The Deeper NHS

On Monday 20 September I woke with similar symptoms of restless digestion to the previous day and so had another drink of milk, honey and spices. I felt detached, lacking a sense of connection with my surroundings and with our cat, who came to sit by me.

Smudge
May she live forever.

I was for a while distracted by the beautiful black cat that wants to adopt us and who made another one of her increasing number of appearances this morning. We have since learned that she has the unpromising name of Frida.

Something was awry, but elusively so.

My wife was about to set off to see her mother, who did not yet know our news. I was lying on the bed, having washed a dressed, when she remarked that I felt rather hot and that it might be a good idea to take my temperature. The mercury—we have since acquired a digital thermometer—that made its way from the bulb up the fine glass tube flanked by a numbered scale fine glass tube showed that I had a temperature in the region of 38 degrees C,. This was above the level at which, I had been advised, I should present myself at the A & E Department of the hospital where I was being treated with a view to receiving intravenous antibiotic. The most likely cause of the raised temperature was that I was in a state of neutropenia (lowered number of neutrophils, white blood cells forming a cornerstone of the body’s defences) and that I had an infection beyond the capabilities of my depleted immune system to defeat. The nagging cough, present at diagnosis, had diminished but not gone away; it had been biding its time, the sneaky little bugger, ready to take a life-threatening hold on my person.

There was nothing for it, even though I felt marginally better than yesterday. I assembled a few personal possessions and we made the 25-minute or so journey down the motorway to the hospital.

There is something about the words “cancer” and “oncology” that opens doors in the current NHS, a sort of  “drop everything and roll out the red carpet” approach. So I found when we presented ourselves at A & E reception and I explained why I was there. My voice gave way a bit when I answered two particular questions: “who is your next of kin?” and “what is your religion?”. Both of these are questions of great significance and emotional freight, putting us on the spot about our deepest concerns, values and relationships.

I was directed to a small side room where I could wait unmolested by the coughs, cuts and sneezes of the rest of those waiting for medical attention, no doubt weighed down by anxieties and insecurities of their own. I did not have to wait long before being ushered into another room, where the triage nurse took some personal details, as well as my blood pressure and temperature. Another short interval and I was directed to a further room, given an ill- fitting hospital gown (who designs these things?) and invited to lie down on the bed. The room was the only one available that offered privacy, but was chilly, its main purpose being the storage of plaster (for casts), dressings and other supplies. A polite notice to leave the sink tidy had been ignored.

My wife re-enters the chilly holding room, where I have my feet up.
I have since learned that it is a bad idea for someone in my condition to cross their legs, or even feet, because of compromised circulation. One by one life's little pleasures are eroded.

I was seen by a succession of staff, who took blood samples, measured my blood pressure and were all extremely kind. There were several Philipinos with soft hands and gentle voices and an Irish nurse of such surpassing rosy prettiness that Kerrygold would make a (further) fortune if they snapped her up for a marketing campaign.

In due course—I lost most sense of the passage of time—a young doctor appeared, spiked my arm and fitted a catheter ready for the drips of saline and gentimicin (antibiotic) that would enable me eventually to regain my freedom and the comforts of home. It was becoming increasingly obvious however that I was shortly to become an inpatient. I suppose I am quite lucky to have reached the age of 55 and not had that experience, although psoriasis since the age of 17 and other issues over the years have meant that I have become familiar with a significant variety of outpatient departments.

Tubes in place, ready to be plugged into the mainframe.
"We have the technology; we can rebuild him."

The drips were set up: another new experience, as I watched the flow of healing fluid into my punctured vein.

Eventually, a porter appeared and I, with drips still doing their stuff, was wheeled to a ward with the inviting name of Aspen. Few experiences speak more of dependence than handing over the care of one’s primary mobility to another and my impression was that people in the corridors on the a way to the ward made way for our little group while at the same time avoiding my gaze.

I was to have my own room in the ward, because of my immuno-compromised and ditto-suppressed status. After a short wait while the room was made ready and the ward sister assured me that I was expected, in spite of appearances to the contrary.

Spacious and clean. But inviting?
The notice is to remind all entering the room to be clean their hands using the basin provided.

A very good banana, following one of the better meals I had in hospital, a sausage casserole.
Whoever designs hospital easy (ha!) chairs should be strung up, by the way.

During this time, I sought assurances from staff that nothing would hinder my having the CT scan for which I had been scheduled as an outpatient the following day. The assurances were given, but the hollowness of these and the consequences for my morale and wellbeing would take some time to emerge.

I stress that this was an excellent hospital, spotless and air-conditioned and with a strong sense of purpose evident among all staff. Certain people however were destined to drop the ball.

More immediately militating against comfort and repose were the loud buzzers that sounded as patients on this large ward summoned nurses, the alarms only being cancelled and so silenced when the nurse reached the bedside. This was to become a significant problem, but that is an account for another day.