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Help in a crisis
Camilo: Consultant Psychiatrist

Camilo Zapata_550px.jpg
What does a usual day look like for you?

On a usual clinical day, I will either start clinic straight away or, depending on the day, I might attend a team meeting to discuss patients that we are most concerned about and might need prioritising for that day. These are usually patients that are out in the community, but we might also discuss our patients that are located in inpatient areas as well.

I will usually run two clinics a day: one in the morning and one in the afternoon. These are held in various locations such as Thetford, Newmarket, or Bury St Edmunds. I also hold two clinics within GP surgeries, and patients love those because some patients don’t like to attend clinics at places known to be mental health hospitals, and the GP surgeries are a more neutral location.

What made you want to work for the Trust?
I did my SHO core training in Oxford and my higher training in areas all around London such as Islington, Hackney, Camden, and Edmonton. I saw that in London it was pretty dynamic and kinetic: there was lots of firefighting and lots of quite ill people – mostly young men – with complicated presentations with hard drugs and associations with criminality and gangs. I thought it might be nice to work in a more rural setting, and I thought it would be less stressful in a less urban setting.

However, there are parts of Suffolk which are very much like those inner-city environments in terms of morbidity and mortality and other complications, but overall I think the pace of work here is much more sedate than it would be from what I remember in my training. I have a few friends who still work in London and they say the pace is frenetic. It was also difficult to find a full-time position in London, and you can’t really afford to live in London unless you’re working full-time!

What parts of your job do you find the most rewarding?
I really enjoy seeing patients as part of my job, and some cases can really be quite complex and challenging. This is where I enjoy having the opportunity to discuss patients with the other members of my team. We have a very good team and we get on very well. We’ve lost a few people recently who have either moved into other jobs or gone on maternity leave, but we’ve had new team members come in on secondment from other teams to replace them.

Although the team has changed a bit recently, we’re still an easy-going team and we like to have a laugh together sometimes. And I think as a team I think you need to do that in order to deal with some of the quite heavy things that we have to manage with our patients, so it helps to have an easy-going team. We’re pretty cohesive as a team, and we do see each other socially from time to time as well. We also try to have some opportunities at work to improve the team morale, such as days when we will all bring food in and have lunch together, or a barbeque in the summer.

Our team is pretty varied and is made up of psychologists, social workers, psychiatric nurses, and some very experience support workers. That makes for a good team and we all pitch in with our ideas. We’re very lateral: we don’t have a hierarchy of one or two more senior people at the top talking down to people. We’re all on the same level, which is how it has to be I think.

What’s the most challenging part of your role?
I think the most challenging part can be when I’m presented with someone who doesn’t have a mental illness but in fact has a very complex personality disorder, and who would very much like to have a mental illness to be treated. They might have been medicated with drugs that aren’t really helping them for various reasons, but nevertheless these patients feel that they do need medication. It can be quite easy for someone with a personality disorder to be diagnosed as having bipolar disorder or schizophrenia, and after that they can be in the system for years and years receiving medication that doesn’t quite make them better.

When someone has become so used to the idea of being given medication for their condition that can sometimes get in the way when one tries to recommend other psychological or social treatments which would work better for someone with severe personality disorder.

What’s it like living in East Anglia?
I like it a lot. When I first started in the Trust I worked here in Suffolk whilst still living in London, but since I’ve moved I’ve found it brilliant living here in East Anglia. The roads are much clearer than they are within the M25 or the satellite cities of London, and the crime rate is much lower. If you want to get to big cities then they’re usually only a short train ride away: Cambridge and Norwich are very accessible, and London is only an hour away.

It’s seen as a bit out of the way, and there are parts of East Anglia that are more remote than others, but there is lots of lovely countryside and lots of wildlife and birdlife if you like that sort of thing. I’ve seen storks and herons and geese everywhere. I had a deer and a couple of pheasants in my garden the other day – not at the same time! I’ve also got six swallows nesting around my house: two in the garden; two in the garage; and two in the front porch. Before I came here I hadn’t really seen much wildlife – you see more foxes in London than anything else.

The other thing is that compared to London the property prices here are very reasonable. What you might pay in Islington for a one bedroom flat, you could easily get a five-bedroom house in Suffolk or Norfolk. And there are beautiful places to visit: you can get to the beach very easily; you can see seals and other wildlife. And if you’re into more gastronomic things, there are some very nice restaurants in Blakeney near where you can see the seals, as well as beautiful restaurants in places like Bury St Edmunds or Ely. If you’re into very intense nightlife then there are parts of Norfolk and Suffolk that might not necessarily be for you, but if you like boating or sailing and you like nature then this is the place to be.

What advice have you got for people who might be thinking of joining us as a consultant psychiatrist?
I would say definitely consider coming to East Anglia. I work in Suffolk so I can speak more for Suffolk rather than Norfolk as I’m not as familiar with Norfolk, although I do hear it's very beautiful. I would say to people looking for consultant posts and looking for training posts in particular, do consider coming to East Anglia. We have excellent links with two universities: the University of East Anglia in Norwich and the University of Cambridge.

Academically it’s a great place to come if you have an academic slant. There’s lots of clinical presentations - many of which you would see in an urban setting – so you’re going to get plenty of experience here as a trainee. There are vacancies and opportunities opening up all the time. You can do academic fellowships if you so wish.

If you want a place where you can become more and more senior, have children, start a family, and embark on a rewarding, professional, academic, and clinical career, then this is the place to be. The best thing I ever did was to get out of London and come and work and live in East Anglia.