“The doctor called me that Friday and asked me to go to the hospital. I went to A&E. They checked my urine and they took my blood. Later, they sent me home and asked me to go and see my GP.”
“Did they give you any treatment?”
“No. They didn’t give me any treatment or tell me anything. Only gave me a letter. I thought everything was okay.”
I had quickly cast my eyes over his records before calling him into the consulting room, now asked for a moment to go through his notes. I felt righteous anger stirring within me. He agreed to my request for his son to go to the waiting room for a short while.
The gentleman had a blood test done because he was thirstier, drinking more, passing urine frequently and had recently lost a bit of weight. His first ever blood glucose test results came in late Friday evening. The salaried doctor received advice from a GP Partner, called the patient and advised him to go to the hospital.
From his notes, they checked for ketones which thankfully were not raised, took blood to do specific tests for Type 1 Diabetes and sent him home.
“Did they give you any medication?”
“No. They asked me to see my GP.”
Date was 15th March and he was squeezed into my Friday afternoon clinic, only a ten-minute appointment on 5th April. Blood glucose test HbA1c had been 120 (Normal 20 – 41) three weeks earlier! Isn’t our NHS mantra Right Person, Right Place, Right Time, Right Care?
The anger boiled over and tears filled my eyes. I apologised to the patient and pulled tissue out of the box and dabbed my eyes. System thinking or its lack thereof.
“What have we done?” This question keeps haunting me. At that moment, I could not understand how a man with such high blood glucose, sent to the hospital by his GP on a Friday evening could have been sent home without commencing any medication. Because he is Black? Not even Metformin or Gliclazide? More water in my eyes.
The gentleman was soft-spoken, gentle, from sub-Saharan Africa. He came across as one of those who would respect and trust authority. A quick summary of plans for immediate and future care before I asked his son to join us. I started him on medication, booked an appointment with the Diabetes Nurse and promised to invite him to our next Diabetes Group Consultation.
I had to do some housekeeping before getting home. I called a colleague during the drive home to “offload”. More water
Got home and told my boss I had cried in front of a patient. Still more water.
Fed, watered and showered, I tried to get off to sleep. A final look at the mobile phone to set the alarm ahead of work at the Hub on Saturday and my eyes fell on a clip on LinkedIn. I don’t know the club or the player (fairweather football fan). The photos below say it all. Tears. That was the cue I needed to get out of bed, switch on my laptop and write, “See, who’s tearing.”
27 years in the UK. Have I been a victim of racism, conscious bias, etc? I can recall a few examples. I remember feeling that one Oncology Nurse during my brief stint at then Cookridge Hospital hated my guts but I knew I hadn’t pulled my weight on the Wards at the time. Over the years, I’ve either been too blind to see racism or have developed thick skin. There’s this gospel song that says, “This joy that I have, the world didn’t give it to me … and the world can’t take it away!”
I have written about the angels in my life and the most significant breaks in my UK life came from White Brits (first employment and first medical job). That said, I have heard many stories and seen people who have gone through hell. If you have not got the time now, please come back to this story later.
You can get a copy of the book, the audio link above was the voice of one of the contributors, Mrs Modupe Hector-Goma (you’re right – she runs things).
Let me find a happy ending to this blog. I am never deep about race, White privilege, ethnicity or religion when it comes to interpersonal relationships. I have my reservations about People of African Descent being side tracked to Equality, Diversity and Inclusion (EDI roles). I don’t want a role carved out for me in the NHS because I’m of African descent. Give me a mainstream role because I am a GP and provide the enabling tools for my team and I to learn and practise conscious inclusion, cultural competence, etc.
Am I being simple?
We have good, bad and ugly genes wired into all of us and it all depends on which genes are suppressed, dorminant or recessive … not forgetting epigenetics and the toxic environment into which some people (of all races) have been born and nurtured. They get to show their bad self in the work places.
Another day, many months ago, a gentleman walked into my consulting room — older man with a broad smile and a lovely voice. He reminded me of Sir Trevor Macdonald, formerly of ITV. His diction was worthy of emulation. He spoke flawless Queen’s English! He was pleased to meet his new GP, a Black Man (just like him). He expressed his joy in a million ways – a wordsmith par excellence. My God! His elation moved me to tears. I had reached for the tissue box that day too and apologised to him. He also had a tear in his eye. There and then I could imagine how many rivers he had crossed. When he makes a routine appointment, I see him as the last patient for the day, usually on a Friday. His body has been through life itself and he tells me at every visit that he takes no prisoners. He fights for his rights. He is prepared to challenge anyone and anything that suggests he is being treated unfairly. His catalogue of woes in receiving generalist or specialist care as a Black man makes me want to cry and laugh at the same time. He said he has learnt to question everything he is told. I have noticed that too. Every time I mistakingly throw medical jargon his way, he would stop me and insist I break it down. No shame there. No fear. He has offered me free lessons to finetune my accent. I’m yet to take him up. That’s what he did for a living before he retired.
I feel better already. Everytime I mentally put myself or a member of my family in place of a patient for whom I have to make a decision, I am reminded to do the right thing. Speed, Accuracy and Service (SAS) remain a delicate triangle in my line of duty. Time is never my friend. As the consultations get more complex and we do more for less, we the willing are no longer able to do anything with nothing. I have stopped apologising. I now say, “Thanks for your patience.”
Last line: Whatever colour, race, accent or other measure of humankind you use for yourself, when dealing with others, just do the right thing – you can never go wrong. Trust me. I am someone’s GP!
Abiye Hector-Goma is a Person of African Descent (PAD) and a General Medical Practitioner based in Leeds, United Kingdom.