Dr Nick Edwards is an Accident and Emergency (A&E) doctor working in the UK and a passionate believer in the NHS. However the reforms, political correctness and the Anglo-Saxon culture of binge drinking and fighting and the resulting A&E visits are a strain on his sanity. So to keep up his morale, he began writing down his feelings - a form of literary cathartic therapy - the results of which make up this book. In Stitches (download the free e-book or buy the book) is his first book.

Mark Thwaite: What first made you want to write about your experiences in A&E?

Nick Edwards: The book wasn't really planned or inspired and to this day I still really don’t know how I ended up as an author.

One of my ways of coping with the stresses of working in A&E is ranting. I have spent years perfecting the art - I do it in a deliberate over the top and sarcastic way, and now would classify it as a hobby. But one of my wife's favourite hobbies is moaning about me ranting.

So, to protect my marriage, I started a blog - as a form of literary catharsis and a way of expressing my frustrations with work without annoying her. It quickly became popular, but the blog only lasted a couple of weeks before my wife made a comment on the blog, reminding me that she was eight months pregnant and that I had to get off the computer otherwise I would loose my testicles!

I closed the blog – saying the powers from above have forced me to close. Readers thought it was NHS management who closed me down and probably in sympathy, within 24 hours, I had two book contract offers and an interested scriptwriter wanting to turn the blog into a TV series.

And so I decided to face my wife’s wrath and write a book in the same blog style – to try and show people what it is like working on the front line of the NHS. As I wrote, I realised that it relieved some of my stresses. But it also made me realise that I have a fascinating, challenging and privileged jobs and that I am lucky to do what I do. I also realised that I should stop moaning so much.

But as interest in the book grew, I realised that it could take on a political dimension – show the reader what is actually happening to the NHS. The NHS is a fantastic institution and has benefited from all the extra resources. But the way it is managed and the way targets distort priorities is demoralising the workforce. Worse still political decisions pervade down to and affect patient care. The NHS Support Federation read the book and realised that it agreed with everything they had been campaigning for and have been a fantastic support.

MT: What was the most disturbing thing you've seen as an A&E doctor?

NE: There are three levels I can answer this on; the most disturbing emergency, the most disturbing patient and the disturbing effect of management interference with clinical priorities.

There are so many disturbing cases but one sticks in my mind. My baby had just been born and so I was probably being very sensitive at the time. A baby had been brought in after a cot death - we tried to resuscitate the baby but failed. I was in charge of the resuscitation and had to tell mum we were going to stop as her baby had died. She seemed distraught but quite with it. We "demedicalised" the dead bay – removed the intravenous lines and the tube in his neck and wrapped him up and gave him to mum. She kissed and cuddled him and I soon realised that she had not taken it in. "We will go to the zoo tomorrow, sorry I wasted our fun today by coming here instead. You love the sheep... We can feed them tomorrow." I wanted to cry and have a coffee, but instead had a whole queue of patients waiting to see me.

The most disturbing patient was a young man who was brought in to us by the police as he had suddenly become unconscious. He wasn’t really unconscious just an episode of AAS – arrest avoidance syndrome.

In the resuscitation area that he came into was an 80 year old man who was with his wife of 61 years. She was dying of pneumonia. He wanted the last few moments of her life to be peaceful and loving. The patient with the police, soon woke up and was swearing, aggressive and rude. It didn’t bother me – I am used to it – but I told him to be quiet as the patient next to him was grieving for his dying wife. He screamed out "old man – your wife's a s***." The police took him, but not before he had traumatised the grieving man.

Then finally there is being disturbed by management and over zealous implementation of targets. In A&E we have targets that 98% of patients need to be seen and sorted within 4 hours. Some mangers panic if patients are in A&E for too long and over-ride our clinical priorities and push us to admit patients who need further work on them in A&E. Patients can occasionally get suboptimal care and I find this disturbing.

MT: The lows -- long hours, violence, etc. -- are vividly explored in your book -- what are the highs?

NE: Numerous. I love my job – especially having the camaraderie of a close set nit of colleagues and the banter that ensues. I think patients prefer to see their doctors and nurses happy and not stuck up in a politically correct snobbery.

I enjoy the challenge of making diagnosis, teaching younger colleagues, continuing learning and researching new things and also – it sounds corny – but of making patients better. I have a very small attention spam and so things like putting back a dislocated shoulder are instantaneously gratifying.

But the best part is working with the public and seeing all their individualities coming to the front. Recently, I had a confused Nun who had got drunk and been brought in. We then phoned the Mother Superior and she insisted on telling us that we had the wrong person and that the nun was cleaning the church. Eventually, the Mother Superior realised her mistake and came round to pick her up.

MT: What can be done to stop violence against A&E staff?

NE: Patients get violent for a number of reasons – they are scared, they are in pain, they have waited too long, they are mentally unwell, they are drunk or drugged or they are just nasty pieces of work. You can’t isolate a cause.

What you can do is protect staff better- better security based in A&E and better training for us. Also we need to change the culture from patients knowing their rights to realising their responsibilities as well and for hospitals to write warning letters when patients are aggressive, not pandering to their abuse………..

A colleague once took a rude and aggressive patient moaning about why he was waiting so long into the window of resuscitation department to show them why they were waiting - a series of very sick patients silenced the moaner. But within a week a complaint letter arrived complaining about the psychological distress the doctor caused. I am told the hospital wrote to apologise…….

MT: How have colleagues in the NHS responded to your book?

NE: Generally very well indeed. Most agreed with my sentiments that we are lucky to have the NHS but it needs to be run better. I was worried that being outspoken would make it difficult for me to get a consultant job and I didn’t want to become known as a writer– and so I wrote it under a psueodname.

So in fact, no one at work knows that I wrote the book. It is quite funny people talking about the book in the coffee room when they don’t realise that you wrote it.

When people are talking about it, I usually slag it off and say it was probably written by a self obsessed egotist who should have just concentrated on his real work. It I quite amusing to hear colleagues ‘defend’ ‘Nick Edwards’ to me

MT: What was the most difficult aspect of writing your book? How did you overcome it?

NE: My wife moaning at me for not spending enough time with her. I bought her expensive shoes with the small amount of royalties - she soon got off my back.

MT: How do you write? Longhand or directly onto a computer, straight off or with lots and lots of editing?

NE: I would come home from work and write how I felt – it helped with the stress and I would just write and write without checking what I was saying. I felt sorry for my editor!

MT: What do you hope your book will achieve?

NE: People will see what it is like working in A&E and so if they ever come to the department they will understand the stresses we are under. Also I would hope that it has a political edge to it – the NHS is under threat from piece meal commercialisation and privatisation. Bodies such as the nhs support federation have shown a great deal if interest in the book and it had been on newsnight and a couple of newspapers and even been quoted by politicians.

However, it came out just as the friday project were undergoing financial problems and it never got much exposure or product placement, or entered for any competitions/prizes.

I still think that there could be a bigger political effect from the book – helping to galvanise people to defend the principles of the nhs but for that to happen, it needs more pr and interest.. Any help from readers would be really appreciated.

MT: Do you read the critics? Have you been pleased with the responses to your book? Have you learned anything from them?

NE: Generally the press interest was quite positive and the reviews generally good. However some of the critical comments online i.e. on amazon were quite true – badly written in places, too political etc and so I will take that on board for the next book.

MT: What do you do when you are not writing?

NE: Doing my job! As an A&E doctor in training I am busy – working lots of hours, doing research into improving outcomes after cardiac arrest and I do a lot of teaching to nurses, junior doctors and medical students. 8 years after medical school and I am still studying for exams – fellowship exams to enable me to become a consultant.

I also have a baby and one on the way and that takes up lots of time. I also play football, although as I am awful I spend a lot of time as a sub, so it doesn’t take that much time up.

MT: Did you have an idea in your mind of your "ideal" reader? Did you write specifically for them?

NE: I originally wrote for myself on my blog and so didn’t have an ‘ideal’ reader in mind.at all. But when I was putting the book together I wanted to make the book interesting to non medical people, without being patronising.

MT: What are you working on now Nick?

From a literary point of view I am writing irregularly for a couple of newspapers on health issues. I am also starting to write In Stitches 2 – although hopefully we will come up with a better name.

I also have a playwright who has approached me to turn the book into a TV series. The rights have been sold to tiger aspect productions and he has written a treatment document which we are trying to pitch to various TV companies.

In the long run I would like to become a part time doctor and part time author – I have penned ideas on popular science books written in an easy to read style similar to In stitches. My ideas are for a book on how the body works, 101 best ways to die and an easy to read and amusing but useful first aid book.

MT: Who is your favourite writer? What is/are your favourite book(s)?

NE: I know you will think I am just jumping on a bandwagon, but I love the Harry Potter books and when I am feeling down get stuck into them. Sorry not very highbrow.

MT: Do you have any tips for the aspiring writer!?

NE: I am not sure I am qualified to say really – my book came about purely by chance.

Write for fun on something you are interested in and have a passion about. From my royalties balance sheet, make sure that you have another job and do it as a hobby and not think of it (initially) as a way of making money.

MT: Anything else you would like to say?

NE: If anyone has any comments on the book, wants to enter the book for a literary competition, is interested in my suggestions for new books, or wants to contact me then please email me on drnickedwards@gmail.com. I also have not got (have never had) a literary agent at the moment so if there are any agents interested please let me know.

Finally I think the book is best read in the bath or on the toilet in small bursts. So although we are giving away the ebook free on the website – see Editor's Corner – I would recommend the reasonably priced paper version – with free delivery!