This is the concluding story of Dr Hendricks.
I finished the first part of my rotation at the teaching hospital and was due to start the second part in a very busy general hospital. There were two options: a rotation where I was on call every fourth night (83 hours/week) and one where I was on call every second or third night (96 hours/week). I decided to plead my case for the one-in-four as it was less exhausting for me with the sickle. I was sent to see the occupational health doctor. He checked my weight, height, blood pressure and pulse, and passed me ‘fit to do the one-in-three’, despite explaining to him that a crisis could be triggered by exhaustion.
Regarding SCD as a patient, I did occasionally develop a crisis while on call secondary to exhaustion and dehydration. By then intramuscular diclofenac had been licensed, so I went to the sister on duty in the A&E for an injection, rested for an hour and carried on, praying for the end of my shift. Embarrassingly, I was admitted to my own hospital on one occasion when I was working at a busy general hospital. I only had four hours of sleep the whole weekend. I worked as a registrar, which was still a junior doctor. It was a position with a high responsibility for patient care. The diclofenac didn’t work so I was eventually given morphine in the A&E and admitted to a side room. Every four hours, the nurse came in and stabbed me with morphine, saying, “I have your injection.” After 48 hours, I’d had enough; I told the doctor looking after me that I didn’t want any more morphine. I wanted to go home. My family members were unable to visit me because of the long distance. So, the hospital chaplain offered to drive me home.
At work, the long hours took its toll on my health. I developed gallstones and my first leg ulcer. The ulcer healed but I was to be plagued with recurrent painful leg ulcers for the next 30 years. On two occasions I had to take a fortnight off to rest my legs to encourage the ulcers to heal, but as soon as I went back to work, they would break down again. I had a leg ulcer that lasted five years. As soon as one healed, another would form. The long hours on call were like being on foot patrol; walking up and down from ward to ward and to the A&E, barely having time to have a drink of water or go to the toilet.
By the end of the fourth year, I was so desperate that I asked my doctor to refer me for a leg amputation. The plastic surgeon refused. She said I hadn’t seen the other side of being an amputee, where they fall over at night when getting out of bed to go to the toilet. She did introduce me to a new dressing, which was infused with honey. Honey has antiseptic properties and aids wound healing. My ulcer healed and stayed healed for eight months, the longest time ever!
Regarding SCD, as a doctor I was on duty in the A&E when a patient with SCD came in writhing in pain. My white colleague on duty didn’t know I had SCD; she turned to me and said, “The pain can’t be that bad, they are all just drug addicts!” Her response was typical of what we all faced as SCD patients in the medical world.
And the rest as they say is history. I worked for 22 years as a doctor in Hackney. When I started, there were African and Indian doctors, but I was the first British born African Caribbean doctor. I started working four days a week, but gradually reduced it over the years, especially when my son was born. By the age of 57, I was utterly burnt out from doing a stressful job and coping with regular clinic appointments to three different specialties and four-weekly blood tests and transfusions. Looking back, it was funny because as a doctor, I had more medical problems than most of my patients! I made the decision to take early retirement. After more than two decades in general practice, my brain felt like a frozen computer screen. It needed rebooting; so, I went back to university to study for my master’s degree in Medical Humanities at King’s College, London. I’m proud to say I passed with merit even though I was the grandma of the class. In my chosen profession, lifelong learning has been instilled in us.
As to sickle cell, there were highs and lows. In my 20s, I used to run an Hb of about 80; in my 30s, it dropped to the 70s; and in my 40s, it was in the 60s; eventually, it hit 59 and the haematologist started me on a transfusion programme. I asked what pre-transfusion baseline haemoglobin I should aim for. I was told 70, thinking that the specialist knew everything. It proved too low to protect my kidneys from developing sickle nephropathy. The chronic anaemia also damaged my heart and brain (forgetfulness).
What I realised was that Thalassemia patients were allowed to run haemoglobin close to normal, but sickle cell patients were kept lower, so we had to suffer a worse quality of life, constantly battling fatigue, shortness of breath and multi-organ failure. Despite having monthly blood tests for the transfusion and having regular outpatient appointments I was never told my kidneys were failing. In 2017, I was told that dialysis was inevitable. Finding out coincided with a worsening of my symptoms. I was finding that in the week before my scheduled monthly transfusions. I could barely leave the house because I was so tired. It was agreed I could run a higher pre-transfusion Hb of around 85-90. This has stabilised my kidney function and there are no immediate plans to put me on dialysis.
The thing was though every clinic I worked at as a locum they would say to me, “Dr Hendricks we want you to stay with us permanently.” They offered me a partnership. I replied, “I suffer from SCD,” and they would say, “We don’t care, all the patients like you and always ask for you when you’re not here.” Despite all my qualifications, my proudest moment was when working as a doctor my receptionist (who was unaware of my health problems) said to me, “What I like about you Dr Hendricks is that you are always able to see things from a patient’s point of view!” Wow!
If you will like to get in touch with me about Sickle Cell, do so, via email: [email protected]. Check out my blog: My book on Sickle Cell – HOW TO LIVE WITH SICKLE CELL – and other books are available for purchase on www.amazon.com