“There is this quote they throw about in nursing,” says Molly Case, “which is wonderful if slightly overused: ‘They might forget your name, but they’ll never forget what you did for them’.”
Cliché or no, when Case had major gastrointestinal surgery at the age of 16, she was never likely to forget the name of the nurse, Star, who held her gaze and her frightened hand until she sank under general anaesthesia.
Almost a decade later, Case found herself doing a placement with Star during her own nursing training. “It was such a lovely coincidence,” she says. That “incredible” care she’d had as a teenager planted a seed that germinated during her English literature and creative writing degree – when she took a carer job in a dementia home – and finally blossomed with her joining the wards herself.
Still, nursing seems an unlikely career move for an arts graduate. “I wonder if having a slightly poetic notion, you’re drawn to people, you’re drawn to people’s stories,” she muses. These boom days for medical memoirs (Adam Kay’s This is Going to Hurt: Secret Diaries of a Junior Doctor is now in its 19th consecutive month in the bestseller list) certainly suggest many of those who wield the knife or needle are just as adept with the pen.
Until recently, the genre has been dominated by buccaneering male surgeons, but now the voices of skilled nurses, once perceived as the handmaidens of hospitals, are beginning to be heard. Last year came Christie Watson’s luminous The Language of Kindness: A Nurse’s Story; Leah Hazard’s hotly anticipated Hard Pushed: A Midwife’s Story is out at the end of the month, and this Thursday sees the publication of Case’s remarkable, lyrical account of life as a cardiac nurse, How To Treat People: A Nurse at Work.
It is an ode both to her profession (“a science, an art and a vocation”) and to her dad, the veteran music journalist, Brian Case, 81 – the first to go on tour with The Sex Pistols – whose stroke sends him into her own cardiothoracic ward at King’s College Hospital for open-heart surgery. The tandem stories of Case as nurse and daughter exert the pull of a novel through pages threaded with philosophy and history, ethics and etymology.
Now a clinical nurse specialist for inherited cardiac conditions at St George’s Hospital in Tooting, south London, the 30 year-old’s calming, empathetic presence is the one you’d wish to find by your bedside.
Doctors may perform miraculous feats for their patients, but it is to nurses that the minute-by-minute ministrations of keeping them alive (or at least, comfortable) fall. Case carefully details these essential intimacies: the washing, the shaving, the soothing, the shrouding.
It is nurses, too, who bear the brunt of patients’ pain and confusion through the small hours, which can manifest in verbal and even physical abuse – one woman accuses Case of soliciting her children on the internet, another of being a prostitute procured by her husband. It takes six of them to stop a little old man throwing himself out of the window, convinced they are Russian spies, thanks to the super-human strength that comes in the grip of post-anaesthetic delirium.
“The smallest, sparrow-sized Deptford old ladies on the intensive care unit, that weigh maybe six stone, are now King Kong,” Case says. “It’s funny to talk about but at the time it’s so distressing for them, it’s distressing for the nurses.”
There are other moments only comic, in retrospect. “The penis story?” she asks, of the instance she had to call the vascular registrar to help her unscrew a 70 year-old gentleman’s genital piercing in the middle of the night, so his bypass surgery wouldn’t be cancelled come morning. “There are so many laughs to be had as a nurse but we never, ever, ever, ever laugh at patients,” she clarifies. “It’s always our own reactions to the circumstances we find ourselves in.”
Case first came to public attention at 24, when her performance of the poem she penned in defence of her profession, Nursing the Nation, brought the 5,000-strong Royal College of Nursing’s annual congress to its feet. It was 2013, the end of her first year as a student nurse and just after the report into the ‘Mid Staffs’ hospital scandal, now a byword for NHS care at its most negligent, which saw morale among her cohort sink to an all time low.
The media narrative ran that “nurses are too busy and too cruel to even pass a glass of water to an elderly person,” she says. “And it was so profoundly wrong. My nurse colleagues were the sweetest, most caring, hard working, funny empathetic people I’d met.” Her words swiftly went viral, garnering over 350,000 views on YouTube in a matter of months.
Having always thought she had to put aside her writing to get better at the elements of nursing that didn’t come so naturally – the clinical theory, the calculations – she realised that she could marry the two. Her first collection of poetry, was published in 2015 and she was appointed the RCN’s first writer in residence.
Poetry runs through every page of her prose: the checking for last breaths that can “become so slow, the only way of catching them is to come in cheek-close and wait for the feel of them.” The night shift before a meteor shower, where a woman who had suffered a heart attack-induced brain injury – leaving it “a constellation of molecular black-outs, burnt out stars and vaccum-like space” – hallucinates the three babies she had lost, “waiting for her beneath the hospital’s celestial collonades.”
Six years since her moment on stage, she believes public perception has changed for the better, again. ”We are still the nation’s most trusted profession, as we should be,” she says. Yet they have cause to consider themselves one of the most undervalued: pay is low, the scrapping of the nursing bursary in 2016 has seen applications fall by 13,000, while there are 40,000 nursing vacancies in England alone.
“I wouldn’t have become a nurse if there hadn’t been a bursary,” says Case, simply. “And I think it would have been a travesty – tooting my own horn, here – if I hadn’t become a nurse.”
She speaks honestly of shifts stretched skin-thin by staffing shortages. “Flying by the seat of your pants is not the word,” she says. “You look at each other and you think, never again.”
Case kept count: “an old-fashioned tally of shifts that made me want to stop nursing. When patient safety is compromised and you can’t do the job that you’re meant to be doing; or you’ve been snappy with a patient, which you can be because you are rushed off your feet, you haven’t eaten in 10 hours, you haven’t been to the toilet. You can feel your heart going and you’re frightened.” The tally reached seven before she was moved to intensive care, which was “so overwhelming, I didn’t have time to tally anything.”
Yet she would never give it up. Her book ends in the febrile summer of 2016, when knife-wielding terrorists stalked London Bridge and the city’s hospitals worked through the night and passed the baton of care for the dying and the wounded through the days beyond. “Even in awful times, we have to believe that people are, at their heart, good and want to do good,” says Case. “I think the NHS is a real expression of that.”
How to Treat People: A Nurse at Work by Molly Case is published by Penguin Books, £14.99. Buy now for £12.99 at books.telegraph.co.uk or call 0844 871 1514