This week’s writer is a specialist social worker in a palliative care team

I phone Daniella, one of my clients, to see how she is. She is one
of the many foreign nurses who keep the NHS afloat, and following a
recent cancer diagnosis, had surgery that left her with a
colostomy. She had feared her fianc‚ back home would find it
repulsive and call their wedding off. Daniella is bubbly on the
phone and said the wedding was fine. Her fianc‚ was very
understanding and the wedding day was perfect. “I am so happy” she
says. She doesn’t need to see me again and I come off the phone
uplifted. It’s great to have good news for a change. The next call
tells me a client has died. Despite more than a year’s involvement,
I and other professionals never succeeded in persuading the single
mum to consult her teenage daughter about whom she will live with
after her death. I reflect that the principle of patient autonomy,
so beloved of health care professionals, is all very well but what
about the social workers’ mantra of “the best interests of the

A colleague and I are delivering a teaching session to 21 health
carers. I start with an icebreaker that involves writing something
down and am astounded to be asked if I can lend them a pen and some
paper. What did they think they were going to do for the next four
hours? Am tempted to abandon the session but soldier on.

The weekly team meeting – the highlight of our lives. Despite
everyone promising total commitment to it, yet again we do not
start on time. The vexed question of an out of hours service
dominates the agenda. The debate takes up almost the entire
meeting, but unsurprisingly no decisions are made as the team
leader is absent. I suspect we will have a rerun of the whole
affair the next week.

My day off and I spend a contented morning in the garden.
Unfortunately my mind keeps straying to the three children whose
mother is ill again with breast cancer. The mum wants me to see
each child individually as she thinks “it would do them good to
talk”. I’m not sure they want to talk, and if they do, whether it’s
me they want. I remind myself I am a professional who doesn’t take
her work home and focus my thoughts firmly on the compost heap.

Visit my old boss who is in hospital with pneumonia. He tells me
since I last saw him tests have revealed widespread cancer for
which there is no treatment. He talks of death, faith and family.
As always in his presence I sit and learn. On the drive home I weep

  In church the preacher
asks God to bless all those who serve the community: nurses,
doctors, teachers, firemen and the police. “What about the social
workers?” I mutter to my partner. Never mind. I’ll be in the pulpit
myself in a few weeks’ time so at least we’ll get a mention

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