Oestrogen, the hidden menace?
Posted on 21 January 2016 by Rachel Clarke |
It takes a brave - or exceptionally healthy - individual to incur the wrath of over half the country's 180,000 doctors. So Dominic Lawson must have a heart of oak and cojones of steel to have broken in the Sunday Times the shock revelation that the real cause of the NHS junior doctor crisis is... oestrogen.
That's right. The ‘one sex change on the NHS nobody is talking about’ is the insidious creeping into medical life of ovaries, malign and deadly.
No branch of medicine is safe. Operations are known to have been halted - with the patient actually on the table - when the female surgeon breaks a nail. Chest compressions are being terminated mid-cardiac arrest when the junior doctor thinks her brow has started to glisten unbecomingly.
And, perhaps most alarmingly of all, every Boxing Day for the last 10 years, in-hospital mortality rates have soared by 11 per cent as female doctors desert their patients in droves, in pursuit of cheap shoes in the January sales.
Small wonder, as Mr Lawson reveals, a hidden debate is ‘raging’ within the medical profession about this grossly irresponsible ‘feminisation of medicine’. The underlying cause of last week's strike is not, it turns out, chronic NHS underfunding, inadequate workforce planning, or constant inflammatory sniping from Jeremy ‘nuclear option’ Hunt.
No, it's the women like me who are first flooding our medical schools, then popping out babies with impunity, and finally abandoning our patients for a lazy part-timer's life.
Once upon a time, all doctors were men. That changed in 1876 when, after a tenacious fight, the law was changed to prohibit the exclusion from medical schools. One hundred and forty years later, female doctors have outnumbered men for around two decades.
Yet certain commentators from both within and outside the medical establishment still seem wedded to a 1950s view of the workplace in which women should jolly well know their place. They point to the one in five unfilled placed in paediatrics, blaming women who work-part time for those gaps.
And now they claim the fundamental reason underlying the junior doctors' position is the fact that the women amongst us are reluctant to disrupt our precious family lives by working at the weekend.
Luckily, Mr Lawson's piece ignited Twitter in satirical outrage, and my hashtag, #likealadydoc, immediately went viral.
Beneath the scorn, of course, is a serious point. Deliberately conflating the increase in numbers of female doctors, with the medical profession's near-unanimous opposition to an unsafe, unfair new junior contract, is as sly as it is inaccurate.
I'm far from hostile to weekend working, already spending one in four weekends at the hospital. But I object to the pretense that we can magically provide new 'truly seven-day' weekend services without a corresponding increase in the number of doctors.
Making us work longer and harder to fulfil an election manifesto pledge might be an attractively cheap alternative - but it's downright dangerous for my patients. It's not rocket science: to make weekends work better, we need more doctors - simple.
Incidentally, Mr Lawson, I have a message for you from my husband who, as a former RAF fighter pilot, now flying civilian planes, knows a thing or two about manliness.
He notes you claim you've received ‘quite a few perplexed letters from airline pilots complaining that they don't get paid extra for flying at weekends, so why should doctors? He says in response:
1 If I worked the shifts and hours Rachel did, my fatigue would turn my plane into a lethal weapon. Junior doctors' workloads are grotesque, and subject to none of the regulations that safeguard us as pilots.
2 In modern Britain, it may surprise you to know that quite a few fathers enjoy spending time with their children at weekends too. We don't tend to pack them off with 'nanny' as may have happened in your day. We try incredibly hard to be there at weekends for our children as well, creating the kind of caring, loving, secure, home environment in which our children can flourish.
3 Next time you insult my wife in a diatribe, please do so face to face.
OK, I made the last one up. But in general, it's fair to say, military men tend not to appreciate misogynistic claptrap at their wives' expense.
One last thing, Mr Lawson, to paraphrase a former Prime Minister: when it comes to my patients' safety, this #ladydoc is not, and never will be, for turning.
Rachel Clarke is an ST2 in cardiology in Oxford. Doctors followed up with tweets against sexism in medicine under the #pinkWednesday hashtag