Doctor with a difference

January 3, 2011

Earlier this year Joanna Moorhead visited the Dr Hickey Surgery here at the Centre. Her article in Faith Today is reprinted here in full: Doctor Mary Hickey runs a busy general practice in central London - but, she tells Joanna Moorhead, she can only do the demanding work she does because she has another vocation" as a nun. It’s a normal NHS clinic in central London, complete with receptionist behind a counter, rows of soft chairs for waiting patients, magazines on coffee tables and posters about vaccinations and health screening on the walls. But what's different about this clinic is that, when the receptionist says the doctor will see you now , the person into whose consulting-room you head will be a nun" or, perhaps, a priest.

In Africa and Asia, it's not unusual to come across practising doctors who are also members of Roman Catholic religious orders: but here in Westminster, a stone's throw from Parliament, it's not what you'd expect. But then again, the clinic itself isn't run-of-the-mill either. Situated in the basement of the Cardinal Hume Centre, from which it rents its space, the practice caters for people who are homeless, or living in precarious accommodation: which, says Sister Doctor Mary Hickey, is the reason why she's doing the work she is. I've worked in Africa, and I could be working now in some country in the developing world, she says. But the needs are just as great here. Sometimes, the people who need you most are on your own doorstep: did you know, for example, that the average age of death of a homeless person in London is just 42, or that an intravenous drug user will be likely to die before his or her mid-thirties?

If that was the national average, we would be one of the poorest countries in the world. Sister Mary" a member of the congregation of the Daughters of Mary and Joseph - opened her clinic in 1987, the year after Cardinal Hume set up the centre. They gave me a corner of the family room, she says. Right from the start we were busy" it's always been busy, and it's busier than ever now. Back when we opened around a quarter of our patients were children, most of them the offspring of Irish travellers. There were lots of travellers living in B&Bs in the area back then" and they all had the same surname, which led to endless complications! Over the years the patient-profile has changed frequently, and often dramatically.

It all depends on what's happening in the wider world, and what communities are in temporary accommodation in this area of London, explains Sister Mary. At one stage we had lots of Africans, and I became a bit of an expert in tropical diseases. Then there was a stage when most of the patients were Bangladeshis; and at another point, they were mostly Kosovo. At the moment, the bulk of patients registered at the clinic are alcoholics and drug addicts who either live rough, or stay at hostels and B&Bs in the area. They’re a very challenged group of people, with deeply complicated problems"

I don't have many quick consultations, and people who come to see me often have very serious conditions, she says. At this morning's clinic, for example, there were at least 25 patients: Sister Mary's partner in the practice, Jesuit priest and doctor Fr Paul O'Reilly, saw the general patients, while she concentrated on the drug addicts. Today there were nine of them: three were new, and three were women, she says. That was a fairly typical clinic.

One of the women is HIV-positive, but she isn't taking her medication and she's getting very unwell: her knees are very swollen and she has back pain. Treating patients like this, she explains, is highly specialised work: You can't just give someone like her any painkillers, because you don't want her to become addicted to something else. Another of her patients today had TB, with a fungal infection on his lungs.

I had to send him to hospital for tests, says Sister Mary. It was a very interesting clinic" it always is. There aren't many of what you might the worried well’. We’re chatting at the end of a surgery: her consulting room is like a thousand consulting-rooms across the country, with a desk and computer screen, an examination bed, weighing scales and charts on the walls.

In here Sister Mary is every inch the knowledgeable, but also down-to-earth, common-sense General Practitioner: what one suspects the patients here are most grateful for, apart from the fact that they're cared-for and valued, is that they're treated exactly the same as any other patient in the NHS. The truth is that it's difficult for homeless people to just walk into a doctor's surgery, says Sister Mary.

Most GPs have waiting-rooms full of parents and small children, and you wouldn't want some of the sorts of people we have here turning up in the middle of them. But here we make them welcome: we give them chocolates and cups of tea while they're waiting. We give them all the help we can. Often, she confesses, that extends way beyond her remit as a doctor. Sometimes there are people who need clothes, or there's a pregnant woman who needs a buggy, and I get money donated which I can use to help. So, after the surgery, I take them shopping"

I can't just give them the money, or I wouldn't be sure they'd actually buy the thing it's intended for, so I got with them to help them choose. Pregnant women, she says, are often the hardest cases to deal with. You get very young women who are drug users and who have got pregnant. Sometimes they're from another country, they have no family here, they have no idea how they'll cope. One thing Sister Mary and Fr Paul can't do is refer women for terminations. But we tell people that we will look after them whatever decision they make, and I advise people to talk to Life, says Sister Mary. As well as the doctors, the clinic has counsellors and a mental health nurse.

It's open, as a walk-in facility, all week, and on especially busy days the patients queue before the door is even unlocked. One thing you're sure of when you work here is that you're fulfilling a need, says Sister Mary. She's a Geordie originally: she grew up at the heart of a Catholic family with several aunts who were nuns. Her own ambition, though, was to be a doctor" and, she says, a mother of four. But God had other plans. After I'd qualified as a doctor, when I was in my twenties, I went out to work as a gynaecologist in Zambia. I thought that would be it, that I'd have done my bit for God then: but He hadn't finished with me, and I realised I was being called to the religious life. A friend who was a priest put her in touch with the Daughters of Mary and Joseph, an order founded by a Belgian priest in the 1800s.

The spirit of the order suited her: it was all about moving with the times, she says, and doing work that seemed relevant to the age in which one found oneself. Today she lives in a house in Southwark with several other sisters, most of whom are retired or working in parishes. But work, she admits, takes up almost all her week. I honestly don't think it would be possible to do this job if I wasn't a nun. It's enormously time-consuming: I come in at 9am,and I often don't leave until around 9pm. As well as the clinics, I try to visit my patients when they're in hospital: one of the things about the homeless is that they don't have the families and support that other people do, so we try to make up for that. Does she, I ask, ever manage to switch off?

After dealing with such difficult, heart-rending problems all daylong, how does she get away from it when she's back home? Oh, I never take problems home, she says. My attitude is that I do the best I can do, every day. At the end of the day, I've given what I can" and I go back to be part of my community, and to fulfil my other role as a religious sister. Will she ever retire? I doubt it! I think I'll be working until I drop, she laughs. And it's certainly not the time to go just at the moment: the needs here in London, for homeless people, are as great as I've ever known them. While my patients need me, I'll be here.