It is my first day as a Role-play actor. My job is to play a series of patients for medical examinations, specifically for doctors trained outside the UK who want to work in this country and who have English as a second language. We have been briefed and prepared. I sign in on the fourth floor of the General Medical Council (all gleaming chrome and spotless glass) collect a swipe card and locker key and am permitted to enter sound-proof room above the Euston Road, where 15 other actors are waiting; sipping coffee, doing the crossword, gossiping and shrieking recognition.
A lady in a suit is ticking off names and giving advice to two lads next to me. "You've done Coma before haven't you? What kind of pants do you wear?"
"Boxers and jock"
She nods, "Safe bet"
"It does hurt when they push around your abdomen you know"
"Yes, we have to agree on a level of pain that's acceptable", she scribbles a note.
She moves over to me. "Pretty straightforward this one."
"Yes, Eye Exam"
At this point a wiry-haired Professor in a linen suit and spotted bow tie calls us to our "stations". It's rather like early-morning speed-dating. The actors have their stations- purpose-built green and white rooms with three chairs for actor, examiner, and candidate. The students rotate around each of the 15 rooms, directed by a disembodied voice - and have 5 minutes to make an accurate diagnosis. They are also marked on their rapport with and sensitivity to the patient.
First sweating victim
So we begin. The candidates have to address and examine me, then diagnose a condition in a sinister looking mannequin head with illuminated amber eyes. Any jitters I have are dwarfed by those of the first trembling, sweating victim in front of me. And we’re off. The first few go steadily enough.. But it soon becomes repetitive. There are 48 five minute exams to get through a day. 42 to go.
"Good morning Ma'm, I am one of the doctors around this place, and how may I address you?"
A young man is standing three feet away, wringing his hands and shifting on his feet.
“Mara”
“Good morning, Miss Lara. I am here to look at your eyes, is that all right with you?”
“That's fine.”
“Thank you. Miss Lara, I may have to come very close to you. I may even have to touch your head. I would like to assure you that your privacy will be ensured at all times, and that there will be a chaperone present. This gentleman (indicating examiner) will be your chaperone today. Is that alright with you, Miss Lara?”
“Absolutely fine.”
“Ok. (turning to the examiner) Ideally I would now undress the patient.”
I start out of my chair. Did I hear him right?? Unsure, I glance at the examiner, who is waving the suggestion away with a smirk curling his lip, but he says nothing. Dry-mouthed and trembling, the candidate squints one eye, peers into the opthalometer and earnestly approaches my head. The effect is something like Inspector Cluedo, one huge magnified eye less than an inch from my own. My stomach contracts with laughter and I give the tiniest of snorts, muffled instantly with a cough.
"Sorry."
The candidate moves onto the glow-eyed dummy and makes his diagnosis. When the five minutes are up, he leaves the room. I gasp for air.
"Did he say what I thought he said? He wanted to undress me? For an eye exam?"
"He meant your headscarf"
"Oh, my headscarf....but I'm not wearing a headscarf!"
"You would be if you were in Sri Lanka"
There seems no comeback to this. Other than: I am not in Sri Lanka.
The next candidate misses the opthalometer and the point of the exam completely and conducts a sight test by waving his fingers around like semaphore. I desperately want to tell him that this is a waste of time but have to play along. Since my sight is near perfect and he hasn’t noticed the dummy he is left with nothing much to say.
"And I would like to comment on the colour of the eyes. Which are blue. Er, very nice....."
I start to enjoy myself.
Day Two: Self Harm
Today is Self Harm. I have gone into the bathroom after an argument with my boyfriend and used his razor on my arm. I am "subdued and withdrawn". Not difficult on a Monday morning.
The candidates have to assess the likelihood of my going home and doing away with myself, and decide whether to keep me in. The examiner wraps white bandages round my arm. This is more like Acting. I choose a lowered gaze and doleful expression.
Many of the candidates are sympathetic and tactful enough, but the pressure of time means that most are reluctant to go the long way round by getting me to talk, preferring instead to push me over the edge by forcing a consideration of the big questions in life.
"Tell me Janet, are you planning to commit suicide again?"
"Do you ever think about, well, just finishing yourself off?"
"Do you think that you are perhaps silly for doing this? Do you feel guilty? Do you feel that what you did was wrong?"(Lack of remorse would certainly be a clue, but I could do without the burden of sin.)
"When you look into your future, madam, what do you see?"
"Do you have a gun in your house? Does your boyfriend have a gun?"
And so forth, 16 times over and I'm feeling quite melancholy. 32 times later and the examiner and I have run out of jokes and conversation between tests. By the afternoon we are staring gloomily at our feet.
Day Three:Scalded Buttocks.
Today I am Alice Hussein, an exhausted and defensive mother who has brought in a child with a burnt bottom from a too-hot bath. He also has a bruise on one arm. The brief suggests inability to cope rather than deliberate abuse, so I play it as such. From the start, the vast majority of the doctors are totally uninterested in my emotional state. It surprises me how few of them seem to pick up the significance of the clues I do give them. A few directed questions would reveal that the mother needs support. Instead they run through the usual checklist of “personal questions”: bowels, diabetes, appetite, birth, milestones, inoculations… What surprises me even more is how many of them decide to risk the direct approach – some even from the first question.
"There is a bruise on the left arm - can you explain how that got there.". Which I do. I am then informed that they will be taking the child in.
“Why?”
“We need to run a few investigations with Social Services into the bruise on your child's arm. Nothing to worry about.”
“What? I've told you what happened!”
Yes but we need to consult with my seniors on this and do some further checks, for you know, fractures.”
“Are you saying I did that deliberately?”
“I am not saying anything madam, please sit back, relax, would you like a tissue or a glass of water?”
“No I want to take my son home!”
The examiner remarks wryly that he has dodged punches for far less.
What knocked me for six was an incredibly kind and sympathetic African doctor, one of only a few who listened and who got me to admit that sometimes I did feel like throwing my child out the window, expressed sympathy with the rigors of first-time motherhood, suggested support, told me that I had done the right thing in bringing him in, and almost had me in tears with his empathy.
At the 30 second bell he turned round to the examiner and said "Definite case of abuse"
I wanted to yelp with indignation!
And there are also the eccentrics. Not to say the plain drugged. About half-way through "Scalded Buttocks", a young African man wanders in. He introduces himself to the doctor and sits down. "Proceed".
Silence.
His soft black eyes travel slowly over me. 25 seconds, perhaps more, pass.
I shrink back in my chair.
Finally he meets my gaze. His eyes cross slightly. He seems at a loss for words.
"So you are Mrs Alice Hussein."
"Yes."
Silence.
"Why are you here?"
"Have you read your notes? I brought my son in with scalded buttocks"
"I see."
Silence. I feel the examiner stiffen.
I can't bear it any more. He'll fail anyway. I bend the rules.
"so would you like me to tell you how it happened?"
An almost imperceptible nod. I give him a brief run-down of events.
Silence.
"You are stressed?"
"A little, I suppose so."
"But why? You do not work."
Fortunately for him he has only 10 seconds remaining to receive the wrath of an exhausted mother.He leaves the room. The examiner and I stare at each other, aghast. And so the week concludes.