Nurses deserve more credit
At the same time as I was reading Neels's novels, I was watching with my devious little hack's eye the interaction between the doctors and nurses around me, and it couldn't have been more different. Nurses spoke to nurses, and doctors to doctors; 'The only time the doctors speak to us is when they want us to do something they don't want to do,' laughed one beautiful young nurse. I thought of this when reading about the new threatened doctors strike and how analysis from the Royal College of Nursing shows that 'nurses pay has been so severely eroded that starting salaries are now over £8,000 lower than if wages had kept up with inflation since 2010.'
Is it a class thing? Nurses are more likely to have gone to state schools, while doctors are more likely to be from the middle class. Doctors staged about a dozen strikes in 2023 and 2024 under the Tories, were immediately given a 22 per cent pay rise by Labour and still feel like they're entitled to more. On a recent episode of Jeremy Vine on Channel 5, an older, working-class female community care worker in Manchester, Sarah, rang in to oppose the doctors' new demand. She took on a posh, young female doctor ('Helena Pugh' – you couldn't make it up) and matched her claim for claim about how hard she worked. All for a damn sight less money and prestige.
One nurse at my hospital ward told me: 'I've done this job since I was young, and I'm just about to retire. In my experience, the hierarchy is still pretty much there and the consultants are still unapproachable.' (Mistrust of 'weird' consultants was very evident among the nurses I met.) 'Nursing is an ill-defined profession,' she continued. 'We're like a sponge sitting in the middle of the team, soaking up all the bits that no one else will do, from admin to cleaning.'
A nurse at the Royal Sussex told me: 'Nurses make terrible strikers because we're out there on the picket line, then our alarm goes off and we run back onto the wards because we're needed. They know they've got us…'
A thread on Reddit by a nurse summed it up for me: 'I'm not resentful of junior doctors striking. I am bitter how bad we do in comparison to their success though. If every nurse just walked out, can you imagine the chaos that would ensue? Patients would come to harm; there would be chaos on the wards, in ICU, in A&E. At the end of the day, nurses do the majority of the labour and graft. But look at the nurses strike in America; the majority walked out and the strikes lasted three days. They got what they wanted. I think if we stayed strong, we would be in a much stronger position.'
To return to the class issue, maybe the difference is that nursing is a calling – like being a nun, if 'the NHS is the closest thing the English people have to a religion' as Nigel Lawson quipped – while being a doctor is something clever bourgeois girls and boys become if they were good at science subjects at school.
Whatever, the mismatch is unfortunate, and having reverberations far beyond who will and won't strike. People may be losing their religion; earlier this month the new boss of the NHS, Sir Jim Mackey, said: 'It feels like we've built mechanisms to keep the public away because it's an inconvenience.' Though she was a comedy character in Carry Onfilms, it's telling and slightly surreal how many people with recent experience of the NHS as patients yearn for a Hattie Jacques-type 'matron' to sort it all out.
There is also a consensus that after graduating, doctors should be made to work for at least five years minimum in the NHS before decamping to distant shores – the same places that the nurses are now being tempted to by adverts on television. In the sunlit wards of Australia, away from the responsibility that comes with being the carriers of a religious flame, maybe at last the romantic alliances between nurses and doctors dreamed of by Betty Neels can finally come to fruition. Until then, it's ironic to think that even the snogging game my generation played as children – 'doctors and nurses' – assumed that this was the natural order of things. If the game was played realistically these days, the two chosen children would simply go into separate rooms, and fume about how easy the other one has it.
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A winter's day. My father in the dark room of my memory developing photographs. The door is shut. My sister stands with him. He aims to teach her the essentials of photography. How to turn a black and white negative rolled from the interior of his camera, unspooled in the dark, then bathed in trays of chemicals, to bring the past back to life in black and white. My sister's special treatment as the only one of nine siblings to learn this skill does not go unnoticed, by me at least. I am 10 years old and long to learn, even as I want only to be an insect in the corner watching unseen. My father taught me fear. Small children rely on their parents for sustenance and survival and when a parent is abusive, where the only love a child comes to know is corrupted, it comes with a sense that other siblings, who also seek his love, are rivals. Writing about child sexual abuse is hard. 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When I was 14, my sister told me the so-called facts of life as relayed to her by our father. He had given her this information to help her grow, he said, because our mother came from a repressed Catholic household and did not know what a man needed. He therefore taught my sister about his desire, confused as hers. And she in turn, wanting to shield me from the pain of his lessons, told me repeatedly: 'If he touches you, scream.' When you're a child, the life you lead is the only one you know. You catch glimpses of other people's lives from a distance. Our family was unique in our foreignness and in the abuses my father meted out. It shamed me when I looked at the fathers of other children at my school who seemed more loving. My father's choice was my fault. If I behaved in a different way, if I was more like my elder sister, if I offered him more by way of interest, or body shape or beauty then he might not only notice me but also he might be kind and not fly into rages at the simplest slight. My mother's overcooked steak. Dishes piled high in the sink. Any child who did not behave as they were told. When I was 12 and shared a room with my elder sister I went to bed ahead of her. Alone under the blankets I imagined myself as Maid Marion from Robin Hood and his merry men. I hid in the forest terrified the Sheriff of Nottingham might carry me to his castle and ravage me. Somewhere in my unconscious mind, I knew what was happening to my sister. I was almost asleep to the soft thud of my father's bare feet on the carpet between our beds. My sister asleep or so I imagined. I did not want him to take me in his arms and possess me. I did not want whatever it was my father did to my sister on those nights, night after night when he came into our room while the rest of the house slept. And yet, I wanted to turn him into Robin Hood. I wanted my father to want me. Looking back, it was as if any woman who commanded my father's attention was one who evoked sexual feelings in him. The rest of us were dispatched. People to cook and clean. My mother bore babies for him, but those already born were of no consequence. Except my sister. My mother believed our father had stopped visiting her in the night. She caught him once in our bedroom, my father hunched over my sister while I was in the next bed pretending to be asleep. 'If you ever come here again,' she said, 'I'll kill you'. Her threat did not stop him, but my mother could not bear to believe otherwise. When you're desperate, you'll do anything to survive. I was in awe of my sister's courage when she stood in front of my father's chair and sometimes asked for money. I could not ask for anything of my father beyond the good night gesture my mother forced on to us younger children. My father stretching up from his chair to make the sign of the cross on our foreheads as some type of fatherly protection. I despised this ritual. The rasp of my father's fingers on my soft forehead, the croak of his words, 'goedenacht', the air puffing back into his seat when he flopped down, and we, my younger sister and I retreated to our respective rooms, ready for the dangers of the night. Bless me father for I have sinned against my younger sister for wanting what was hers. I borrowed her dress when she did not give me permission. Then I ruined it. My sister's dress was too small. I slipped into it well enough, but the buttons could not hold against the pressure of my first attempts to skate around the ice rink at St Moritz in St Kilda with school friends one summer holiday. I came home in the dress; its underarms ripped from their sockets. My sister was enraged. I had destroyed her favourite dress. Blue denim with buttons up the front. Jealousy ruins things. Ruins people. But my therapist reassured me it was a feeling, and not evil, however painful. It's bad enough to endure this feeling, she told me, but ten times worse if you're given the message it's wrong to feel it in the first place. If we squash the feeling because we believe it's wrong then the feeling will bury itself inside, until the sinews of our hearts are like shards of stone that can harden into volcanic rock. Explosions are dangerous. They can destroy everything in their path. Better to feel the tug and pull and pain of jealousy than to let it enter the vaults of the hidden and forgotten. My father in the dark room of my memory holds my sister close and I shudder, relieved to be spared while sad to have missed out. Only in writing can I reconcile these two opposing emotions. When you know something is wrong it surrounds you every day. In families where child sexual abuse occurs, not only are you silenced in the childhood of your home, you're silenced throughout your lifetime, because it hurts other people to hear. But on the page, we can see it, the marks of memory. The open secret. The weird jealousy of an unloved child. The colour green.
