Your Life In My Hands: A Junior Doctor's Story

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My times are in your hand. Deliver me from the hand of my enemies, and from those who persecute me. Clarke is a superb storyteller as well as a clear-eyed polemicist . . . she writes with such compassion and humanity that you feel you are in the room . . . Clarke is certainly on the side of the angels and she has produced much more than a snapshot. Breathtaking is a beautiful, blistering account of a key moment in our history. If I were Boris Johnson, I wouldn't want to read it -- Christina Patterson ― Sunday Times Yet, when she finally emerged as a junior doctor at over thirty years of age and entered into the profession she had pursued with fervour, she became disillusioned by the punishing workload and Health Secretary Jeremy Hunt’s unjust accusations towards junior doctors for failing to deliver an exemplary standard of care and a seven-day NHS. Despite being at the lowest position in the hierarchy of the medical profession, Clarke, like many other junior doctors, felt the need to speak up and voice her concerns. This led her to adopt a leading role in the activism against the proposed junior doctors’ contract. Through it all, she stayed true to the prioritisation of patient care and expressed her deep attachment and loyalty to the NHS, which threatened to be upended by unreasonable governmental policies. Tinted with a mixture of worry and optimism, this personal account promulgates a sense of hope for an increasingly battered and underfunded health service. Reflections The Distinctiveness of Britain’s Health System Throughout the book, Clarke makes striking associations between her own encounters and those at Mid Staffs, beginning with the death of her grandfather, who suffered a fatal fall as he was unable to get help from the hospital staff to use the bathroom. In her own hospital, Clarke also observed such unsettling callousness when a surgeon simply called for a palliative care nurse instead of setting aside time to talk to a patient about his cancer diagnosis. As the abrasive culture of Mid Staffs seeps through the NHS, Clarke notes that this has largely been the result of “the severely depleted numbers of frontline staff”, which aligns with the findings from Sir Robert Francis’ independent inquiry. My times are in thy hand: Deliver me from the hand of mine enemies, and from them that persecute me.

In this heartfelt, deeply personal account of life as a junior doctor in today’s health service, former television journalist turned doctor, Rachel Clarke, captures the extraordinary realities of ordinary life on the NHS front line. From the historic junior doctor strikes of 2016 to the ‘humanitarian crisis’ declared by the Red Cross, the overstretched health service is on the precipice, calling for junior doctors to draw on extraordinary reserves of what compelled them into medicine in the first place - and the value the NHS can least afford to lose - kindness. This shows that medicine can never operate efficiently on an individual level; it takes a well-organised and system to keep the profession going. While individual healthcare workers often enter the profession with the best intentions at heart, their idealism can soon be crushed by the weight of responsibility in underfunded, understaffed hospitals, where speaking up to seniority is equated with blatant disrespect. This culture of silence, compliance and submission that seems to be a subsidiary trait of the hierarchical nature of medicine only perpetuated the establishment of an increasingly brutal culture, where patients can no longer receive quality care. The Health of the Medical Workforce Conjunctive waw, Preposition-m | Verb - Qal - Participle - masculine plural construct | first person common singular As Clarke shares some of the traumatic experiences she went through in understaffed hospital shifts, I am moved by her longing to do the best for her patients—a worthy desire which is constantly being thwarted by the long hours and an impossible workload. She describes herself running between wards, frenzied and sleep-deprived, trying to stay sane while not letting her mounting frustration get in the way of treating patients with kindness and respect.To toughen up the hard way, through repeated exposure to life-and-death situations, until you are finally a match for them? My times are in thy hand: deliver me from the hand of mine enemies, and from them that persecute me. I am a junior doctor. It is 4 a.m. I have run arrest calls, treated life-threatening bleeding, held the hand of a young woman dying of cancer, scuttled down miles of dim corridors wanting to sob with sheer exhaustion, forgotten to eat, forgotten to drink, drawn on every fibre of strength that I possess to keep my patients safe from harm.’ And when thy days be fulfilled, and thou shalt sleep with thy fathers, I will set up thy seed after thee, which shall proceed out of thy bowels, and I will establish his kingdom. My times are in Thy hand; Deliver me from the hand of mine enemies, and from them that persecute me.

A searing insider's account of being a doctor during the tsunami of coronavirus deaths . . . It says everything about her character that Clarke refuses to settle for despair, focusing on the human decency she has seen ― IndependentIn the Sunday Times best-selling Your Life in My Hands, Rachel depicts life as a junior doctor on the NHS frontline. A heartfelt, deeply personal memoir that is both a powerful polemic on the degradation of Britain's most vital public institution and a love letter of hope and optimism to that same health service. This memoir of the first wave of Covid will, I predict, be read a century from now as one of the best eyewitness accounts of what happened in the nation's wards in 2020. But it is no less important that it be read now, as a riveting, heart-wrenching testimony from the front line . . . Clarke writes with grace and empathy about her patients and colleagues . . . A must-read -- Matthew D'Ancona, Tortoise Media How does it feel to be spat out of medical school into a world of pain, loss and trauma that you feel wholly ill-equipped to handle? Unsurprisingly, this book made its way into my life through the Oxford Medicine Introductory Reading List. Another medicine-related read, it will be enlightening for all aspiring medics and medical students, especially those who are living or studying in the UK. For myself, this has served as an invaluable introduction to the health system which I am about to enter but have never experienced first-hand. Albeit from a slightly condemning perspective, the candid reflections are deeply moving.

Unfortunately, such a system is not always easy to run, and it takes extraordinary wisdom and foresight to properly allocate funding, resources and manpower while still ensuring patient satisfaction. As exemplified by the Mid Staffs hospital scandal, when doctors and nurses are overburdened, it results in unintended callousness and a systemic mistreatment of patients that becomes the norm. At Stafford Hospital, hundreds of patients died unnecessarily from neglect and poor standards of care. While this has been dismissed by some as an isolated case, it is in fact a microcosm of widespread failings in the entire health service.Why does the Almighty not reserve times for judgment? Why may those who know Him never see His days? Clarke, who comes from four generations of doctors, is a skilful writer and her passion for her profession shines through the many personal, moving and unsettling stories of life on the front line. One patient with cancer is told with extraordinary tenderness that she is going to die; another makes an astonishing recovery when all seemed futile. And there is a very intimate description of death itself.

Thank you to Rebecca Fincham (Bigmouth Presents Book events) and also Metro Publishing (John Blake Books) for the advanced review copy of Your Life in My Hands. The course of my life is in Your power; deliver me from the power of my enemies and from my persecutors. My lots are in thy hands. Deliver me out of the hands of my enemies; and from them that persecute me. My times are in Your hands; Rescue me from the hand of my enemies and from those who pursue and persecute me.

Nearing the end of the book, the reversal of roles is again brought to the fore as Clarke’s father was diagnosed with aggressive cancer, and she faced the anguish of being the loved one of a patient who might slip away at any moment. Yet, even in the midst of despondence, Clarke expresses heartfelt gratitude towards her country’s health service for its collective decision to “provide healthcare without charge to those in need”. Her pride in being an NHS doctor shines through the impending tragedy and general miasma of uncertainty that hangs over its future. Ellicott's Commentary for English Readers(15) My times are in thy hand-- i.e., the vicissitudes of human life (LXX. and Vulg. have "my destinies") are under Divine control, so that the machinations of the foe cannot prevail against one whom God intends to deliver. For the expression comp. 1Chronicles 29:30, "the times that went over him," Isaiah 33:6. Clarke has written the UK's human story of Covid. Weaving together stories of patients, families, nurses, doctors and paramedics as the virus spread from New Year's Day to the end of April 2020. She reveals the desperate times and the government's mistakes but also how people from all walks of life - inside the NHS and out - have tried to reach out and show goodness to one another ― Stylist Powerful, uplifting and even reassuring . . . Clarke's tone is more intimate, much of the book written at night when she couldn't sleep for fear, fury and frustration - the last two she attributes largely to the inadequacies and lies of politicians. Rage lurks beneath many paragraphs as she lambasts the delays in decisions, and the "number theatre" of statistics. You get the sense of someone trying to remain calm and reasoned, often on the verge of being overcome . . . superb -- Madeleine Bunting ― Guardian Since his days are determined and the number of his months is with You, and since You have set limits that he cannot exceed,