Fillers A memorable patient


BMJ 2006; 332 doi: (Published 23 February 2006) Cite this as: BMJ 2006;332:448
  1. Lesley Jean Morrison, GP principal (lesley{at}
  1. 1 Teviot Medical Practice, Hawick

    I'm not sure how I managed it but, when I was arranging my preregistration year, I persuaded my medical school to let me satisfy my urge to experience New York and spend my year in hospitals in Brooklyn. The second six months were in Greenpoint, a hospital in a very poor Puerto Rican barrio made famous by the filming of the mob movie Serpico. The T-shaped emergency room had an unusual architectural feature, a portcullis arrangement at the juncture of the two corridors. When the going got tough with some of the local clientele, as it inevitably did on Saturday nights, the troublemakers were herded by the police officers on duty down to the intersection, where iron grid walls slid down from the ceiling and the offenders found themselves neatly confined in an iron cage. Such were the working conditions.

    Three months into my time there, a junior doctors' strike was called for better pay and better conditions. They had a point: there were far too few of them, there was little attending (consultant) support, and the quality of care suffered badly. On the assigned day the wards emptied of junior staff as they took up position outside on the picket lines. I was in a dilemma. I wanted to support my colleagues, but I felt bad about leaving my patients. I felt especially worried about an elderly Puerto Rican woman at the end stages of chronic obstructive pulmonary disease. I didn't want to leave her, and it wasn't really my strike, but I was terrified of being the only doctor left in the hospital, exposed and expected to do things I did not feel competent to do.

    I went to the picket line, and my elderly patient died. I don't remember the outcome of the strike, but I'll never forget her face.

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