Giving heartbreaking news to families is all in a day’s work for consultant paediatric neurosurgeon Jay Jayamohan. But that doesn’t make it any easier. “It’s unfathomable what parents go through,” he says. “I do get upset but you just have to keep it inside your chest; you can’t be upset in front of the family. And you can’t allow emotion to cloud your judgement, although that is a real danger, especially if you’ve treated a child for years and you’re recommending surgery that could be life-threatening. You have to put yourself outside the friendship category and sometimes be a very brutal member of the team who has to give bad news.”
How does he react if a parent opts for what, in his view, is not the best course of action, or even refuses potentially life-saving treatment? Would he ever consider legal action, as in the case of seven-year-old Neon Roberts, which hit the headlines last December when his mother refused radiotherapy?
“We always say to parents, ‘Whatever decision you make for your child is the correct one.’ If parents want to do nothing – which in many cases is probably not what we would choose, but there is an argument for it – we’ll support them. It’s easy to think you would always go for all the treatment, but actually there are some conditions where you think, ‘If it was my child I wouldn’t’.”
Jay admits there are ways of guiding people towards the treatment he thinks is best and quickly gauges how much involvement parents want. He’s noticed that generally mothers and fathers react differently: “Dads need to know more of the technical details of the operation; I think that’s their way of coping. Mums seem more ready to cope with the worst questions that dads are often scared of asking.”
In theatre he switches his emotional side off and his “pernickety freak” side on, and turns his iPod to shuffle between heavy metal, ragga, techno and jazz to help him concentrate. Operations average six hours, and he sometimes performs three in one day.
When things go well he comes out exhausted but high. But how does he cope when things go badly? “Sometimes I splurge out six weeks of bad stuff when I play golf or go for a beer with my mates, and that’s very therapeutic. And I talk to my wife and play with my daughters, who are five, three and nearly two – that’s hugely helpful. We all get annoyed with our kids but with my daughters I often think, ‘Do whatever you want, because you’re here and you’re with me and you’re well.’
“Emotionally I think our work is much harder because we are dealing with children. But on days when you feel absolutely rubbish you’ve just got to think, what must it be like being that kid or that parent? That’s what drives you on.”