Visit to Gastroenterology

by Chris Birch (Patient Governor)—One of the perks of editing a weekly news magazine, which I did for 13 years, is that you get to do a lot of expenses-paid entertaining, and I have had many interesting lunchtime discussions with a wide variety of people.

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Chris Birch, Patient Governor

E: chris.birch@chelwest.nhs.uk

One of the perks of editing a weekly news magazine, which I did for 13 years, is that you get to do a lot of expenses-paid entertaining, and I have had many interesting lunchtime discussions with a wide variety of people.

But never before my shadowing visit with Consultant Gastroenterologist Dr Marcus Harbord at Chelsea and Westminster Hospital had I spent my lunch hour listening to a discussion of other people's bowels.

I had been invited to meet Dr Harbord, one of six consultant gastroenterologists, for a sandwich lunch but I had not realised that I would be attending an inflammatory bowel disease multi-disciplinary team meeting, or IBD MDT for short.

Dr Harbord was in the chair and there was also a surgeon, a surgical registrar, a radiographer, two stoma nurses and an IBD nurse. And while we munched away, we watched and discussed pictures of patients' colons on a large screen.

Inevitably, much of what was said was way above my head but I was impressed by certain things. When I was a young man, long, long ago, doctors treated their patients as cases. Their patients had technical problems which they would solve without becoming emotionally involved. But the cases that were discussed by the IBD MDT were not just 'cases'. They were human beings whom the team knew as individuals with individual problems.

"This patient is a young man in his early 30s with his whole life ahead of him so we must bear that in mind."

"This gentleman in his 80s lives alone, if we do this or that how will he cope?"

The team's compassion for their patients was obvious.

I was also struck by a certain understandable defensiveness. "We ought to do this and this, because if the outcome is that and the finger is pointed at us, we would then be able to say so and so."

After lunch Dr Harbord took off his gastroenterology hat and put on his other hat as a general physician responsible for the 28-bed Edgar Horne Ward. Another MDT meeting with Dr Harbord in charge and attended by Consultant Hepatologist Dr Matthew Foxton, a registrar, two junior doctors, two sisters, two occupational therapists, two physiotherapists, the discharge team co-ordinator and a social worker from the Royal Borough of Kensington and Chelsea.

A total of 11 patients were discussed in detail and I was again struck by the detailed knowledge that the team had of their patients.

We then did a ward round and I was impressed by the fact that, if a patient was asleep, Dr Harbord did not wake them. When I was an inpatient last April, I was continually being woken up for a variety of reasons and so Dr Harbord scored several brownie points in my book when he allowed a patient to continue sleeping.
Dr Foxton then took me to the Intensive Care Unit to visit one of his hepatitis patients, a young man in considerable pain. The unit has 10 beds which are used flexibly, depending on the level of care needed by the patient.

Finally, a quick visit to Thomas Macaulay Ward and then home, exhausted, in time to catch Neighbours.

I am extremely grateful for having had this opportunity to do and see what I did. I was greatly impressed by the high standards, quality and compassion of the doctors, nurses, therapists and others I met.

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