Tuesday, May 27, 2014

A Review of "Little Stories of Life and Death" by Dr David Drew

I don't often review books on this blog - but this book was and is an exception.  It is very important to me personally for a number of reasons:

  • It is about child patient safety - something both Dr David Drew and myself have dedicated our lives to.
  • It is about injustice - something that I cannot tolerate personally or professionally.
  • It is about endurance - the story doesn't always end with a happy ending.  But has the story ended?
A few words about how I came across Dr David Drew.  I am an unashamed social media advocate.  Yes I do believe it can be used for harm, and can (like any medium) be misused.  I am grateful as a nurse - to my regulator the Nursing and Midwifery Council - for not blanket banning use of it but promoting professional use.  Any nurse, midwife, doctor or Allied Health Professional must bear in mind at all times we can be called to give account for what we say, write or do.  But the massive benefits of social media mean a far wider social and professional network beyond your immediate workplace.  So it was due to Twitter that I became familiar with the account of Dr Drew and his whistleblowing account, and difficult personal and professional experience at the hands of Walsall NHS Trust.

Haven't heard of Dr Drew?  This page is the best summary with links to appropriate news articles.  The most heart breaking link is this news report concerning baby Kyle Keen.  "Little Stories" - Dr Drew's autobiography - is dedicated to the memory of baby Kyle.  It can be objectively argued that his professional difficulties began when he argued that the manner in which baby Kyle died was unacceptable and should not have happened.  But for more detail on that - you will have to read the book.

Here's what struck me about the book:

1.  Dr David (and all HCP's) is first and foremost HUMAN and have stories.

This book is published at a time when our beloved NHS is coming under a lot of criticism (much of it deserved) because NHS professionals are sometimes not giving their human patients the respect, dignity and care that they deserve.  Much of this inexcusable care is often delivered because a basic human fundamental truth is being forgotten - PATIENTS are HUMAN BEINGS (Mid Staffs and Winterborne show an appalling demonstration of this).  But we must not forget that NHS professionals are human beings too - there's a reason why we ended up wanting to care.  And when that duty of care fails - is anyone asking why?

So I urge and encourage and recommend the first few chapters of "Little Stories" because Dr David writes candidly and honestly as to how he "ended up" in medicine.  I very much found an affinity with him because like him, my parents did not actively encourage me into nursing.  I ended up in nursing quite by accident.

Throughout the account of "Little Stories" - I found myself being drawn time and again to the pain and agony that Mrs Janet Drew must have gone through - living Dr David's pain as an observer.  Again it is something I am hugely familiar with.  In a way healthcare professionals families can suffer uniquely because they have to watch (and not understand) the pain their loved one experiences being mistreated at the hands of their employer.  All they can do is watch.  Their healthcare professional loved one must walk it alone!  And for that (as has been said before) Mrs Drew is very much the heroine of "Little Stories" for standing and walking by his side - what a wife!  What a hero!

2.  Dr David cares passionately about his patients.

Any reader of "Little Stories" - whether they be critic or supporter - cannot deny (I feel) that Dr David cares passionately about the patients under his care.  The quite incredible case of extremely low temperatures on the paediatric ward due to facilities failures demonstrates his concern greatest.  I was gripped by his account of getting up during the night and coming in to direct equally concerned night nurses to ensure electric heaters were distributed appropriately and babies were clothed with woolly hats.  

His heartbreaking account of Baby Kyle - and the healthcare failures that led to his premature death - again demonstrate this beyond doubt.  The reader can easily get into Dr David's head and ask; "Could I have done more?".  To any healthcare professional reader - who has gone through the agony of losing one of their patients, this will be familiar territory.  While death is an accepted part of life, something within our very souls rejects it as abnormal and wrong - particularly in the paediatric world.

I noted particularly - in scouring the Employment Tribunal hearing of Dr David, that the Trust did not once claim he did not care about his patients.  Their claims were directed elsewhere.  The Nursing and Midwifery Council is making this statement key in it's review of the Code; "Make the care and safety of those in your care, your primary concern".  Dr David did this - but confusingly he paid an awful price for it.  The reader must ask - is this right?  Is this just?

3.  Dr David won't give up if patient safety is at stake.

This is the issue for all whistle-blowers I feel - and it is an issue that the Department of Health, NHS England and perhaps the Government have yet to grasp.  They are not trouble-makers.  They are not makers of "toxic culture" - ridiculous phrase.  They - we - are simply people who care desperately about the best for the patients and families under our care.  If they - we - see politics or bureaucracy interfering or hindering that care, then they - we - get mad.  And the whistleblowers - Julie Bailey, Deb Hazledine, Dr David Drew, Sharmilla Chowdhury and so many more - are mad people.  They are not mad because of loss of income, indignity, reputation - no, they are mad because of loss of due right to the patients under their care.

I am ashamed to say there was a part of me that was inwardly begging Dr David to accept the gag bribe that Sue James - the CEO of Walsall Manor - was offering him.  It would have provided temporary safety and security to his family and would have ensured a "happy ending" - that he and Walsall Manor parted company.  But THE hero moment of the account of "Little Stories" comes when Dr David comes home and reports the gag offer to Mrs Janet Drew and his sons.  Her response?

"If you accept that money - I will divorce you".

His sons response?

"If you accept that money - we will never speak to you again".

THAT is family!  THAT is support!  I leapt and whooped in my chair while reading it.  I am ashamed to admit that if I were in Dr David's position, I suspect some of my family may urge me to take the gag offer for the simple results of immediate financial security and peace.  But as healthcare professionals we have a duty to constantly ask ourselves - yes, but is our patients at risk because of our actions?  Dr David rightly noted that his patients WERE at risk if he compromised to the offers from Walsall Manor.  So he didn't.  At his personal detriment.  I hope that Walsall Manor have learned from that experience, and I hope desperately that patients are far safer today than ever before.  I don't know.  But I hope.

But I closed the chapters of "Little Stories" absolutely without question - a true NHS Whistle-blower who really cares for their patients will NEVER accept a gag offer - if the safety and security of their patients is left at stake.  And whistleblowers and their supporters hope and pray the day is coming when the government, the Secretary of State for Health and the Department of Health are wakening to the fact that the safety of our patients will ALWAYS be of higher concern than the "reputation" of any NHS organisation.  Let's face it.  Any "reputation" of ANY NHS organisation based on spin and lies and not on true fact of patient safety - really isn't worth the paper it is written on.

So in conclusion:

I cannot commend "Little Stories" highly enough to you.  If you are the Chief Executive of an NHS Organisation then you need read this.  It may save your career.  You may save your organisation and "political face" in the short term.  But you are managing people.  And truth will out.  Stand for truth - and you will be respected.  Hide - and spin - and you will never escape.  If you are a healthcare professional - nurse or doctor - then you need read this.  It will make you ask the question: how much am I willing to sacrifice for my patient's well being?  Am I willing to remain silent to their cost?  Why am I in nursing or medicine?  And if you are a parent, family member or patient - you need read this.  We who are looking after you are human.  We are fallible.  But the most of us really do care.  So let us connect with you.  Tell us your fears, your hopes, your dreams.  We want to help.  We want to care.

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