Wednesday, April 08, 2015
Two visits to A and E. Or: what it feels like to be a thing
It’s 4 in the morning and I’m fighting for breath.
My heart is racing, too: 170 beats per minute, the ambulance man tells me, as he responds to my 999.
And they take me in to Edinburgh Royal Infirmary, and I’m taken straight to treatment; and while I then have to wait another eight hours in the A & E for a hospital bed , I feel cared for, and I feel safe.
4.30 am on Thurday March 26th feels like quite a good day to choose to be horribly ill in.
But I can’t help but notice the constant presence of people in the passage way outside my cubicle: patients of all ages just parked wherever there happens to be space.
People all sharing the same look of helpless bewilderment as they wait to be seen.
And I can’t shake off a sense of a service in grave danger of being overwhelmed.
By the first of April I’m back at home and everything seems fine.
Until 4am on Saturday 4th April when I’m awake with the most intense and terrifying chest pain.
Pulse at 150, says the ambulance man, and we’re back on the all too familiar journey.
But something happens in the ambulance: the pain subsides, and the pulse slows down to 80.
A and E is so busy at first the ambulance man can’t even get me checked in.
I’m shivery and frightened, still, and my heart feels so desperately fragile.
“Put her there” a nurse says, and when I open my eyes I find my chair’s been parked in a line of 4, right in the middle of everything, and nurses rushing past us as if we weren’t there.
Police officers everywhere: a palpable sense of aggression in the air.
Eventually a medical student takes me away to a cubicle, and I feel safe there. He inserts a cannula into my arm, and he takes blood, and records an ECG of my heart.
Because he’s a student, he’s immensely painstaking and full of care, and I’m so grateful to him, and then he says, “Come this way and I’ll take you to where you’ll be seen”.
And before I know what’s happening he’s taken me to a chair in the middle of all the commotion and he’s left me there.
Somewhere I’m invisible, and yet in everyone’s way, and not so far away there’s a man with a bloody bandage round his head screaming “it’s an expresso! It’s an expresso! I want my f***ing money back” at the top of his voice, over and over again, and where I am feels like such an unsafe place to be, and a tiny a bit of me wonders, Should I protest?
But I don’t have the strength, I feel so tired and so ill and so shivery and so weak and I’m so painfully aware of the fragility of my irregularly beating heart.
And I curl up inside. There’s a kind of space where it all seems to be happening to someone else, and it feels safer there. And so I give up on myself. I give myself up to being abandoned.
Looking back, it’s obvious that what happened was that as my pulse slowed and my pain subsided in the ambulance, so I, too, dropped down all the urgent categories until I ended up at the back of the queue and the bottom of the heap.
And I won’t complain about this. It’s what the staff have to do, they have to prioritise, and they do it with expertise and skill.
But I would say of those of us who are medically uninteresting, those of us who aren’t urgent: we are still human beings who suffer.
Suffer thirst and pain and cold and fear and bewilderment and above all, as we are left in helpless in our chairs, suffer from a sense of abandonment.
I was there for over an hour, I think, in that dreadful place.
And then I was led to a trolley in a cubicle and the trolley had a clean sheet on it, and I could lie down. And I felt as if in heaven.
And I was seen, and my chest was x rayed, and decisions were taken.
The most likely explanation was that a chest infection had got worse; and that was where the chest pain was coming from.
And under the circumstances it was hardly therapeutic to spend over an hour abandoned in a chair.
Later, I was moved out in the centre of the passageway again, but it didn’t feel so bad, because I knew what was happening.
My trolley was parked in front of a place where admission forms were stored, and nurses had to continually lean over me to get them.
Lean over me as if I wasn’t there.
And I said to one, quite gently, “This is terrible”.
“Yes” she agreed sadly. “It’s so bad for everyone”.
Bad for patients, obviously, because there you are, a thing, and you’ve lost your humanity.
And so bad for staff, too: continually forced to ignore suffering people who are there right in front of their eyes.
Now it’s over, it surprises me a little that I do not feel the slightest bit angry.
Much more sad: the NHS represents so noble and so beautiful an ideal it so deeply saddens me we should have come to this.
I don’t want to blame anyone. I don’t want administrators to be bullied or front line staff to be bullied or more pressure to be applied. Because none of that will make things better.
Because at the end of the day I can’t help thinking these things are happening because we live in a society that considers it more important to possess and maintain weapons that can kill millions: more important than to cherish and maintain a system of health care that could look after the general good.
Not to mention a social structure that puts enriching those who are already rich above taking care of everyone’s welfare.
It matters very much we overcome our sense of cynical helplessness and do what we can to turn this around.
But more immediately, it would be good to see evidence of a consensus among all professionals concerned that there is a crisis: and a willingness to look and work for long and short term solutions to it.
Meantime I know I’ll get better: I would like everyone who ends up in that place, staff and patients, to be treated better too.
Labels: Accident and Emergency, NHS
Saturday, December 17, 2011
On the medical ward.
A very lovely friend came to visit me today. Deirdre McCloskey is an extraordinary and inspiring transwoman, a free market economist whose views affected me profoundly in writing THE TREE OF KNOWLEDGE and was able to come and see the show half way through a lecture tour of Europe.
The wonderful thing about having a houseguest is that it roused me from a state of sadness and depression. I had to get going, make her room nice, sort myself out...
And she is a wonderful houseguest. An extraordinary thing happened at lunchtime - that I'm not allowed to talk about - and we celebrated together.
And then saw Adam Smith's house. And Adam Smith's grave - Deirdre being a devotee.
And then went to the hospital. "This place is terrible" says Jean as I arrive. "They are so disorganised".
That is, in fact, the impression I get. It's not that they're bad people, as far as I can tell, but they don't seem to have adequate medical cover and the nursing staff do not seem to be organised in an effective way at all.
This afternoon, as last night, Jean's alarm went off because her drip had run out. She is suffering acute kidney failure. She needs fluids. She needs to drink loads, and she needs a drip.
Last night the same alarm went off. And nobody came. And while I managed to get someone to turn off the alarm last night, I had failed to get someone to change the drip.
Today i thought I would do better. The first three attempts failed. People would come, look a bit helplessly through her file, and say, "There's nothing written up" and then "I'll ask".
And then disappear.
I happened to see the doctor in the middle of this. The third visit, the third attempt.
She was perfectly pleasant and willing to help. But clearly pretty low down the hierarchy; generally working on a completely different ward; no knowledge of Jean; and no access to the treatment plan.
But she did her best. I did learn something from her. And as I left, i said "Please write up Jean's drip".
And so the fourth nurse came, with a full bag, and hooked it up to the machine.
I felt triumphant. But after ten minutes it became clear that while she had hooked it up to the machine, and the machine was functioning perfectly, she had neglected to hook it up to Jean.
So the drip was dripping onto the floor.
So off I went again. it's important to be pleasant on these occasions, there's no sense blaming individuals, but the first nurse said "I'm doing something else". as if my request was a bit outrageous. But she did get the other nurse back, who did hook the drip up to Jean. And then left without cleaning up all the liquid that had by now dripped onto the floor.
In the circumstances, Jean's spirits remain remarkably high. But I wonder how much longer she can possibly withstand so health destroying an environment.
And then off to the show. Another full house. This is unprecedented outside the Festival.
Lovely meeting with Orla O'Loughlin, the Traverse's new artistic director. She said the play has already far surpassed its target for ticket sales for the entire run.
And then I got home, and there was me on the trailer for SEX CHIPS AND THE HOLY GHOST. Which we filmed yesterday. Looking remarkably like a nun.
But that is another story.
The wonderful thing about having a houseguest is that it roused me from a state of sadness and depression. I had to get going, make her room nice, sort myself out...
And she is a wonderful houseguest. An extraordinary thing happened at lunchtime - that I'm not allowed to talk about - and we celebrated together.
And then saw Adam Smith's house. And Adam Smith's grave - Deirdre being a devotee.
And then went to the hospital. "This place is terrible" says Jean as I arrive. "They are so disorganised".
That is, in fact, the impression I get. It's not that they're bad people, as far as I can tell, but they don't seem to have adequate medical cover and the nursing staff do not seem to be organised in an effective way at all.
This afternoon, as last night, Jean's alarm went off because her drip had run out. She is suffering acute kidney failure. She needs fluids. She needs to drink loads, and she needs a drip.
Last night the same alarm went off. And nobody came. And while I managed to get someone to turn off the alarm last night, I had failed to get someone to change the drip.
Today i thought I would do better. The first three attempts failed. People would come, look a bit helplessly through her file, and say, "There's nothing written up" and then "I'll ask".
And then disappear.
I happened to see the doctor in the middle of this. The third visit, the third attempt.
She was perfectly pleasant and willing to help. But clearly pretty low down the hierarchy; generally working on a completely different ward; no knowledge of Jean; and no access to the treatment plan.
But she did her best. I did learn something from her. And as I left, i said "Please write up Jean's drip".
And so the fourth nurse came, with a full bag, and hooked it up to the machine.
I felt triumphant. But after ten minutes it became clear that while she had hooked it up to the machine, and the machine was functioning perfectly, she had neglected to hook it up to Jean.
So the drip was dripping onto the floor.
So off I went again. it's important to be pleasant on these occasions, there's no sense blaming individuals, but the first nurse said "I'm doing something else". as if my request was a bit outrageous. But she did get the other nurse back, who did hook the drip up to Jean. And then left without cleaning up all the liquid that had by now dripped onto the floor.
In the circumstances, Jean's spirits remain remarkably high. But I wonder how much longer she can possibly withstand so health destroying an environment.
And then off to the show. Another full house. This is unprecedented outside the Festival.
Lovely meeting with Orla O'Loughlin, the Traverse's new artistic director. She said the play has already far surpassed its target for ticket sales for the entire run.
And then I got home, and there was me on the trailer for SEX CHIPS AND THE HOLY GHOST. Which we filmed yesterday. Looking remarkably like a nun.
But that is another story.
Labels: medical ward, NHS, Tree of Knowldge
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