It was inevitable that I would have to read Friday's Child by Ben Palmer after my post about Touching Distance by Rebecca Abrams last week. It had all been one of those strangely-meant serendipitous connections as I read in the Guardian about the tragic death of Ben's wife Jessica from puerperal sepsis just six days after giving birth to baby Emily, at the same time as I was reading Rebecca Abrams fictional account of the 1790's epidemic of Childbed Fever.
I knew this would be a tough emotional read and I suspect, like many people, I studiously avoid books like this because I don't want to be upset, but also because I work for the organisation that was culpable. As an employee it gives books like this a There But For the Grace of God factor and wouldn't it be nice to just bury my head in the sand?
Be warned this book will make you cry (seem to have had a few of those lately) and even tough-as-old-boots me spent half the book reading through eyes blurred with tears. The book leapt clean across all of my carefully placed professional boundaries and right into my heart.
The impact cannot be overstated and I think it's all down to the way Ben has written Friday's Child. It's searingly honest and he writes in an amenable, down to earth style and intersperses e mails throughout which give the book an intimate personal quality. There is ample opportunity to get to know Jessica well too, she had a vibrant and bubbly personality, loved motherhood and she and Ben made a great team. This all makes the reality even more shocking and palpable, that in this day and age of knowledge and advanced medical science Jessica died of an entirely treatable infection.
But as her death proves, time and observation is of the essence.
The window of opportunity for effective treatment between diagnosis and complete organ shutdown in puerperal sepsis is frighteningly narrow, it's one of the reasons midwives used to visit twice a day for ten days and do old fashioned things like check pulse and temperature. In Jessica's case had she received treatment just eight hours sooner her chances of survival would have been far greater.
But Friday's Child feels like a book that should be read by all health professionals and not just those of us involved with childbirth.You can't be a registered health professional of any description without carrying some burden of responsibility for assessment and decision-making and thereby accountability. A book like this is a stringent reminder that there is no room for complacency or short cuts, even given fewer staff and increasing workloads, you can't afford to take your eye off the ball for a second. This involves being at the top of your game every single working day, nothing less will do and most certainly not second best.
I think I'd like health service managers to read this book too.
The people who in times of financial constraint have to juggle budgets and yes, I know they all tell us it's difficult and we don't understand how difficult, but in my experience we do understand all too clearly. It is staffing levels and staff training and updating that are the first casualties when budget deficits are on the agenda and more often than not the buck stops with the person with the NMC registration. Plenty of you will know that there's nothing quite like that to really define and focus your thinking and coincidentally I've just written the £76 cheque for mine this weekend for the coming year. After reading this book my hand didn't feel quite so light as I wrote.
I wasn't entirely sure whether there was a manager standing shoulder to shoulder alongside (alongside, not behind) Jessica's named midwife who I think very bravely and honourably took responsibility for her mistakes in court, but if not there should have been.
This must have happened on someone's watch and they are equally accountable.
There were a disastrous chain of errors and lapses in communication but amongst them all it will not have been the community midwife's preference to have had to prioritise the workload as she was forced to on that fateful day. Many lives have been changed tragically and irrevocably as a result of Jessica's death and hers will be one of them.
The legal battle that ensued makes for very uncomfortable reading indeed. Ben delineates his struggles with a transparent honesty and openess as he copes with life as a single parent to Harry and Emily. Whilst Emily is a developing little person Harry knows a great deal more and some of his 3 year old out-of-the-mouths-of-babes observations will have you biting your lip and fighting back the tears.
Ben's resources are tested to the very limits of human endurance as the grief and anger rage and he descends into depression and alcoholism and then, depleted and exhausted, has to take on the mighty and seemingly heartless behemoth that is the NHS. I was overwhelmingly relieved to see the name Havers in Family Palmer's excellent legal team.
I emerged from this book and encountered an unexpected whirlpool, a swirling mass of disturbing and uncomfortable emotions. Firstly because few books make me really cry, to the point where my voice falters if I talk about them, but also because I of all people could see this tragic situation from both sides, but what happened was indefensible and by admitting liability the NHS clearly agreed.
So why read a book that's likely to have such a profound impact?
Isn't life upsetting enough sometimes without adding to the grief ?
Well that's a decision you will have to make for yourselves. I am so glad that I've read it, I was deeply moved and humbled by Ben's experiences and as a health professional it makes you consider some very unpalatable evidence.
Clearly the time has come to admit that we can no longer afford to be complacent about puerperal sepsis and it is an illusion to consider it a problem consigned to history. Ben is now campaigning widely via Jessica's Trust to raise awareness. If you decide not to read the book at least follow the link to Ben's website and familiarise yourself with the symptoms. Like many Ben had no idea but assumed that the health professionals would, and that fact has caused him undeniable anguish and heartache since. I sense a subtle irony to that title given that Jessica's trust was placed wholly in the care she thought she would receive from the NHS.
Ben and Jessica's children depended on his survival, he has survived and Friday's Child and Jessica's Trust are a magnificent testament to that.
Emily will be four years old tomorrow, and the memories will doubtless return through this coming week for Ben, and having read Friday's Child I can assure him hand on heart that Jessica would have been rightly very proud of her lovely family.