On his first day as a trainee psychiatrist, Dr Benji Waterhouse –conflict averse, bookish, balding – receives a crash course in martial arts. A brawny ex-policeman with tumescent biceps exhorts the gaggle of junior doctors never to wear a tie unless they want to getthrottled, never to make a patient a cup of hot tea unless they want to get scalded, and to always sit in the chair closest to the door in case their life depends on making a quick getaway.
It’s the start of a litany of rude awakenings, documented in brisk and self-deprecating style. Waterhouse’s decision to specialise in psychiatry, for example, is dismissed by one medical consultant as “a waste of a perfectly good doctor”. A cardiologist tells him a psychiatrist is nothing more than “a social worker with a stethoscope”. Nevertheless, he arrives for his first job on an acute psychiatric ward buoyed up by the conviction that he is going to help his patients live happier and more fulfilling lives. The ward handover is dominated by a clipboard-wielding bed manager who sneers at the patients, belittles the junior doctors, and whose sole measure of success is how quickly he can pressure the team into discharging the inpatients. When Waterhouse meets his first patient – a young woman called Paige with a tortured history of neglect, abuse, prison, addiction and innumerable episodes of self-harm – the consultant in charge dismisses it all. “There’s no true mental illness there. It’s all just personality disorder and drug-seeking behaviour and there are no wonder drugs for that,” says the fearsome Dr Glick (names have been changed). Even Paige’s threat to jump out of her flat window is derided, since she only lives on the second floor.
