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Updated: Jan 19, 2019

The beginning of the new year is usually a treat for me. It's a chance for a new start with new hope and a fresh perspective. But this year more than usually I could hardly contain my excitement. Why? #Luther WAS BACK! If you didn't catch the fifth series of Luther on #BBC1 in all of its glory, which premiered on New Year's Day, you missed a treat. I highly recommend that you make a date with #bbciplayer to catch up. It will be well worth it. This blog post contains spoilers. So, if you haven't watched it yet and you want to remain in suspense until you do, I suggest you turn away now.

As a health and social care specialist, I took great interest in the fact that both of the murderous villains in this series were healthcare professionals. One was a psychiatrist, Dr Vivien Lake (Hermione Norris) and her husband, Mr Jeremy Lake (Enzo Cilenti), equally perverse if not more so, was a heart surgeon. After the first episode, it is confirmed that they work in cahoots to commit deadly crimes together. It becomes clear as we continue to watch that after their seedy deeds at night, they resume their day jobs with as much normalcy as possible. Except, after one exceeds a certain level of perversity, it isn't that easy to return to normal, which we are about to see.


So, Mr Lake goes to work and later steps into a room to see a patient. He has a quick consultation with her while he prepares her for surgery. As he calmly explains the procedure he's about to do on her heart, he gently calls her a 'diseased whore' and says he's going to kill her. Right... so... when I heard that, my mouth fell open and I rewound the Sky+ Box, only to hear for certain that, yes, that's what he just said. Given that this was just an episode of 'Luther', and not real life, I allowed myself the freedom to burst into laughter. What killed me was the patient's facial expression. Instead of shrieking in horror, she sits quietly with only a slightly quizzical brow, wondering to herself if she just heard right. I mean, really! Yes, he just called you a diseased whore and threatened to murder you. Even if she wasn't sure, couldn't she at least have queried, 'Excuse me, can you repeat that?' But no. She just sits there. About to let this crazy guy carve into her chest.

Later, as he is about to put her under general anaesthetic, it seems she's had a think about things and realised that she has reason to worry. She suddenly finds a voice and expresses her misgivings about having surgery. Except, if a surgeon is crazy enough to call his patient a whore to her face and advise her of his intention to take her life, he's hardly likely to honour her wishes right when he's about to wheel her in for surgery. So, he ploughs straight ahead as expected, completely ignoring her concerns and rendering her unconscious, while all we can do at home is hope that he isn't nuts enough to murder his patient in front of his colleagues.


While I actually found those scenes quite hilarious, they made me think about the relationship between patients and healthcare professionals. As exaggerated as those scenes were, they weren't that far of in reflecting just how much faith most people place in those they entrust with their health. Everyone who goes to a health professional is vulnerable to some degree because you generally don't go to see one unless something is wrong. And if something is wrong, you're concerned, you're seeking help and you're deferring to someone for this help whose expertise in the matter exceeds yours. For these reasons, the healthcare professional is almost always in a position of power. When a patient has concerns about their treatment, they often find it difficult to assert themselves. Because of what I do for a living, there is no way anyone could call me a diseased whore and I just sit there. I'd say a few choice words and be out the door. However, although it was a TV show, my guess is that many more people than expected would react in the same way as that fictional patient did. And that's because when you need healthcare, especially if it something as serious and urgent as a heart procedure, it's very difficult to take a stand against a professional with so much power over your life.

This is why #selfadvocacy is so very important and why it is necessary to cultivate this skill even before you need to use it. We must take our own views and concerns seriously during our healthcare experiences. This attitude must be developed. Here are three tips to help you do just that.

SELF-ADVOCACY is... The ability to voice your concerns and/or assert your rights

SELF-ADVOCACY TIP 1 - Your healthcare professionals are people FIRST. We go to see professionals because they have years of academic and practical experience in their field. But it is also true that they are only people. Don't put them so high on a pedestal that you believe they can't make mistakes or that everything they do is always right. Speak to them as equals and use your voice. Ask questions and raise concerns. Do your own research about your condition and treatment plans available. Discuss what you've learned at your consultations and be determined to arrive at decisions that you are comfortable with. Unlike the patient on Luther, don't be afraid to say, 'STOP!' immediately for fear of who they are. View your healthcare professional as someone with as equal importance as you. If you don't view them as normal people, this will be difficult to do.

SELF-ADVOCACY TIP 2 - While the professional is the expert of their field, YOU ARE THE EXPERT OF YOU. This is ESSENTIAL. Their advice must be taken seriously and there could be grave consequences if you choose not to do this without good reason. However, sometimes there IS good reason not to take their advice. And there are times that you know this because of your instincts. So, trust your instincts. If you feel something warrants more investigation than has been conducted, tell your specialist this or seek a second opinion. If you have symptoms that you feel aren't being taken seriously, speak up. Your health is ultimately your responsibility so consultations should be a collaborative effort. You know yourself better than anyone else does. Healthcare professionals are experts in their field and this must be respected. But you are an expert in the subject of YOU.

SELF-ADVOCACY TIP 3 - Learn to make formal complaints. Healthcare professionals will not know how to improve their practice unless they are aware of how they are failing. There is no point mumbling to yourself about a grievance. Put it in writing and let someone appropriate know about it. This is not always easy to do when you're unwell. But you are unlikely to have an impact on healthcare practice unless your matter is addressed formally. Most importantly, taking this action will increase your confidence in asserting yourself. As a patient, you deserve to be treated with respect and to be listened to. When you decide that you are worth complaining about, you are reinforcing your own value, and therefore demanding that others value you, too. Don't be afraid to take action.

Please like and share this blog, and tell us your self-advocacy stories in the comments section!


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