Love is Food in the NHS

So, I'm now 18 months into this blog, and I've yet to mention anything about my day job. That's because, for most days of the week, and some nights too, I'm actually a spy.

Okay, I'm not really a spy. But having a double life as a food-writer and a doctor can feel like I'm inhabiting two very different identities. And you know, I enjoy that. I enjoy engaging two very different sides of me, tapping into two different parts of the brain, experiencing two types of good n’ bad days in the office. (Although, admittedly, a bad day in my NHS office is invariably worse than writer's block.)

I became a doctor in the year 2000, making me a millennial of sorts. When I look back, it's certainly been packed with experiences. Mostly highly rewarding. Some terribly challenging. A heady mix of immeasurable joy and painful sorrow. And though of course it's an incredibly serious job, there's always room for moments of humour.

And food. In fact, some of my most memorable career moments are related to food ( - ‘quelle surprise’, you might say!)

I remember one time as a medical student - four of us had gone out for a post-exam celebratory slap-up dinner in Camden, when we noticed our placement tutor at the adjacent table. She spent a moment to chat with us before returning to her dining companions. At the end of the evening, as we ordered the bill, the waiter just smiled and gestured towards our tutor: it had already been taken care of.

Such generosity early on in my training greatly impressed on me the importance of colleagues looking out for each other - working in the NHS is a tough gig, we need to be kind to each other. (And more on that later..)

When I eventually qualified that year, I was immediately thrown into the non-stop slog of a house-officer. In those days we worked 80-hour weeks, sometimes over 100, with some shifts lasting a continuous 32 hours. Whatever you may think of Brexit, thank goodness for the European Working Time Directive. (Well I guess that's one thing the E.U. has given us! Oh, and of course wine. And labour for the food industry. And medical research grants. A healthy economy. The aqueduct..)

Anyway, to get us through those long laborious shifts, we needed some good solid food. In fact, food became more than just fuel. A meal was an oasis, a respite from the maelstrom, and when taken collectively, a moment for doctors to share experiences, swap stories and provide support.

In those early years, it was my job as the most junior member of the team to collect the curry from the take-away opposite the hospital. That I was carrying the emergency bleep may sound concerning. And it sure was. Not because I was out of the grounds - it happened to be even closer to A&E than the hospital canteen - but because if the bleep went off, then I'd have to leg it back to A&E balancing a lamb rogan josh, chicken biryani, and a bagful of onion bhajis. Not a great entry.

Those shifts were extremely demanding, physically as much as mentally: dashing from ward to ward, pounding up and down the stairs. Good job then that lining each and every ward station would be a reliable array of chocolate, props that were as ubiquitous and defining as blood pressure machines and drip bags on wheels. Each box of Celebrations or Heroes a symbol of gratitude for being cared for so diligently. For having a leg mended. For having a life saved. For me though, it also meant an extra stone in weight.

By the time I'd moved on to my psychiatry training, the hours did start to ease - after a 24-hour shift we even had the relative luxury of a day off. And so food also became a symbol of relaxation. A sigh of relief on a plate, somehow.

And without exception, my post on-call treat of choice was a breakfast fry-up at a greasy-spoon down the hill from The Royal Free. After a whole day and night on your feet, there was nothing better in the world than sitting down to some chips - good ones you know, crispy on the outside, fluffy on the inside - and dipping them into an inviting pool of fried egg yolk and a comforting swathe of baked beans.

(And yes, you heard right - a greasy-spoon in Hampstead! And a great one at that! I do hope it's still there and hasn't gone all smashed avo and quinoa..)

A few years later, and my first taste of child psychiatry was at Great Ormond Street Hospital. It proved an inspiring place to work. And a highlight came at Christmas, when the hospital was frequented by all manner of worthy celebrity visits.

Our ward put on a good show for the children - a full turkey dinner with all the trimmings, presents under the tree, and an appearance from Santa. And that year, who got to be Santa? Me. Perhaps not the most obvious role for a Jewish doctor, but I was totally up for it, and it certainly helped tick the organisation’s diversity box!

And when I say Santa, I mean the full Santa - natty red outfit, voluminous padding, fake bushy beard, bright shiny buckle, elfin boots.. I was quite the sight. But not the sort of gear you'd want to be wearing in the presence of, say, Sharon Osbourne.

It was actually very kind of her to join the lunch - celebrities don't often visit our ward - even if my cheeks did turn a shade redder than my Santa suit, and all I could muster was a throaty ‘Ho Ho Ho!’ and a slightly soggy mince pie.

(Funnily enough, that wasn't the first time I'd encountered an Osbourne in somewhat peculiar circumstances - I had previously bumped into her renown husband Ozzy a few years before, up a Mexican pyramid no less. For more on that story, click here..)

Anyway, it obviously wasn’t enough to put me off, as by the end of this placement, I'd made up my mind - child mental health was the career for me.

*

Years have since passed, and I now work as a consultant in an NHS Child & Adolescent Mental Health Service - known more colloquially as ‘CAMHS’.

The fact that I had hardly even heard of the term CAMHS when I first qualified as a doctor was evidence of its low profile at medical school - in itself a reflection of the paucity of investment in children’s mental health  nationwide. If adult mental health was the poor Cinderella of the NHS, then CAMHS was Cinderella’s poor forgotten cousin who never even knew there was a ball to go to - Camhserella, perhaps.

Things have changed a bit since then, luckily. I am heartened to see that our society is finally starting to appreciate the impact that mental health problems can have on children, and indeed their wider family and friends; bit by bit the starkly high frequency of such problems is coming to light.

And people are thankfully talking about it. It's in the papers, on the radio, and on TV - as never before. And over the years, CAMHS services have grown. But not enough. Nowhere near enough.

I know this because I see how relieved people are when they finally get to their first appointment, even if they're understandably a bit anxious as well.

I know this because I see how children and their families have already been suffering, often in silence, long before they even first come through the front door, long before they even went to their GP in the first place.

And I know this because I see how hard my colleagues work. Invariably way beyond their hours. Not to mention the sheer intensity of the job - supporting parents who are stretched beyond measure, often with their own mental health problems, or teenagers who self-harm or have active plans for suicide.

We do this because we know there are so many children and families out there, needing help. And we are continually humbled by what people go through, not to mention the privilege we feel when people so bravely let us into their lives at these most difficult of times.

And yes, the NHS is also experiencing some tough times. Really tough times. I don't want to get too political about it. Health economics is a complex issue, and even more so when our country's economy is under such pressure and uncertainty.

But what I do want to say is this: when the going gets tough, the tough get going. And that's not just the NHS staff’s dedication to caring for patients and families - but also the way that they look after each other.

I simply couldn't do what I do without my team. They're an amazing bunch of people - highly skilled, so unassuming, but always going about their work with humility, diligence, and a desire to learn. They are incredibly professional, yet always in touch with their humanity, and that of our patients.

And we look out for each other.

There are lots of ways we do that. Sometimes we double up on a particularly complex case, sharing our expertise and experience. Often we will seek advice from each other outside a patient appointment.

And on the rare occasions when moments of drama or crisis come to the clinic - a teenager who barricades themselves in the toilet, or a child whose behaviour ‘creatively’ refurbishes the clinic decor - the team rallies round to keep things safe and calm, defuse the tension, and provide support for those in the front line.

So when we see a child, once overwhelmed with crippling anxiety, but then able to perform on stage at a service event; or when we hear that a teenager, once housebound with depression and trauma, has done a bungee jump and delivered a speech, or another who competed in a dance competition, or in fact, just the majority of cases who eventually leave our service in a better state of mental health and that bit closer to reaching their potential - well, it makes it all worth it.

And on an everyday level, a real reflection of this mutual team support and love are the little offerings of food we often provide for each other. Each little donation a sign of mutual respect, and acknowledgement of the tough nature of NHS work, and a battle cry to keep our energy and spirits up, doing the absolute best we can for people that come to our clinic.

As testament to this, throughout September, I thought I'd document every single item of food brought in by staff and left in the team kitchen for people to help themselves. The diversity of the foods - from Indian biryanis to Greek baklavas - also reflects the diversity of our staff, which only serves to further enrich our team.

So, this post is dedicated to my colleagues, to the young people and families that we serve; to other children's’ mental health services around the world, performing a similar role in challenging circumstances; and to the fuel that keeps us going:

One tray of homebaked raspberry cupcakes

One lamb biryani

One allotment marrow (large enough to feed a whole CAMHS team!)

Two packets of Greek pastries

One lemon drizzle cake

Some allotment runner beans

A box of chocolates

Another box of chocolates

More chocolate

A box of baklava

Turkish Delight

A packet of cinder toffee

Teatime Treats

Biscuits

More Biscuits

And More Biscuits

And finally a mention of M's incredible home-baked cakes - no photos sadly - which brighten up our monthly doctors’ meetings. It's rare to leave the meeting without the agenda smudged in chocolate icing.

This post has been a reflection on a personal journey and a dedication to NHS staff. I haven't even mentioned the importance of good food in the healing and helping of people recovering from illness and surgery. On this note, hats off to campaigns aiming to improve hospital food, for such food is possibly the most important sustenance we will ever have, and yet often so sadly neglected. For more, click here. Finally, if you'd like more information about child mental health, feel free to check out Young Minds, ACAMH and the Royal College of Psychiatrists.