Unity of Purpose: a team of voices from inside the NHS.
Margaret Adkins
Although patient care is practised by individuals, for care to be effective it is of course dependent on a whole team approach. NHS care is a constant, continuous force, generated by thousands from various disciplines and departments, contributing experience, judgement and unstinting effort.
These Are The Hands: Poems from the Heart of the NHS (Fair Acre Press, March 2020) is a collection of poems, edited by Deborah Alma and Dr. Katie Amiel about administering patient care. It is written by clinical and non-clinical NHS employees, past and present, with leading UK poets donating work alongside. Michael Rosen wrote the titular poem for the 60th anniversary of the NHS and has also written the foreword. The date of publication happened two days before the United Kingdom was placed in lockdown in response to the global spread of coronavirus.
Never have we been more aware of NHS staff. Of course, all members of NHS staff expect to deal with infectious disease, but before coronavirus spread worldwide, employees were not focusing on the stark reality that their lives were at risk through patient care.
These Are The Hands continues to raise money for 'NHS Charities Together' (including Covid-19 Emergency Fund) through proceeds from sales. In August the sum had reached £11.000.
This anthology is more than a collective celebration of the NHS. These poems do not glamorise. On the whole they avoid sentimentality. They are forged from interior knowledge of this monolithic institution. They rise raw from within hospitals, clinics, therapy rooms, surgeries and patients’ homes. Tender voices mingle with those that bleed, weep or simmer with anger.
Tender voices mingle with those that bleed, weep or simmer with anger.
The poems were all written before Covid 19 errupted. They reveal the tenacity of employees working in an NHS beleaguered by lack of investment. They provide a lens on a workforce affected by lack of funds and diminished recruitment, expected at the start of the Covid crisis to rally and practise and succeed in adversity.
Only a few poets describe work without referring to patients. Those who do, such as Sarah L Dixon, a Medical Laboratory Assistant in Media Room who will: ‘Load up the autoclave’ to start the process in which, ‘Growth patterns / and the regular crunch of antibiotic discs / can predict a cure,’ give the reader a glimpse of the vital, unseen cogs at the core of the NHS machine.
The clinical environment of pathology contrasts well with emotive imagery that fills the collection. Debz Butler, a Cancer Specialist Nurse for example, admits that she is no ‘Ginger Rogers’ in Dream a Little Dream of Me and yet when an agitated patient is asking for his wife, she smiles and says, ‘I’m the nurse. Shall we dance?’ They dance, ‘Past drip stands, cleaning trolleys / plastic chairs….’ Each turn of a page brings cameo after cameo illustrating sensitive interaction between givers and recipients of healthcare.
Where the anthology cuts rather than tugs at heartstrings, clinicians have dared to reveal frailty and write with brutal honesty. The speaker in Psychiatrist, Penny Shutt's poem berates herself for not anticipating a new mother’s intention in My First. In a gush of remembrance, she says, ‘I should have made you stay…we couldn’t send you home in the state you were in.’ In a similar vein, Craig Coyle, an Advanced Nurse Practitioner in mental health writes from the more detached position of second person in The drive home. When the speaker of this poem is back home, he grapples with feelings of failure, when faced with, ‘just your cold bed / your conscience.’ It is easy to gloss over the consequences of clinical responsibility on mind and body and ignore the effects of such daily wear-and-tear for healthcare professionals.
It is easy to gloss over the consequences of clinical responsibility for mind and body and ignore the effects of such daily wear-and-tear on healthcare professionals.
Patients are inevitably defined by vulnerability. Poets who reflect on challenges to their health or that of a loved one illustrate this. Laura Lennard, the Paediatric Student who switches from, ‘Dark blue uniform to clammy patient gown’ in Rearranged; Iora Dawes, the Medical Social Worker who sits ‘where thousands have sat before’ in Day of the Results; Katie Amiel, the GP (and anthology editor) who knows ‘the result before she speaks’ in Genetics Clinic and Katherine Murray, the ENT Surgeon who says, ‘I yearned for Outside / I craved Control’ in Doctor to Patient, all describe the universal experience of surrendering to the system and trusting professionals in charge of healthcare. As readers we are in touch with their experiences because we recognise the familiar or imagine what we fear.
Any rise of heat in the anthology is rooted in daily struggles with governance and micromanagement. For instance, the pressure felt by GPs to maintain time constraints for every consultation, is sensed in the opening words of one GP, Rachna Chowla in Stop before crying. She says: ‘And I finally stood and stopped / After a day of running, whilst sitting.’ It is a day where she was already, ‘running late before starting.’ These harried sentiments echo those of another GP, Chris Woods who writes succinctly from the point of view of a patient noticing their doctor’s dejection in Consultation and who thinks, ‘He doesn’t look too good, /suit not as snappy.’ The observations of Emma Halliday, a Public Health Research Fellow, who writes, ‘he drained wine like coffee / to cope with the next shift’, distil the ruinous effect of work-related stress in Burn Out. With palpable anger in Treating an epidemic with one bottle of pills, Charlotte Ansell, a Child & Adolescent Psychotherapist compares the futility of stretching inadequate resources to cope with demand, with ‘bailing out a cruise ship with an egg cup’ or treating ‘a child / who broke every bone in their body – with plasters’. These are fraught clinicians, jaded from the effects of austerity and being expected to do more with less.
These Are The Hands deserves to be read as a contemporary record as much as an ode to healthcare.
These Are The Hands deserves to be read as a contemporary record as much as an ode to healthcare. It is worth remembering that the poems were written during times when key workers were not hearing nationwide clapping and pan-clattering. In fact many were written in the wake of falling public satisfaction when NHS staff felt undervalued and exhibited widespread low morale. This anthology tells of resilience and a common unwavering desire, even when despondent, to administer excellent patient care. When read closely, These Are The Hands is a herald. Coronavirus must not obliterate these pre-pandemic memories of the NHS. It is imperative that the public remains supportive of those in the NHS who are subject to changing national and local politics; who are currently coping with a backlog of work; who have no choice but to manage healthcare in the evolving pandemic, yet are still recovering from the yoke of the first wave of coronavirus.
These Are The Hands: Poems from the Heart of the NHS is available online: Fair Acre Press. £9.99 The Poetry Pharmacy and from all good bookshops.
Links:
Editors: Deborah Alma and Katie Amiel
Titular Poem written and read by Michael Rosen
These Are The Hands appeared as a featured publication (June 2020) in Atrium
These Are The Hands Live Recital (Zoom) May 2020 Organised and hosted by Louise Winters and Matthew Matheson
I am a contributor to this anthology. See my next blog post for Part Two: a Review as a 'Personal Reflection'.
Links to Margaret Adkins:
Website: margaretadkins.co.uk
Twitter: @M4dkins
Instagram: margaretadkinswriting
Margaret Adkins started writing when her nursing and midwifery career came to an end in 2015 after thirty-six years. She become a full-time student at the University of Worcester. She gained a BA (Hons) in Creative Writing & English Literature and an MRes in Theatre & Performance. Winner of the inaugural University of Worcester V. Press Prize, her debut poetry pamphlet Mingled Space is published by V. Press (2019).