on the shelf. Who will care for the carer

* Within overburdened and under-funded public health systems, healthcare workers have been bearing the brunt of rising Covid-19 cases worldwide

*Adam Kay, a former doctor, chronicled his experiences in the UK’s NHS in his memoir This Is Going To Hurt

For the last 10 weeks or so, every Thursday at 8pm, everyone in the UK — or in my street, at least — stands on their doorsteps and claps to show their appreciation to all of those working in the National Health Service (NHS) and for other essential workers.

That first evening, my son and I stood on our doorstep applauding away, with a feeling I know that most, if not all, of our neighbours shared. It was incredibly moving: That sense that we were all in it together, that we had each other’s best interests at heart, we had each other’s backs. Clapping felt like such a pathetically tiny payout in the face of the size of our debt to the people this invisible virus had revealed we owed.

But, genuinely moving and heartfelt as that first and subsequent claps were, we are now at a point when the applause feels worse than inadequate — a mockery even — given that, as one anonymous NHS doctor writing in The Guardian recently put it, “the NHS is not a charity and it isn’t staffed by heroes”. She, or he, goes on to point out: “It has been run into the ground by successive governments and now we are reaping the rewards of that neglect, on the background of the public health impact of years of rampant inequality in the UK.”

My lockdown reading this week has been British writer Adam Kay’s hilarious, heartbreaking, snortingly laugh-out-loud book This is Going to Hurt: Secret Diaries of a Junior Doctor , a memoir of his time as a doctor on what we now routinely call the NHS front line. The book was published in 2017, seven years after Kay had walked away from his career in medicine to become a TV scriptwriter and comedian, where the consequences of a bad day are far less likely to be lethal.

This is Going to Hurt: Secret Diaries of a Junior Doctor; Adam Kay; Non-fiction; Picador; ₹550

There are many bodily fluids that swirl around this book, sweat and tears not the least of them. On one of Kay’s first days on the job, he has to deal with a patient who “unexpectedly started hosing enormous quantities of blood out of his mouth and onto my shirt”. Having quickly run through all the available options for dealing with this, he runs through some others: “Start looking for the patient’s stopcock? Shove loads of kitchen roll down his throat? Float some basil in it and declare it gazpacho?” Reader, the patient dies. The doctor peels off his blood-soaked clothes and changes so he can get on with the next. “So there we go,” says Kay — not so much philosophically as PTSD-dazed. “The first death I’ve ever witnessed and every bit as horrific as it could possibly have been.”

The next entry in full reads: “Bleeped awake at 3am from my first half-hour’s shut-eye in three shifts to prescribe a sleeping pill for a patient, whose sleep is evidently much more important than mine. My powers are greater than I realized — I arrive on the ward to find the patient is asleep.”

In the new afterword for the paperback edition, he writes about his experiences on book tour. “Night after night I spoke in village halls packed with people who clearly cared passionately about the NHS — people who hadn’t quite realized the extent of the pressures the staff who work there are under and the effect the job has on them... I learned... that love for the health service runs much deeper than any religion; that it transcends political belief and party membership.”

He was asked by people, time and again, what they could do to help. There is the ‘pay decent wages’ answer, there is the give-them-proper-resources answer, there’s the stop-the-97-hour-working-week answer. These days, there is the crucial PPE-kit-and-testing answer. But above all — or rather alongside all of these — Kay has a simple suggestion: “Ask them how their day was”, and then “give them that opportunity to offload at the end of every shift, whether it’s a tiny irritation, a rant, or a full-on sob... Let them know you’re there. Care for the carer.”

So there we are: From the horse’s mouth or, at least, in dispatches from the front line. The first claps for carers were tearful, partly because this was a spontaneous outpouring of emotion. But the longer they go on, the more they risk not just masking but almost facilitating the inequalities and injustices that the current crisis has cruelly exposed: You’re more likely to die if you’re black, for example. Or how punitive the system is toward migrant workers. Or, as Kay’s book so painfully and poignantly reminds us, just what insanely superhuman demands were made of healthcare workers on a daily basis even before coronavirus hit. Let’s just make sure, once the claps have died down, that ‘getting back to normal’ doesn’t mean going back to a system “that barely has enough slack to allow for sick leave, let alone something as intangible as recovering from an awful day”. Caring, we ourselves become carers, and the virtuous circle grows.

Anita Roy

Anita Roy is a writer, editor and environmentalist; www.anitaroy.net