The Prison Doctor

by Dr Amanda Brown

  We both had strong personalities and didn’t always see eye to eye.

  I leant forward, crossing my arms on the table. My shirt tightened across my back, absurdly making me feel even more trapped.

  Rohit leant back, giving me a tight little smile.

  ‘Well . . .’ I started, and didn’t stop until I’d expressed how unhappy I felt about the new scheme. I was open and honest with them about what I was – and, most importantly, wasn’t – prepared to do.

  They glanced sideways at each other.

  We were all silent for a while.

  Rohit cleared his throat. ‘Well, if you don’t pull your weight financially, we will resent you,’ he said in an icy tone.

  I felt like the wind had been punched out of my lungs.

  Resent me? I was the one who had built up the practice!

  I felt furious. Unappreciated. But most of all, hurt.

  Resent me? To be made to feel so worthless, to be expected to live with their resentment, or toe the line to make more money . . .

  I couldn’t work like this. I wouldn’t work like this.

  It was my Sliding Doors moment. In the blink of an eye, my life took an unexpected turn.

  ‘Well, I’m leaving then,’ I said.

  All three stared at me in disbelief as I slowly peeled myself out of my chair and walked out of the door.

  I must have looked white as a ghost, as Kirsty on reception asked if I was all right.

  ‘No, I’m leaving.’ I choked back tears.

  I heard her gasp, but whatever words followed were lost as I walked through the front doors, out into the cold. The wintery air hit my lungs, making it even harder to breathe.

  What was I going to do now? I was forty-nine and turning my back on my career, my income, on everything.

  I spun around and stared at the surgery I had created from nothing all those years ago. With it’s pretty rhododendron hedge that I’d planted to give it a more welcoming, community feel. The building my property developer husband, David, had built for me. I thought about the thousands of patients on my list, many of whom had become like friends. I’d watched their children grow up, I’d listened to them when they worried, seen some make huge life changes. I’d held the hands of heartbroken elderly patients as they cried with loneliness. I hadn’t been just a doctor: at times I felt as if I’d been a counsellor, a social worker, a vicar, a friend, all rolled into one. I had loved my life as a village GP, and over the years I had grown to know and love so many of the people I cared for that I used to joke I could write a book on many of them. Apart from my family, my surgery had been the most important thing in my life.

  And just like that, it was all over.

  *

  I couldn’t sleep.

  I’d been staring at the same spot on the ceiling for hours. David held my hand while I lay there, chewing over my decision. My husband, my boys – Rob and Charlie – they were everything to me. Doing something that lurched us into financial risk wasn’t something that sat well.

  David had reassured me it would be okay. Luckily he had a good job and would be able to take care of us. I wasn’t used to someone taking care of me though. Ever since I was a little girl I’d wanted to stand on my own two feet. I loved working, it gave me a purpose, I didn’t want to give that up. I also loved helping people, that’s why I became a doctor. My thoughts went back to my patients. I felt a huge pang of guilt for walking away from them.

  Guilt, fear, sadness, anger – a cocktail of emotions were turning and churning around in my mind, growing louder and more intrusive in the quiet of the night, until I finally snapped.

  I peeled back the duvet, tiptoed across the room and slipped into my thick fleece dressing gown that was hanging from the hook on the back of the door. The cold fabric, chilled by the winter air, sent a shiver down my spine.

  David stirred. ‘Are you okay?’

  ‘I’m fine, go back to sleep.’

  Downstairs, I made myself a cup of warmed milk. I took a seat at our chunky wooden table and stared through the kitchen windows into the night. The infinity of black felt as dark as my future.

  I didn’t have a formal agreement with my partners about my notice period. We had agreed I would leave the surgery in just three weeks’ time.

  Leave my surgery – those words stoked my anger again. I didn’t feel it was right! GPs shouldn’t be getting paid bonuses for doing their jobs!

  I took another furious slurp from my mug.

  My partners had also been keen that I keep appointment times to ten minutes, and only address one problem in that time. But often my patients had been waiting weeks to see me, and if they came in with more than one problem I didn’t have the heart to tell them they would have to book another appointment, that they would have to wait another three weeks to tell me the rest of what was bothering them. More importantly, one ailment could be related to another; it was important to hear the full story.

  I felt more indignant than ever.

  I stared through the kitchen window again. But this time I looked past the darkness to see my own reflection.

  My hair, short as it was, had managed to find entirely absurd, startled shapes. I flattened it down the best I could with my hand, and swept my fringe from my eyes.

  I looked utterly exhausted but I knew I wouldn’t be able to get back to sleep until I had got everything off my chest.

  I made my way to the study.

  I didn’t need to switch the light on, the moon was beaming through the large sash windows, illuminating the cluttered room.

  The shelves were so packed with medical journals they were warping under the weight, sinking in the middle like a hammock. The desk which overlooked the garden wasn’t much better. Either side of the computer were mountains of paperwork. The weight of a life, mountains and mountains of paper, and I was throwing it all away.

  Beside the keyboard were silver-framed pictures of my boys in their school uniforms. They sported proud grins. Were they proud of me?

  Twenty years. Twenty years of looking after people and it was all over.

  I switched on the computer and reached down to turn on the electric heater by my feet. It rattled and hummed, the noise strangely comforting.

  I started writing. Pouring my heart out at half past three in the morning, tipping all of my emotions onto the blank page.

  It was everything I wished I had expressed in the meeting earlier, every argument against the new contract and their new policies. Explaining exactly how it had forced me into quitting the job I loved.

  I wrote for nearly an hour and then sunk back into the padded leather swivel chair, letting out a huge sigh of relief.

  What I should have done was pressed ‘Save’, slipped back under my duvet and snuggled into David, now that I had got everything off my chest.

  Instead, I pressed ‘Send’.

  Chapter Two

  I didn’t expect to make the front page!

  Sitting in my room at the surgery, I found myself staring at my own words, splashed across the pages of Pulse, a national magazine for GPs.

  ‘I just ride off into the sunset and no one gives a toss.’

  That was what I’d said, but I didn’t think they were going to quote me word for word!

  I cursed myself for being so impulsive and emotional. What I meant by that line was that I’d worked so hard to try to do a good job, for nearly twenty years, but it felt like it counted for nothing in the end because no one cared. All they wanted to see was boxes being ticked.

  I wished I’d packed a pair of sunglasses to hide behind.

  But there was nothing I could do about it now. My opinions were in black and white for all to see. The best thing I could do was straighten my back and get on with working out my three weeks’ notice at the practice.

  I was yo-yoing back and forth between anger and regret again. It wasn’t a healthy place to be and thank goodness I had a half-hour break in my schedule. I grabbed my bag and made a run for some fresh a
ir.

  Everywhere I looked I was reminded of what I was losing. As I walked through the waiting room, I could feel dozens of pairs of eyes staring at me in disbelief – the leaving letter I’d written to patients was pinned to the notice board.

  I crossed the tree-lined street to the coffee shop opposite the surgery, but the atmosphere in there wasn’t much better. Sandra, the pharmacist from the chemist next door, was in front of me in the queue. She’d been dispensing medication as long as I’d been a GP in the area. I thought she was going to mention the article, but she had other news for me.

  ‘It’s as if the village is in mourning,’ she blurted.

  Sandra had become a close friend over the years. She had the kindest face, which was framed by her masses of chestnut hair. She wasn’t much over five foot tall, and looked up at me with her dark eyes.

  I couldn’t respond. I had no idea what to say. She carried on, every word tugging at my heart.

  ‘Your patients are so sad. They don’t know what they’re going to do without you. Amanda, do you really have to go . . .?’

  I gently squeezed Sandra’s arm. Really I wanted to throw my arms around her and give her a bear hug.

  ‘I’ve made my decision, and I’m just going to have to see it through now. I feel terrible though,’ I admitted. The urge to cry rose up in me. That was the last thing I needed: to burst into tears in the middle of a coffee shop queue.

  Then came the big question. ‘But what will you do now?’

  Well, yes, what indeed?

  ‘I guess with your experience you could easily get a job in another practice,’ she continued.

  That was the last thing I wanted. I’d be faced with the same problems, just in a different location. But what was I going to do? I felt like I was going through a bereavement. I felt sad, lonely, lost, unable to see a way forward, a thick dark fog of self-doubt and guilt obscuring my vision of the future.

  Suddenly, the roasted aroma of coffee beans smelt acidic, nauseating and unbearable. The sounds of the café, the white noise of chatter, the hiss of the milk steamer . . . It all felt more than I could bear. I felt waves of heat rush up my neck and I was desperate to return to the chill of the winter air outside.

  It was torture. What had I done?

  ‘I’m going to have to get back to work,’ I said to Sandra.

  ‘But you haven’t even had your coffee. We have to do drinks before you leave . . .’ Her voice trailed off as I gave her the thumbs up and dashed for the door.

  Outside, I took a few deep gulps of air, drinking up the freshness in place of my coffee. I felt like crying. It was all too much. Seeing my outburst in the magazine, hearing how my patients were feeling and then, of course, the final panic: the realisation that I didn’t have the faintest idea what I was going to do with the rest of my life.

  Back inside my consultation room, things went from bad to worse when Mr Collins knocked on my door.

  If only I could have hidden behind my desk for the afternoon, but there was no getting away.

  ‘Come in,’ I said, hiding behind a cheerful voice.

  Brian Collins was one of my long-standing patients. He was 56 years of age, tall, with grey receding hair, and was always clean shaven. He had long spindly fingers that always made me think he should play the piano.

  Brian poked his head around the door and gingerly made his way across the mottled carpet towards my desk. His steps were uncertain; a man whose confidence had taken several knocks.

  He’d been on and off antidepressants for as long as I could remember. They eased his depression, but then he would stop taking them, convinced he was feeling better, only to fall back into a depressive slump.

  Brian was typical of so many of the patients I saw at my practice. Wealthy, successful, middle class, well-spoken. The stereotypical pinstripe-suited man who travelled into the city every day. When I’d first started working in the area, he was the type of man I must admit that I felt a bit intimidated by, as I thought they might not trust a young female doctor. But, to my surprise, I managed to win him and many other patients over. I think as much as anything else it was by showing them that I really cared about them. I’ve always believed that the root cause of many illnesses can be found in the emotional problems that lie bubbling underneath. The problem then became that many of my patients seemed to depend on me as a counsellor, more than as a doctor . . . Mr Collins was no exception.

  ‘What can I do for you, Brian?’ I asked, my voice gentle, warm, doing my best to set him at ease.

  His eyes were downcast as he slumped into the chair opposite.

  ‘Is it really true you’re going?’ he said, his eyes filled with worry.

  It was the first time I’d come face to face with the effect my departure was having, and it was unbearable. The tension in my little consultation room was palpable.

  ‘Yes, I’m afraid so.’

  He fell completely silent for a moment, staring, intently, at one spot on the carpet before finally looking me in the eye. I could see the tears. It was heartbreaking to watch.

  He tugged free a tissue from the box on my desk and dabbed the corners of his eyes.

  His voice trembled. ‘But what will I do without you? You’re the only person who understands what I’m going through, and I find it so hard to open up to people.’

  His fears were completely natural, and were shared by many people who might feel anxious about changing their doctor.

  ‘Will you be moving to a surgery nearby?’

  I opened my mouth to speak, but nothing came out. I was going to tell him no, but the question had thrown me – all the way back into that pit of uncertainty. I swallowed hard and whispered. ‘I don’t think so.’

  His eyes dropped again, crestfallen, and then he suddenly lurched onto his feet.

  He shot out his hand, as I imagined he had done hundreds of times in his board meetings, disguising his distress with formality.

  ‘Well, I wish you all the best for the future, Doctor Brown.’

  I felt a lump rise in my throat as I shook his hand.

  ‘You’ve been wonderful and I really appreciate everything you’ve done for me over the years,’ he carried on in his rigid, staccato voice. ‘And anyone who has you as their doctor next is blessed.’

  I bit my lip – hanging on by a thread to stop myself breaking down in tears. Hiding behind my medicine, I told Mr Collins to continue with the same dose of antidepressants, and to review how he felt in three months.

  I walked him to the door and we had a moment’s silence, both aware of each other’s grief. ‘Things will get better,’ I encouraged.

  With that, he slipped out of the door and I broke down, the avalanche of the day’s emotions crashing in on me.

  It was no good; a doctor’s life is a constant flow of difficult situations, of emotional patients, of pain and sadness and death. I needed to be stronger than that – I was stronger than that, always had been – but I just couldn’t see how I was going to get through the next few weeks.

  My phone rang.

  I wanted to leave it ringing, and I almost did, but I needed something – anything – to pull me out of the low mood I was descending into.

  ‘Is that Doctor Brown?’ asked a voice on the line.

  ‘Yes, who’s speaking?’

  ‘It’s Doctor Phil Burn here. I saw your story in Pulse.’

  My stomach lurched.

  ‘I’m recruiting doctors to work in prisons in the South East of England.’

  ‘Sorry?’ I wasn’t sure I’d heard correctly.

  ‘I’m looking for a doctor to work in a prison,’ he repeated.

  I was stunned by the thought. I had been so locked away in my village practice that alternative placements like he was suggesting hadn’t really occurred to me.

  Dr Burn continued to explain the job. It was a part-time position at a youth prison for 15–18-year-olds, HMP Huntercombe in Oxfordshire, not too far from Henley-On-Thames. ‘Would you be interested?’ he a
sked.

  The thought of prison conjured up images of fights, stabbing, hangings – the horror often portrayed in films. Could I really see myself working in that world?

  On a deeper level, of course, I knew that my immediate mental image of prison life could hardly be accurate. And I needed to do something . . . Something new, something that would challenge me, something that would make all of this feel worthwhile. Something that might help people.

  ‘Yes!’ I said, actually shocking myself. I hadn’t given myself time to think deeply, I was relying on gut instinct, I had no idea what the salary was, I should have been asking so many more questions . . .

  But how bad could 15–18-year-olds be? My boys, Rob and Charlie, were that age, so hopefully I would be able to relate to the inmates and perhaps they would view me as a mother figure and not a threat.

  Had I really been that naïve? Yes. But I would learn.

  He went on to explain that not many doctors wanted to work in prisons, as it was seen as an intimidating and unpleasant environment, dealing with difficult, unwilling, unpredictable and possibly violent people.

  ‘But’ – and he laughed as he said it – ‘anyone as outspoken as you should be able to handle a challenge!’

  I couldn’t believe it, my candid words in the magazine had opened up a whole new world of possibilities. Dr Burn had recognised the fighting spirit in me.

  Just because I was nearing fifty, why shouldn’t I try something new? It’s never too late to start over. Whether it be your career, your marriage, your lifestyle. That’s what I’d been telling my patients for years, and now it was time to embrace the unknown myself.

  And maybe I could even make a difference to these boys’ lives.

  *

  Dear God, what have I done?

  Back at home, I was questioning my decision. Had I been rash, accepting a job I knew practically nothing about?

  I was sitting at the kitchen table doing some background reading into Huntercombe prison.

  It was officially classified as a young offenders’ institution, having housed teenagers since 2000. It had originally been built as an internment camp during the Second World War and was turned into a prison in 1946.