to Jeremy Hunt.

Sometimes I find I need to stop reading the news on Twitter or Facebook and watch a Buzzfeed video of stoned people getting surprised with a sloth or something equally inane because the news makes me so fucking angry and often I feel there’s so little I can do to help.  At least in my work I sometimes get that validation that what I’m doing is the right thing, that what I’m doing actually matters.

Make no mistake, there are so many reasons right now why the political establishment has fundamentally lost my trust.  Neither is this confined to the Westminster parliament.  When the SNP allow INEOS to have a stall at their autumn conference and a widely supported motion to SNP spring conference to ban fracking and unconventional gas extraction was blocked from above, I certainly do not believe I can trust the SNP government on that issue at least.

I’m not trying to put you on a downer here, I promise.  But sometimes the realities of life are pretty bleak – it would be dishonest to say otherwise.  Given the realities of life in the UK at present and the undeniable corruption, privilege and lack of democracy embedded at the heart of the Westminster establishment, I for one am glad I live in Scotland at least.  In having a Scottish parliament with some devolved powers (not enough, but that’s a whole other longer article), we have a level of protection from this.  The electoral system we have here is fairer.  In Holyrood smaller parties with bolder, more radical policies, ie those who will challenge corruption in big business and the establishment in general, have a good chance of getting some representatives elected to influence governmental policy.  As a Scottish Green party member I’m actually pretty excited about the election in May, because it’s looking like we’ll gain more representation in Holyrood than ever before – however the election is just the beginning.  The next Scottish government will then have 5 years to prove its worth or otherwise.

Each individual’s vote can seem like such a small and unimportant thing but it’s not.  Through your vote you have a stake in shaping your country’s future.  That’s a responsibility that must not be ignored.  So get informed about who and what you might be voting for, then you’ll be able to trust yourself to make a wiser decision.  And when you look at that ballot paper on the 5th of May (or earlier if you’ve got a postal vote), even if you see the name of just one candidate or one party you feel you can maybe trust a little bit, perhaps you should think of giving them your vote.





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