‘What happens when the GP becomes the patient – and then writes a play about it?’

After becoming a patient herself, former GP and Pulse writer Farine Clarke reflects on the stark divide between the roles, and why she has written a play to explore it

As much as we would all like to deny it, there is an inevitability that most doctors will become patients one day. If we’re lucky, it’s towards the end of a life well-lived. But for others, it comes much sooner. For me, there was something disconcerting about this role reversal.

I had a condition since childhood that made me familiar with hospitals long before medical school. But there was always a distance that allowed me to embrace life and career with vigour. I saw myself as a doctor, just like my colleagues; no outward sign set me apart.

It was only when I became severely ill decades later and had a renal transplant with subsequent immunosuppression – followed by a couple of painful years with morphine as my closest friend – that I found myself in a new and surreal situation.

Sometimes the best way to make sense of a collision of perspectives is to share it with others who can imagine, if not inhabit, the new place with you. I’ve shared some of this experience through a play: Heartsink.

The lead character in Heartsink is a GP who gets diagnosed with cancer. Dr Jeffrey Longford’s world is turned on its head as he makes the transformation from self-assured medical professional to vulnerable patient. He remarks at one point: ‘After years in practice seeing through a doctors’ eyes I find myself on a crash-course as the patient. The view isn’t quite so attractive from this side, you’d be surprised to know.’

As his ‘Dr’ title becomes less defining and his condition more consuming, labels begin to matter – ‘asthmatic’, ‘diabetic’, ‘cancer patient’ – as do the small indignities, from reduced eye contact to the intrusion of computers into consultations.

I believe it’s vital to describe this juxtaposition of two worlds of doctor and patient – with their intricately shared aim but widely different experience -with balanced honesty. I know how empowering it is to walk along a ward donning a white coat and stethoscope, but have learnt how disarming it feels to lie in a hospital bed wearing a NHS gown and paper knickers.

To say my career path from GP to writer was not straightforward would be an understatement. I qualified from St George’s in the 1980s and then as a GP after through the St Helier Hospital VTS scheme. So far, so on-track. My problem however, was that I’ve always been passionate about writing.

With no professional experience, medical magazines were my ticket of entry to writing and Pulse was the obvious choice. And so, armed with the insolence of youth (no, not innocence) I hounded then-editor Howard Griffiths, begging for a place on his team. Eventually he succumbed –  I suspect out of exhaustion – and hired me as a freelancer. As the writers were very experienced journalists, not doctors, it was my job was to check the medical copy for accuracy and tone, in exchange for learning magazine craft.

At Pulse, I was taught how to structure stories and features, write headlines, standfirsts and leaders, skills that remain central to my work today. Producing plays similarly requires collaboration across multiple disciplines – before even factoring in cast and script.

After freelancing for a year, I was given a permanent contract at Pulse. Over time, I moved from reporting into senior leadership roles. But, like many medics who find themselves in management roles, I’d stopped doing what I enjoyed most. Instead of penning stories, I was producing board reports.

Illness is not always solely negative. My transplant reminded me that time is limited. To resume writing, I needed to stop procrastinating. In 2021, I launched a production company to produce the plays I had long been postponing.

The medical certainties which come with being a doctor are vital to being able to do the job. Medics are also used to the public making clear assertions without an abundance of evidence, or presenting single issue, biased opinions as fact. To argue often seems pointless – but in theatre, you can respond.

For example, when it comes to the assisted dying bill, Dr Longford toys with Dignitas in a way he would never have considered in the past, when solely in the role of a doctor. At a personal level I had a friend who went to Dignitas; I struggled with her decision, yet I also understand clinicians’ concerns about a slippery slope. The play does not tell audiences what to think. Instead, it explores the complexity of medical ethics and invites reflection on the unintended consequences of seemingly simple choices.

Theatre is not for the faint-hearted, I’m already well acquainted with the parapet but staging plays is like raising your head to its highest point and then inviting people to whom you’ve already sent a gun, to take their best shot. Having said that, just like working in a GP surgery, the joy is in the team – of which Heartsink has a fantastic one with cast and crew familiar with the West End, the National Theatre, BAFTA nominations and Derry Girls.

Back when I was at medical school I believed my life had a pre-determined order. Today when I’m asked to talk at my old all-girls school, the inevitable question – ‘Are you pleased you did medicine first or would you rather have started as a writer?’ – fills me with dread. I now know there is no right answer.

Heartsink is not solely my story but a comedy about intertwining lives. Only now, have I felt able to draw on experiences from medicine, with sufficient distance. I liken it to soldiers who either can’t talk about being in a war for decades or silently take their memories to the grave. Only with time comes the ability to reflect.

Sharing medical insight is a weighty responsibility with an accompanying duty of care and risk. It can also bridge gaps in society’s understanding of the medical world and be life-enhancing. For me, it is a risk worth taking.

Of huge importance to me is that GPs and colleagues who attended the preview enjoyed it – after all, when do doctors hold back on criticism? They described seeing their daily reality reflected back at them – consultations, tensions, ethical grey areas – captured with an accuracy that was at times uncomfortable.

For Dr Longford, life on the other side of the stethoscope throws much of what he held true into sharp relief. Heartsink is not a criticism of medics, but instead uses humour to highlight issues which frustrate those working in, as well as experiencing, the NHS as a system.

Heartsink is on at Riverside Studios, Hammersmith from 21 April – 10 May. Pulse readers qualify for a £10 reduction on band A tickets with the code ‘PULSE’.

Farine Clarke is a former GP and writer for Pulse. She is also an award-winning playwright, producer and founder of Unequal Productions Ltd.