Dr Amanda Brown - The Prison Doctor

Brian poked his head around the door and gingerly made his way across the mottled carpet towards my desk. His steps were uncertain; a man whose confidence had taken several knocks.

He’d been on and off antidepressants for as long as I could remember. They eased his depression, but then he would stop taking them, convinced he was feeling better, only to fall back into a depressive slump.

Brian was typical of so many of the patients I saw at my practice. Wealthy, successful, middle class, well-spoken. The stereotypical pinstripe-suited man who travelled into the city every day. When I’d first started working in the area, he was the type of man I must admit that I felt a bit intimidated by, as I thought they might not trust a young female doctor. But, to my surprise, I managed to win him and many other patients over. I think as much as anything else it was by showing them that I really cared about them. I’ve always believed that the root cause of many illnesses can be found in the emotional problems that lie bubbling underneath. The problem then became that many of my patients seemed to depend on me as a counsellor, more than as a doctor … Mr Collins was no exception.

‘What can I do for you, Brian?’ I asked, my voice gentle, warm, doing my best to set him at ease.

His eyes were downcast as he slumped into the chair opposite.

‘Is it really true you’re going?’ he said, his eyes filled with worry.

It was the first time I’d come face to face with the effect my departure was having, and it was unbearable. The tension in my little consultation room was palpable.

‘Yes, I’m afraid so.’

He fell completely silent for a moment, staring, intently, at one spot on the carpet before finally looking me in the eye. I could see the tears. It was heartbreaking to watch.

He tugged free a tissue from the box on my desk and dabbed the corners of his eyes.

His voice trembled. ‘But what will I do without you? You’re the only person who understands what I’m going through, and I find it so hard to open up to people.’

His fears were completely natural, and were shared by many people who might feel anxious about changing their doctor.

‘Will you be moving to a surgery nearby?’

I opened my mouth to speak, but nothing came out. I was going to tell him no, but the question had thrown me – all the way back into that pit of uncertainty. I swallowed hard and whispered. ‘I don’t think so.’

His eyes dropped again, crestfallen, and then he suddenly lurched onto his feet.

He shot out his hand, as I imagined he had done hundreds of times in his board meetings, disguising his distress with formality.

‘Well, I wish you all the best for the future, Doctor Brown.’

I felt a lump rise in my throat as I shook his hand.

‘You’ve been wonderful and I really appreciate everything you’ve done for me over the years,’ he carried on in his rigid, staccato voice. ‘And anyone who has you as their doctor next is blessed.’

I bit my lip – hanging on by a thread to stop myself breaking down in tears. Hiding behind my medicine, I told Mr Collins to continue with the same dose of antidepressants, and to review how he felt in three months.

I walked him to the door and we had a moment’s silence, both aware of each other’s grief. ‘Things will get better,’ I encouraged.

With that, he slipped out of the door and I broke down, the avalanche of the day’s emotions crashing in on me.

It was no good; a doctor’s life is a constant flow of difficult situations, of emotional patients, of pain and sadness and death. I needed to be stronger than that – I was stronger than that, always had been – but I just couldn’t see how I was going to get through the next few weeks.

My phone rang.

I wanted to leave it ringing, and I almost did, but I needed something – anything – to pull me out of the low mood I was descending into.

‘Is that Doctor Brown?’ asked a voice on the line.

‘Yes, who’s speaking?’

‘It’s Doctor Phil Burn here. I saw your story in Pulse .’

My stomach lurched.

‘I’m recruiting doctors to work in prisons in the South East of England.’

‘Sorry?’ I wasn’t sure I’d heard correctly.

‘I’m looking for a doctor to work in a prison,’ he repeated.

I was stunned by the thought. I had been so locked away in my village practice that alternative placements like he was suggesting hadn’t really occurred to me.

Dr Burn continued to explain the job. It was a part-time position at a youth prison for 15–18-year-olds, HMP Huntercombe in Oxfordshire, not too far from Henley-On-Thames. ‘Would you be interested?’ he asked.

The thought of prison conjured up images of fights, stabbing, hangings – the horror often portrayed in films. Could I really see myself working in that world?

On a deeper level, of course, I knew that my immediate mental image of prison life could hardly be accurate. And I needed to do something … Something new, something that would challenge me, something that would make all of this feel worthwhile. Something that might help people.

‘Yes!’ I said, actually shocking myself. I hadn’t given myself time to think deeply, I was relying on gut instinct, I had no idea what the salary was, I should have been asking so many more questions …

But how bad could 15–18-year-olds be? My boys, Rob and Charlie, were that age, so hopefully I would be able to relate to the inmates and perhaps they would view me as a mother figure and not a threat.

Had I really been that naïve? Yes. But I would learn.

He went on to explain that not many doctors wanted to work in prisons, as it was seen as an intimidating and unpleasant environment, dealing with difficult, unwilling, unpredictable and possibly violent people.

‘But’ – and he laughed as he said it – ‘anyone as outspoken as you should be able to handle a challenge!’

I couldn’t believe it, my candid words in the magazine had opened up a whole new world of possibilities. Dr Burn had recognised the fighting spirit in me.

Just because I was nearing fifty, why shouldn’t I try something new? It’s never too late to start over. Whether it be your career, your marriage, your lifestyle. That’s what I’d been telling my patients for years, and now it was time to embrace the unknown myself.

And maybe I could even make a difference to these boys’ lives.

*

Dear God, what have I done?

Back at home, I was questioning my decision. Had I been rash, accepting a job I knew practically nothing about?

I was sitting at the kitchen table doing some background reading into Huntercombe prison.

It was officially classified as a young offenders’ institution, having housed teenagers since 2000. It had originally been built as an internment camp during the Second World War and was turned into a prison in 1946.

Unlike adult prisons, which are categorised by letters, from A to D, depending on the seriousness of the crimes of the prisoners locked up, a young offenders’ institute has no grade. That didn’t reassure me though.

I’m not frightened easily, but I was filled with self-doubt as I read up about the crimes some of these teenagers had committed. It wasn’t just theft and burglary but also murder and rape.

I turned to David for advice.

‘Do you think I can do it?’ I asked

He was peeling the spuds for dinner and laughed. ‘Don’t be ridiculous, of course you can, you’re more than capable.’ He smiled. ‘You always are.’

I loved the fact that he was so supportive of both me and my career. God knows how many evenings he’d spent alone, looking after the boys while I’d worked very long days or been called out in the middle of the night. He understood my drive and my need to help others. He understood I had worked too hard for my career to give it up.