In 2017 I was selected by New Perspectives, a theatre company based in Nottingham, to complete a series of photography assignments to document the role of the NHS over a three-month period. The work was commissioned to mark the 50th anniversary of Booker Prize-winning writer John Berger's and documentary photographer Jean Mohr's book ‘A Fortunate Man: The Story of a Country Doctor’.
The project was directed by theatre maker Michael Pinchbeck, who supported and guided the process to examine the parallels between John Berger’s masterpiece and the NHS today and create an exciting new piece of theatre inspired by the book. Together we explored current general practice in the NHS and spent time in doctor's surgeries talking to patients and staff and observing and documenting their behaviour.
«A photograph of unwashed cups in a kitchen sink tells us more about the NHS than anything we could write.»
Michael Pinchbeck, ‘A Fortunate Man’.
«Some of the most satisfying doctor-patient relationships that I have had have been relationships where a patient comes to see you and, through whatever therapeutic process that takes place in that conversation, actually does feel better afterwards, because you have been able to reassure them. Conversation is hugely important.»
«If the patient trusts you, thinks that you’ve got their best interest at heart and thinks that what you are doing is good, that’s going to have a much more positive outcome than when that’s not the case. And sometimes you can’t really put a finger on why it should be the case that having had this ten minute chat the patient feels much better, but often they do, and often I feel better as well – it works both ways.»
«My GP trainer used to talk about the doctor being the drug.
General practice is relational; huge amounts of your therapeutic value is in that relationship with the patient.»
«Being a GP is the best job in the world if you have the resources and time to do it.»
«Almost every week there’s something that gives you a warm feeling inside. It’s hard to think of specific examples, but it’s like if you’ve got someone who comes to you just utterly depressed and really hopeless and you take them through a process of talking to them, treating them, building a relationship with them, and then you see them a couple of months down the line and they are so much better and they feel that you’ve made a real difference. That’s a hugely positive thing.»
'Nurse Nancy' has been at the practice for seven years and a nurse for thirty five. «I was five when I first knew I wanted to be a nurse. I used to get a comic called Twinkle and there was a nurse in it called Nurse Nancy, I really wanted to be her. I had a little nurse outfit and I used to put bandages on teddies all the time, and if someone fell over in the playground I loved it (laughs). I've been a nurse for most of my life and I've never wanted to do anything else. It's hard at times and it's changed a lot but I don't regret it.»
«We try not to mother patients too much
but empower them instead, so they are able to make their own decisions.»
Nurse Nancy credits conversation and a warm, welcoming approach as essential components of the care that the practice provides to the community. «I think, increasingly, people are a lot more isolated nowadays. We also get a lot of people and families who come over from other countries and don't have a support system for advice if they are not well. We are in some ways taking on that motherly role a little bit as well.»
«The best thing about working for the NHS is seeing patients and helping people. In general practice you can build a bit of a rapport with patients. And if things are going well they come back and let you know, it feels like you are making a bit of a difference. The worst is probably no pay rise for five years (laughs). It's also the stress of the work, there's a lot of pressure now. Our role has expanded quite dramatically and nurses are doing a lot of the things traditionally GPs would have done».
'Nurse Nancy' has gone beyond the call of duty on many occasions, and recalls a recent case: «We saw this man at the practice recently. He was 67 and homeless so, because he was over 65, he didn't come under the normal services that are provided for homeless people. He was sleeping under the railway arches and he can't read or write, so he didn't really have the wherewithal or the mental capacity to get himself out of that situation.»
«I took that step further than just looking after his physical health and rung Help the Aged, and I also rung another agency and got him some support and he's now in a flat. The help didn't come just from me but I think that I got the ball rolling a little bit because I just took that extra bit of time, so that was quite rewarding.»
Photography and text © Susana de Dios
Quotes extracted from interviews by Ed Roberts, Cabin Fever Theatre Company