Trust him, he's a doctor

Phil Hammond juggles many career hats--comedian, campaigner, and lecturer--as well as doctor. Finola Lynch talks to the media doctor who argues the NHS might just be saved if more medical students were to follow his lead

Phil Hammond's medical career started off on the same traditional trajectory as so many others. He got three A grades in his science A levels and went to Cambridge University to study medicine because "it was almost expected."

But something happened during his clinical training at St Thomas's Hospital, London. He felt angry about medicine and all its faults, and his way of dealing with it was to "laugh in the face of adversity" and turn being angry into a second career.

"Comedy is a form of catharsis for me," says the 40 year old genitourinary doctor--he would say he works at a "clap clinic." His line in medical black humour has earned him praise and damnation in equal helpings. "It helps me to work out what I really think.

"You get honest feedback from an audience. If they laugh you know you've hit the nail on the head. If you die on stage and don't get a laugh, you've got live criticism there and then. On top of that, your work gets scrutinised by the media. This is completely different to medicine, where health professionals work largely in isolation: nobody scrutinises their work and they never get any feedback."

Hammond has been giving the medical establishment plenty of feedback since 1990 when as a junior doctor he formed one half of the comedy duo Struck Off and Die. After a three week run at the Edinburgh Festival in a sweaty masonic lodge on the Royal Mile, the BBC noticed their comic talents, and an award winning Radio 4 series was born.

But Hammond hasn't always played it for straight laughs, making another career by stepping over the thin line that separates comedy from tragedy. Three years before it went public he was writing about the developing scandal at the Bristol Royal Infirmary's children's surgery unit in his anonymous
Private Eye column "Doing the Rounds."

Surprisingly, he later told a public inquiry that he was not particularly proud of his role in uncovering the scandal. As no action was taken as a result of his biting satire, he felt that his articles had undermined trust and morale in the unit, probably made professional rivalries worse, and intensified the grief of parents who later discovered that the information had been in the public domain since 1992.

Others might argue he was being a little too hard on himself. He was a junior doctor at the time and probably felt he had little clout to raise these concerns in a more public forum. He has since cowritten a book, Trust Me, I'm A Doctor, which spawned a BBC television series of the same name, aiming to make patients more inquisitive and assertive about their health and the treatment they get from doctors.

Hammond says that getting serious about an issue and bringing it into the public domain brings "a lot of guilt and reservations." Earlier this year he went public about the "unbearable" conditions at the Bristol sexual health clinic where he works. When reminded of this, he sighs, "Campaigning can make things much harder for the people around you. They feel guilty because they've kept quiet and they worry your whistle blowing is going to reflect badly on them.

"I've spent my life flitting between comedy and serious campaigning. When I get serious I make things harder for people, so I then have to entertain them and cheer them up."

His recent decision to make comedy his full time career derives from the fact that he feels "less guilty" doing comedy. He is about to start a two month tour of his show 89 Minutes to Save the NHS and has a comedy sitcom in the pipeline. "I've come to the conclusion that I'm good at blowing things out of the water, and comedy gives me the freedom to tell it like it is," he says.

But who is listening? Hammond is the first to admit that his audience is largely "the converted." When he starts his act with a show of hands from the audience around 30 per cent are health professionals and the rest "have already reached the same conclusions about the NHS." Once the doctors in the audience have been singled out, you start to notice that they're also laughing the loudest-- although none of them admit to killing a patient.

Hammond does admit to nearly killing one when as a junior doctor he confused potassium with a saline drip because it came in an identical bottle. Had the cannula been properly in the vein, the patient would have had a cardiac arrest. Fortunately it wasn't, and she suffered a swollen, painful hand instead. Hammond covered up his mistake by telling her she must be allergic to saline.

"I can admit to my mistakes because at the end of the day I can always make a living out of another career," he says, "But it's like going over the top in the Battle of the Somme for junior doctors. There wasn't anyone out there when I was starting out prepared to talk about these things and I wish there had been."

Hammond wanted to be a general practitioner while he was training but his sideline in stand up comedy, writing, and a few years lecturing in communication skills mean he has never done full time doctoring. "I've never taken the job too seriously," he admits, but perhaps this was as much a defence mechanism as a career choice. "My dad was a workaholic, suffered depression, and took his own life," he says, "I hate doing things badly and I wonder if I took medicine too seriously whether it would affect my mental health. Certainly I've kept the black dog at bay so far, but the fact I've always pursued interests outside my career has helped me keep the whole thing in perspective."

In a career that attracts, "brainy, assertive, and individualistic people who want to save the world," a self-imposed brief to pursue at least one other career in tandem with medicine is sound health advice in Hammond's opinion. "Students should drive change in medicine," he argues. "They haven't yet been worn out and desensitised by the daily grind. Mature students in particular have more of a world view because they've seen life outside and they know how things should be."

Medicine attracts talented and well rounded people--musicians, writers, and sportsmen and women--and then, Hammond says, "it sticks you down a sieve." Outside interests will help you keep a perspective on a demanding career and, importantly, help you to see more clearly where changes are needed when you're doing the job. So don't give up the oboe or your comedy leanings. Your hobbies might just help you to save the NHS and give you a second career to boot.