Malpractice - Season Two
I can’t imagine how I missed season one of a prime time medical thriller on TV. It seemingly came out in 2023, when I spent almost a month in an Amsterdam hospital, almost three in a Glasgow hospital, and then another 10 days in a Glasgow hospital, all for a smashed tib and fib, as well as a few two week stays in for gastro bleeding and pneumonias. So on second thoughts, I can see how I missed it completely, but season two started tonight, and on the back of it, I’m jumping at the chance to watch season one.
Episode one of season two was a gripping watch. The plausible nature of the hospital scenes and language between doctors and other health workers gives away the fact that the writer must have been a medical professional, and she was. Grace Ofori-Attah worked as a consultant psychiatrist in Camden and Islington in London before giving up to become a screenwriter. Inner city psychiatry is as hectic as regular A&E, and the workload and stress has increased as provision for mental healthcare has decreased. It sounded very laudable to move institutionalised psychiatric patients back into the community 50 years ago, but without provision of community resources - enough psychiatric nurses in the community; adequate methods of chasing up patients who had been psychotic and violent in the past and who did not comply with oral medication, and had not presented for depot injections of the medicine that kept them calm - as well as lack of back up hospital beds for those who were not safe to keep in the community, the idea of contented patients being served by calm, caring staff in the community was shown to be a fairytale. Psychiatric nurses in the community are run ragged and they do not have enough time to spend with each patient.
Ofori-Attah is obviously well aware of the pressures facing junior doctors in almost every specialty (possible exception dermatology, where only a couple of emergency conditions exist.) As well as the grinding hours, she depicts the terrible stress on doctors torn between two emergencies at the same time, under pressure to make a choice about who to deal with first while knowing that they can’t just glance at a patient and then run without finishing the job. Medicine is all about being professional, absolutely meticulous, and, crucially, explaining what is going on to the patient and relatives, and outlining a plan to them and, if they are to be admitted, to the staff on the ward.
Ofori-Attah is obviously also familiar with another presence in the medical world: unsupportive consultants. I should add that nowadays, the majority of consultants are extremely conscientious and do not dump their workload onto juniors. But in every profession there are a few people who take advantage of others, and so it is in medicine. This is why there is an unstated rule acknowledged as soon as you start clinical medicine: do not dump on your peers. However, there is nothing to stop an unscrupulous consultant dumping on a junior. The age old fear has been that if you stand up for yourself and argue that you have your own tasks to do, you will receive a terrible reference. There is also the need to show that you can cope with any workload. Any signs to the contrary and the already lengthy , arduous climb up the career ladder, involving long hours and numerous exams which you have to pay for the privilege of taking, may well be thwarted.