in social chit-chat. I find it hard to talk about things that are trivial. You’d think I’d relish the break, the relief from the seriousness, but I don’t think of it like that. Every day I’m part of something important. I think of it as an honour, a privilege, that people, often from completely different worlds from mine, will choose to confide in me and relate to me.
I don’t know if it was his break away from the place, but Gary was in a philosophical mood. As we walked towards the gates which lead on to the Healthcare unit, our keys jangling with every footstep, he turned to me and said, ‘You know what, Doc, I’ve been thinking.’
‘Uh oh!’ I teased him.
He flashed me a smile and then suddenly looked serious.
‘I’ve been thinking about life. This place, and why people end up here.’
I was intrigued. ‘Go on.’
Gary had been at HMP Bronzefield for fourteen years and was one of the good guys. He liked the challenge of dealing with the emotional needs of prisoners; he wanted to see them reformed.
He frowned, thinking for a moment. ‘I think most prisoners have had a Sliding Doors moment,’ he said. ‘You know, that point in life where your life could really go either of two ways.’
I stood back while he opened the next set of gates. Like me, his fingers found the right key without ever having to look.
We made our way into the medical suite, a selection of rooms off a narrow corridor. I waved hello to Soheila in the pharmacy.
‘It could happen to anyone, couldn’t it?’ he continued. ‘A moment, a random moment when your whole life hangs in the balance. Like …’ He tried to think of an example.
‘You’re having a drink in a pub, a fight breaks out, you hit someone, that person falls back and smacks their head. They die. The next thing you know, you’re banged up inside for manslaughter.
‘Your life can change in the blink of an eye. You know what I mean, Doc?’
Of course I knew. After all, it was just such a moment that had led to me being there.
Buckinghamshire
2004
The warmth of the central heating blasted into my face as I walked through the entrance doors of my GP practice.
I was greeted with a smile from Kirsty on reception.
‘Morning, Amanda!’
I had no idea how she managed to be so cheerful, so early in the day.
As usual I felt daunted at the thought of how many patients I was likely to be seeing that day, but I loved my job as a GP – however exhausting it was.
I tugged my gloves off with my teeth, and picked up a pile of letters and notes Kirsty had put aside for me. So much paperwork.
‘How’s today looking?’ I asked.
‘Fully booked. Biscuit?’ Kirsty waved the packet under my nose.
I shook my head. ‘Don’t forget the lunchtime meeting.’
‘All scheduled, she said, tapping at the calendar on her computer screen with her biscuit.
My stomach somersaulted thinking of the meeting, and the changes it might bring to my cosy practice.
In less than a month, on 1 April 2004, the new GP contract would be introduced, in which the whole pay structure for general practice would change. The basic pay would be reduced, but bonus payments could be earned if certain questions were asked and checks were done during the consultation.
I think it was intended to make GPs perform better, but I knew I’d struggle with it – gathering such information when perhaps a patient was deeply depressed or had recently been diagnosed with cancer, might feel inappropriate.
After twenty years my patients knew me too well. They would be able to see through why I was asking the questions, and I knew I couldn’t do it just for the sake of it.
I reflected on how things had changed in the two decades since I’d started the surgery from scratch. The practice was within easy reach of London, and I’d managed to build my list up to about four thousand patients.
I’d moved with the times, always adapting to the changes within the health system and my surgery, but this latest scheme was threatening my core beliefs and principles concerning patient care. I was deeply concerned that I wouldn’t be able to change my consultation style and gather the information required to earn the bonus payments. I also had a terrible inkling that my practice partners would demand I do so.
At 1 p.m. I steeled myself for what was to come, grabbed my note book and pen, and headed along the corridor to the meeting room.
Pretty pictures of landscapes, seascapes and flowers lined my way. I’d worked hard over the years to remove the sterile feel a new-build can have, to create a welcoming environment where people could feel relaxed. Small touches like that mattered to me.
I was the first to arrive.
I sat down to wait for the practice manager and my two partners, who now co-owned a share of the surgery. They were both excellent doctors, young and ambitious, and as I had never been particularly good at managing money or the business side of running the practice, I was more than happy to let them take charge.
The door swung open. Rohit, one of my GP partners, walked in, rubbing his hands. The other two followed close behind. They took their seats.
The tension was palpable. I sat there, legs crossed, anxiety building. My heart was pounding and I felt sick.
Rohit looked directly at me. ‘So, how are you feeling about the changes, Amanda?’ he asked.
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