Tag Archives: hospital

John’s UK Coronavirus Diary – No 16 – “The first of the blood tests begins…”

CONTINUED FROM DIARY No 15

THURSDAY 21st May

Throughout the night, I was on a liquid drip, linked into my left arm.

0930 – The first of the needles and blood tests begins.

First new consultant of the day. A white South African. Never usually a good omen. But she seems fine.

Now a drug bloke with questions about my lifestyle. Alas, I am very dull. No smoking. No drinking. No recreational drugs. No bestiality beyond the norm.

I am attached to a bag of gooey stuff with an electrical thingie in between it and me

Around midday, I have to drink unexpected vegetable soup and have a new drip tube inserted into my left arm linked to a bag of gooey solution. I have to keep my left arm as straight as possible otherwise it cuts off the electrical thingie between the bag and my arm. Not good if I want to eat or hold an iPad with my left hand and type with my right hand. 

It will be there for the next 8 hours, so presumably they won’t be sending me home today. Hopefully tomorrow.

This billed day of multi-tests has turned into some brief blood-taking at the start… then the first four hours (1200-1600) of new planned 8-hour drip treatment.

A new bag is attached at 1700 and the next bit is now going to be three 2-hour bag drips – presumably ending at 2300. So one suspects definitely not getting out tonight!

I am reattached to this new drip bag for my latest 6-hour stint at 1700 but then taken along corridors at breakneck speed in a broken wheelchair (although I can walk fine) for a scan. 

There had been some bureaucratic SNAFU – the scan people hadn’t known which ward I was in.

The wheelchair pusher was very much a jobsworth. He told two other wheelchair pushers we passed by that they were leaving their wheelchairs in the wrong places and told a cleaner bloke outside the scanning room that a couple of other staff had been saying he (the scanner bloke) had been being lazy but he (my bloke) had said the other guy was a good worker not lazy. Psychological workplace politics at play.

I had the scan lying on my back. They scanned from top of my chest to my pelvis, to include lungs, liver kidneys, etc etc.

It was then back to my ward where my evening meal was waiting at around 1810 but I was only reattached to my drip around 1830, presumably to avoid me switching off the drip by bending my left arm when eating. Who knows when this attachment to bags will finish?

“So bad at chemistry, my teacher emigrated”

FRIDAY 22nd May

They have just (1041) changed the drip feed bag again. 

I have already had another blood test. The nurse (Hispanic) says this new bag is for eight hours. I guess that means another night in. 

A nurse tells me the liquid in the bag is 98% or 99% water and the rest sodium chloride. It is only later I realise ‘sodium chloride’ is actually salt. Like I knew?

At school, I was so bad at chemistry, my teacher emigrated to New Zealand. I am convinced my inability to do the subject was at least a contributory factor.

Yesterday, a young Thai nurse told me this is an awkward ward to work on because the patients tend to be old men, some either doolally (my word) or very awkward.

My night nurse was a black (I guess from the accent) African lady.

This morning, round about dawn, further down the corridor, my African nurse was having an argument with an old patient. Raised voices, I’m guessing because his hearing was not good:

HE – “Don’t touch me! Do NOT touch me!”

SHE – “You have wet yourself. I have to change you. Your bottom is full of poo.”

HE – “Get out! You are fired!”

(Later)

SHE – “Who is Darkie? Who is this Darkie?”

She eventually got him to let her look after him by a combination of shouting back and not letting him tell her what to do – to leave the room etc – and by getting some laughter into their exchanges as if they were chums having a play fight.

Then she immediately had to come back into my ward where she was quietly tender, gentle and caring to a patient. She should write a book on psychology: How To Control Uncontrollable People Who Have Uncontrollable Mouths. 

One clever thing they seem to have done in the hospital – this is only my guess from observation – is to split the teams on ethnic or linguistic grounds. I have so far not seen any white nurse. All 100% are non-white, multi-ethnic, multi-national.

My night team are black Africans and share a language – I’m guessing Swahili but the main nurse is probably West African.

During the day I have Spanish-speaking teams. (Not necessarily from Spain itself.)

Occasionally there are a few Asians – Thai, Chinese-origined, Filipino etc.

What this means is, as they are almost all working in a second language, they can communicate nuances to each other in their own shared first language and there can be clearer communication.

In strict PC terms, there should not be teaming by ethnicity or nationality but, in this case, I think linguistics and a shared social background wins over.

The doctor tells me they still have no idea what is wrong with me. So they are just testing everything in sight. I will be in here at least one or two nights, I am told.

If they can find a cause for my calcium and kidney problems, then they can maybe send me home. If not, more needles ahead.

During the current coronavirus lockdown, the hospital allows no visitors unless you are dead or giving birth and then only (I think) one person. There are special rules for the end-of-life wards, but I’m not exactly sure what they are and it would seem presumptuous to ask a nurse.

I get a text message from British performer Matt Roper in the US… “God forbid I ever have to stay in a hospital in America. I pay $355 for health insurance every month and I’m still billed for co-pay regardless. I have to pay $30 for a visit to a GP, $50 for a specialist, $35 for urgent care and $200 for a trip to A&E. They are running a racket. God bless the NHS.”

My friend in Central London, whose friend is still in the Intensive Care Unit of an NHS hospital with COVID tells me: “A COVID-19 ICU bed costs the NHS £1,500-£2,000 per day. He has been in there 45 days”… at no cost to him, of course.

Ariane Sherine, currently training to be a celebrant at Humanist funerals (true), has offered to give me a free funeral. It is a bargain, though there are personal pros and cons to my having a funeral right now.

Personally, I think a funeral for me is pointless and have told my executrix Lynn I don’t particularly want one – Just bung me in the ground.

But I don’t really care: the real me won’t be there.

Unlikely to happen in the near future, but a pig may fall on my head at any time.

Worldwide, that is not as uncommon as it might seem.

… CONTINUED HERE

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John’s UK Coronavirus Diary – No 15 – I suddenly get taken into NHS hospital

… CONTINUED FROM DIARY No 14

The COVID-19 self-administered swab test pack arrived…

SUNDAY 17th MAY

The COVID-19 home test kit with explicit 12-page instructions arrived: I had to do the test around 0700 tomorrow; a courier would collect it between 0800-1600 tomorrow and I would get the result within 72 hours.

Later I had a FaceTime chat with Ariane Sherine’s 9-year-old daughter whose first question was: “Why are you talking so slowly?” I had not known I was.

The UK’s daily increase in coronavirus deaths has dropped to 170 – the lowest since the day after lockdown began.

The announcement comes a week after the first easing of restrictions in England – and, although the numbers are typically lower on Sundays, the figure is almost 100 fewer than the 268 reported a week ago.

The overall UK death toll remains the highest in Europe.

Sticking a swab into your own mouth – Easier said than done

MONDAY 18th MAY

I took the COVID-19 swab test at 0700.

I could stick the swab up both nostrils no problem. Trying to get the swab into my mouth and rubbing it over both tonsils and the back of my throat for 10 seconds was another matter. I couldn’t see the two tonsils nor the wiggly thing – whatever it’s called – at the back of the throat at all, even using a mirror or an iPhone in one hand and the swab in the other. I tried my best and hoped I got it but was gagging/almost puking up so badly I gave up after about 20 or 25 seconds. 

I then waited for the courier to arrive sometime 0800-1600. 

I slept under a duvet on the living room floor, near the door, in case I slept through the courier (They had my mobile phone number anyway.)

Still very tired.

Around 1100, the UK government added loss of smell and taste to the coronavirus symptoms; I’ve never had a problem there, but it always seemed glaringly obvious these were possible symptoms. 

At 1143, the test, duly packaged-up and boxed by me, was collected by a terrified-eyed young man wearing a baseball cap and gloves. He used the gloves to hold out a plastic bag at arm’s length into which I dropped the box containing the test. The tube containing the swab sample was now, together with a soft tissue, inside a plastic bag inside another plastic bag inside the box – and now inside another plastic bag…

In the afternoon, Health Secretary Matt Hancock announced that everyone aged five and over in the UK with symptoms could now (in theory) be tested for coronavirus.

Captain Sir Thomas Moore – a tribute to the power of walking

TUESDAY 19th MAY

Just before fully waking in bed in the morning, I was slightly gasping for air in gulps into my lungs. But only very minor.

The test result came back negative.

Captain Tom Moore is to be knighted for his fundraising efforts after a special nomination from the prime minister. The war veteran raised more than £32 million for NHS charities by completing 100 laps of his daughter’s back patio before his 100th birthday in April. Boris Johnson said the centenarian had provided the country with “a beacon of light through the fog of coronavirus.” Now, under Ministry of Defence protocol, though promoted to honorary colonel, his official title will be Captain Sir Thomas Moore.

The knighthood, which has been approved by the Queen, will be formally announced tomorrow.

WEDNESDAY 20th MAY

The email with the negative test result suggested that, in any case, I should phone either NHS 111 or my GP.

I expected them to ignore me as bureaucratic generality kicks in and I have little trust in GPs – General Practitioners – The clue is in the word General – they know a little about a lot not a lot about a little – let alone non-GPs at NHS 111. At least the GP surgery has my records.

To say the unsayable, I have a very low opinion of basic NHS bureaucracy. Only the hospital and specialist levels work. At the GP/general advice level, it’s one-size-fits-all bureaucracy. 

Obviously, in the hospital Intensive Care Units, it is (one hopes) the creme de la creme of expertise. Mostly.

My GP’s phone was working, which was a surprise as there was a “This phone number is no longer available” message on it last night.

I phoned my GP’s surgery and they told me to phone 111 because I had had the negative result to the COVID test so it was, they said, “not our responsibility”.

I tried NHS 111 online to avoid jamming the system and because I thought it would be quicker. That was a long endless mess because their tick-a-box screens could only deal with single symptoms not multiple symptoms. 

I then phoned the NHS 111 number and, after going through about 6 or so keypad multiple choices, was connected, actually, reasonably quickly.

The phone woman got all the symptoms and dates and then briefly consulted a doctor. They, like I, thought my symptoms – though not coronavirus – were something that I should follow up. They told me to re-contact my surgery and tell them NHS 111 had told me to ask for my GP to contact me within two hours – I think just before any symptoms changed, not cos it was in any way dangerous.

I phoned the surgery at 1246 and, after going through two receptionist people and telling them I had been told by NHS 111 to ask for a doctor to talk to me within 2 hours, got an appointment. I was told he would phone me from his home “within a few hours”. I expected this would be maybe 1700 or 1800 tonight or tomorrow morning.

He phoned back at 1501.

He was/is not really a listener. He was talking on speakerphone in an echoey room in his house so was barely audible. 

He said I might have had a mini-stroke. I didn’t believe this as I didn’t really have stroke symptoms except Ariane’s 9-year-old  saying once: “Why are you speaking so slow?” (Maybe I had just woken up and was sleepy.)

The GP arranged an ambulance to the A&E Dept of a local hospital.

I packed my iPhone and iPad and toothbrush/toothpaste, even though it would just be a check-up.

I was tested in the ambulance. Nothing showed up except some very mild anaemia; but nothing to worry about. They looked at my inner eyelids: fine. They didn’t think I needed to go to hospital. (Neither did I.) They phoned the GP. He insisted. The ambulance lady said my GP was “very rude”. 

I said, “Well, yes, he is always very abrupt.”

“I think just rude,” she said.

I could not really disagree.

The ambulance duo said I would probably sit waiting in A&E  for 4-6 hours, have brief tests, then be sent home.

I had some preliminary tests at the hospital and very quickly (after maybe 5 mins) a long talk with a doctor. He didn’t think I had any truly serious symptoms – certainly not a mini-stroke (zero symptoms). And I am a mildly anaemic, but nothing serious.

Then another wait.

I sat in the waiting area.

A girl in her teens or twenties was brought in to wait with two carers, I think both nurses. She looked like she was on an acid trip or something similar. She changed between staring into the middle distance or staring up very inquisitively at the ceiling or suddenly being startled by something; sometimes moving her two forefingers slowly together and watching them intently, then jiggling like a seated disco dancer, then staring blankly into the mid-distance – all without saying anything.

I had a chest x-ray.

Then another wait and I was elsewhere, having some blood taken out of my hand and some fluid put into my arm. The presumed acid girl was brought in next to me, a curtain dividing us. She was having a blood test.

I gave a urine sample. Awaited another test. Basically, everything was AOK. They were going to repeat the fluid in the arm thing and check it was the same as the last test.

I sat in the waiting area, ready to go home while they repeated the blood test results.

The doctor came back to say I had to have an x-ray. I had slight light kidney damage.

I felt fine. Over the next 45 minutes I had liquid dripped into my arm – 99% water, I think, then another doctor saw me.

They thought the sudden kidney problem was to do with dehydration. 

When I had an X-ray of my back last October (looking at some lower spinal damage I got in 1991 when I was hit by a truck while standing on the pavement) I had a kidney function of 90, which is OK for a man of my age. Now I had a kidney function of 19. So they were confused why I suddenly had kidney damage. They decided dehydration.

They took a bladder scan and decided to keep me in at least overnight for observation.

More blood tests tomorrow. 

No big problem though.

Tomorrow would be a day of tests.

I had maybe 7 or 8 tests and repeat tests end-to-end. Then maybe 5 or 6 more tests and needles and fluids and probing and finally another COVID swab test before they took me up to the ward with another urine test on the way.

Then another COVID swab test before going into the ward and a one-off chat and probe and questioning by the young evening consultant and some younger assistant I guess being trained. The main guy described himself as “a grunt dragged in for the night” and my real personal consultant would start tomorrow. Nice bloke as they all are.

I felt miles more awake since I had been in the hospital. Maybe a result of just being out and about.

They basically didn’t understand why my kidney function was down from 90 to 19. I might be in for more than a day – some possible tests might take longer to come back. They also found my calcium level was suddenly high. I think they said it should be around 2.6 and was 3.3. Might have misremembered by a digit but somewhere in there. Pretty sure that’s right.

Everyone was basically saying I didn’t have any symptoms of anything specific and that night’s consultant said they would never normally have me in on the results but now they had found these inexplicable kidney and calcium weirdnesses…

They put me on another 45-minute drip and would continue dripping liquid (saline solution?) into me through the night.

The COVID test in the ward was a swab test up each nostril and down both sides of the groin(???)

My friend Lynn told me (text messaging is a wonderful thing) that the groin swab was probably the usual one for MRSA. Lynn is the executrix of my will, my designated next-of-kin and has Medical Power of Attorney over me, if I become incapacitated. So it is always best to let her know if I go into a hospital or visit North Korea.

… CONTINUED HERE

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John’s UK Coronavirus Diary – No 8 – Captain Tom and the cytokine storm

… CONTINUED FROM DIARY No 7

(Photograph by rottonara via Pixabay)

WEDNESDAY 15th APRIL

My friend in Central London, who has a close friend with coronavirus in a hospital’s Intensive Care Unit tells me: “He had a stable night. Everything as before except they are trying a tiny reduction in ventilation today. No feedback about that yet. A nursing friend says that ‘stable’ when in ICU is a good thing.

“Over the last week we have been inundated with emails and texts from his colleagues, neighbours and friends. There’s so much gratitude and respect for him out there. He has helped so many people. The moral support from everyone is amazing. We hope he knows just how appreciated he is.” 

The latest government figures today were: 761 coronavirus-related deaths in UK hospitals in the last 24 hours… so now 12,868 in total.

THURSDAY 16th APRIL

The latest government figures today are: 861 coronavirus-related deaths in UK hospitals in the last 24 hours… so now 13,729 in total

There are lots of feel-good factors on the news today because of 99-year-old Captain Tom Moore. He had set himself a target of walking round his back garden (he lives with his daughter) on his Zimmer frame 100 times before his 100th birthday on 30th April to raise £1,000 for the NHS. He started his fundraising on 8th April and completed his 100th lap today… and he has actually raised over £15 million. A petition has started to get him knighted.

Media company Public Radio International reported: ”Kalsarikännit, the Finnish tradition of getting drunk at home in your underwear, might be getting traction globally with over half of the world population under stay-at-home orders due to the novel coronavirus pandemic…”

Reacting to this, Esko Väyrynen, who organises the World Fart Championship in Finland, told me: “The day after proper kalsarikännit is called alushousupäivä (=underwear day). It makes easy to select how to dress. Six feet distance during pandemic is hard to keep. We Finns are so distanced already that no one of us want to go so near to anyone.”

From Holby City fiction to NHS reality…

Another story re-reported today from almost a week ago was the surreal fact that the BBC TV’s hospital drama series Holby City has given two fully-functioning ventilator machines to the new NHS Nightingale Hospital at the Excel Centre in London. Quite why the drama series needed a real one is a good question but the surreality of a fictional hospital giving a spare life-saving ventilator machine to a real hospital takes a bit of getting yer head round.

Today, after three weeks, the UK government extended the social lockdown, restricting people to their homes, by another three weeks.

FRIDAY 17th APRIL

By breakfast time this morning, Captain Tom had raised over £18 million.

My friend in Central London told me that the hospital now thought what was happening to her friend with coronavirus is a ‘cytokine storm’ – an over-reaction by the body’s immune system.

Basically cytokines are small proteins released by many different cells in the body, including those of the immune system where they coordinate the body’s response against infection and trigger inflammation. But, in some patients, excessive or uncontrolled levels of cytokines are released which then activate more immune cells, resulting in hyper-inflammation. This can seriously harm the patient.

Cytokine release (Photograph from scientificanimations.com via Wikipedia)

According to the New Scientist: “Cytokine storms might explain why some people have a severe reaction to coronaviruses while others only experience mild symptoms. They could also be the reason why younger people are less affected, as their immune systems are less developed and so produce lower levels of inflammation-driving cytokines.”

In the evening, my friend in Central London shared with me a newspaper article about a man in similar circumstances to her friend – and of the same age – and in a nearby hospital. The headline was: Dad With Zero Chance of Surviving Coronavirus Weaned Off Ventilator – But He is Not Out of The Woods Yet. The doctors had told his wife that he had no chance of surviving and allowed her and her two children ten minutes with him to say goodbye, though they had to wear Personal Protective Equipment and were not allowed to touch him.

The latest government figures are: 847 coronavirus-related deaths in UK hospitals in the last 24 hours… so now 14,576 in total.

SATURDAY 18th APRIL

The latest government figures are: 888 coronavirus-related deaths in UK hospitals in the last 24 hours… so now 15,464 in total 

Captain Tom has now raised £23 million for the NHS.

Captain Tom completes his 100th circuit…

… CONTINUED HERE

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Comedians, ‘madness’ and psychiatrists

(From left) Juliette Burton, Jorrick Mol, Laura Levites

(From left) Juliette Burton, Jorrick Mol, Laura Levites (Photograph by Brian Higgins)

A couple of weeks ago, I staged five daily hour-long chat shows in the final week of the Edinburgh Fringe.

In the second show, I talked to comedians Juliette Burton, Laura Levites and Jorick Mol.

All of us had experience of being in mental homes.

This is a short extract from the chat:

____________________________________________

JOHN: Laura, you were telling me last night that you had been really happy at the Fringe this year. Surely that’s bad creatively? Performers need to be troubled to be creative.

LAURA: No! I’ve spent my entire life being troubled. Why would I continue wanting to be troubled?

JOHN: You won’t have a show next year if you’re not troubled.

LAURA: That’s not true! That’s not true at all. I’ll find trouble anyway but if I’m not troubled, it doesn’t mean I have to have a life without experiences. You don’t have to be miserable to be creative.

JORICK: I’d like to pick up that idea that performers and mental illness are, in some form, related. I think that’s complete nonsense. It’s only when people actually do have mental health problems and are performers that that conversation will very quickly start. Although performers and writers and creative people are maybe more willing to play with the spaces in their mind and go places people wouldn’t normally go. They won’t go for the easy answers.

JOHN: Isn’t there a point that creative people, in order to create something new and different, are thinking laterally and, in order to think differently from other people, you have to be different?

JULIETTE: The experiences I’ve had – the psychoses and stuff – forced my brain outside a certain box and I feel like it’s a gift in a way, although it fucked up my education. But I have had experiences that were outside the normal way of thinking. And to try and make any sense of that… I kind of think that the world’s crazy anyway, but… to not laugh at it all… The fact that I heard voices and I saw weird things that weren’t there…

LAURA: Oh my god! I’m so jealous!

JULIETTE: Yeah?

LAURA: You did?

JULIETTE: Yeah, totally. I saw God and the Devil and…

LAURA: You saw God?

JULIETTE: I time-travelled.

LAURA: You time-travelled? I don’t have that. I’m so upset. What’s your diagnosis?

JULIETTE: It was a while ago. It was 11 years ago I had a psychosis as a result of anorexia. I don’t have that now.

LAURA: You stopped eating?

JULIETTE: No, I… I have been told not to take any drugs because it might happen again. If you have those weird experiences and try to make sense of those experiences… For me it just means that anyone who’s doing a normal job in a normal office, it’s like…

AUDIENCE MEMBER: I’m a psychiatric social worker. My work is to sit talking to people like you with two medical doctors and to argue your case. And it’s really hard.

JOHN: Why is it hard?

AUDIENCE MEMBER: They say That person is completely off-the-wall. They have to be hospitalised. The last sectioning I had to take part in – luckily I didn’t sign the paper – the patient was saying I feel this love for this person and the psychiatrists wanted to section them because they were having this wonderful overwhelming feeling of love. They couldn’t understand…

What you are talking about is really interesting, because you’re talking about being in a certain world and having certain ‘mystical’ experiences that a lot of mystics and spiritual people have had. But, because ‘spiritual stuff’ is so alien to the medical model…

I’m interested in the spiritual emergency that comes from these experiences, that pushes people through into something else – the medical model isn’t looking at that. They’re saying This person needs medication in order to be ‘managed’ either by a family unit or by society in general, because they’re ‘dangerous’.

JULIETTE: With me, I was sectioned for anorexia and then I had this experience – seeing all this stuff – and then they got me on all the pills and got me away from seeing all these things and hearing all these things and then they carried on treating the anorexia. But they didn’t treat what I saw and all the theological implications of that.

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More injured and bloody comedians cause chaos at the Edinburgh Fringe

Casual Violence - concentrated comedy

Casual Violence – injured minds, bloody strange, very funny

James Hamilton of comedy sketch group Casual Violence has been nominated for an increasingly prestigious Malcolm Hardee Award in two consecutive years for his bizarre writing. This year, Casual Violence are performing not one but two shows at the Edinburgh Fringe.

When I first saw one of Casual Violence’s shows, I wrote of  James: “I think he might need psychiatric help. Though not creative help. There’s something very original in there – I just don’t know what the fuck it is”

My opinion has not changed.

Yesterday afternoon, I was heading to see the new Casual Violence show House of Nostril at the Pleasance Courtyard when a tall young man handed me a flyer for Alexander Bennett’s Afraid of the Dark with Jorik Mol.

For some reason, I asked: “Are you Jorik Mol?”

“Yes, John,” he replied.

“People keep telling me I should meet you,” I said.

“We met a couple of years ago,” Jorik said.

“I have a shit memory,” I told him, “Where have you been?”

“I was in Amsterdam for a year,” said Jorik.

“I’m not surprised,” I said, “You’re Dutch.”

Jorik Mol up against a wall at The Pleasance

Jorik Mol – very pleasant at The Pleasance yesterday

“I was convalescing from clinical depression,” continued Jorik, “I basically spent a year in a haulage container doing voices to myself.”

“Because?” I asked.

“Because what else is there to do in a haulage container? I also read Tolstoy’s War & Peace.”

“You mean the big metal containers they transport on ships?” I asked.

“Yes,” he replied.

“You need money to afford a haulage container,” I suggested.

“You don’t,” said Jorik. “I was given one. I was a student at the University of Amsterdam and they give them out to people who either live very far away from Amsterdam or who are strange. The containers have all been turned into flats. There’s a window at the front and a window at the back.”

“When did you stop living in a container?” I asked.

“I’m still officially living in a container in Amsterdam,” Jorik told me. “But I’m moving to London next month, going back on the comedy circuit and starting to study a Masters in Comparative Literature at University College, London.”

Jeremy Bentham sits, stuffed, at UCL

Jeremy Bentham sits, stuffed, at UCL

“Is that where Jeremy Bentham sits stuffed?” I asked.

“Yes,” said Jorik.

“And you’ll be gigging on the side?” I asked. “Comedy is difficult.”

“No,” said Jorik. “People say comedy is easy but, when you’ve been through severe clinical depression and hospitalisation, maybe everything is easy.”

“Ah…” I said. “Stand-up comedians and mental hospitals…”

“Mental hospitals are great,” said Jorik. “I was punched in a mental hospital. People in the mental hospital really fucking hated me.”

“Because?” I asked.

“Because,” said Jorik, “I’m young, I can speak and I can read novels. There was a guy in the mental hospital who was like the alpha male – he was like a white van man. He thought I was threatening his position in the ward. There were seven completely inert people there, three of whom had regular ECT treatment. So there wasn’t a lot of pride to rule over as the Lion King he thought himself to be.

“One day I woke up late, because I was on a lot of medication, and I was about five minutes late for finger painting or whatever I was supposed to do and the guy just came up to me and just knocked me out.

“I am pretty proud that I am so viscerally annoying that I annoyed someone out of severe inert depression.”

“It sounds like good training for playing comedy to British audiences,” I said.

“Absolutely,” said Jorik.

It turned out he and I were both at the Pleasance to see Casual Violence’s House of Nostril, as was uber-mindreader Doug Segal (he, of course, already knew in advance that we were going to bump into each other).

It was a full house as, indeed was Casual Violence’s other show – Om Nom Nominous at the Voodoo Rooms. It is their ‘greatest hits’ show which I also saw yesterday and, inevitably, it was very weird, very funny, strangely dark, strangely melancholic and the full house pissed themselves laughing.

PekkaStrangeboneComedyShowpiece

Pekka & Strangebone’s accident-prone Fringe show

I also saw Pekka & Strangebone’s Comedy Showpiece at the Voodoo Rooms – another odd sketch show with a dash of darkness added to basic (this is a good thing) silliness. There were three cast members. One had twisted his ankle – the bone had popped out then popped back in again. He had had to go to A&E earlier in the day. Another of the trio had fallen onto a piece of broken glass in the Meadows and gouged a great bloody hole in his hand. He had had to go to A&E earlier in the day.

When I came out of their show, I told them they should try to get publicity on the basis of being the most accident-prone show in town – or the show with most accidents soonest. Then (this is true) I checked my iPhone for e-mails and there was one from this blog’s occasional Canadian correspondent Anna Smith. It was headed:

PLEASE, NO MORE INJURED AND BLOODIED COMEDIANS…

I thought I started to hear the theme music from The Twilight Zone.

The Malcolm Hardee Comedy Awards disasters

The increasingly medically challenged Malcolm Hardee Comedy Awards Show

Then I opened another message. It told me that Miss Behave – who broke her heel in Dublin a few weeks ago and is compere of the increasingly prestigious Malcolm Hardee Comedy Awards Show on Friday 23rd August… is NOT.

The message read:

“Not possible for me to stay without cutting my foot off and clubbing myself to death with it.”

Miss Behave, rightly, is going back to London to recuperate rather than continuing to damage herself by leaping around Fringe shows in Edinburgh.

I asked Janey Godley – the comedienne who can handle any situation – if she could compere the Malcolm Hardee show instead. She said Yes. Yippee!

Then I opened another e-mail…

It was from Andy Dunlop, the President of the World Egg Throwing Federation. He will be supervising the Scottish national Russian Egg Roulette Championships at the increasingly prestigious Malcolm Hardee Comedy Awards Show on Friday 23rd August. Except that he will not be…

The e-mail said:

Andy Dunlop in happier days

President Andy Dunlop in happier days

I am meant to be in Australia right now but I am not…..

My wife is unwell and starts Iodine 131 radiotherapy on Friday. Currently she is exhausted, can’t sleep, faints a lot, is over heated and very very grumpy.

As from this Friday she will also be radioactive for some considerable time and in quarantine at home for at least 14 days. This prevents her from being left alone, cuddling cats or sleeping with husband. She is upset about item 2.

My suggestion that I bugger off to Edinburgh for a few days may lead to suffering from a beating and probably divorce although it would reduce my risk of cross contamination by gamma and beta emitters.

I am unable to predict her recovery and thus am unlikely to make it for the 23rd but John Deptford, our World Vice President, is available due to his Russian Visa not coming through.  He is better than I at compering. Can he crash at yours?

I said Yes.

But it is going to be a crowded night in my Edinburgh flat on Friday 23rd August.

There will be me, John Deptford, Martin Soan, Mr Methane.

Four men and one bed.

It could be a Richard Curtis comedy.

If Mr Methane farts, he may die.

Perhaps all of us will.

So it goes.

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The British NHS – pain is still pain & death is death despite good intentions

My personal experience of the blind bureaucracy of Britain’s National Health Service – which I blogged about yesterday – continued after yesterday’s blog.

I blogged about how I encountered well-meaning bumbling when I had to have my eyes checked at the Ophthalmology department of my local NHS hospital in Hertfordshire.

My friend's painful horizontal wisdom tooth (left)

My friend’s painful horizontal wisdom tooth is seen on the left

Later yesterday, though, a friend of mine encountered continuing blind bumbling at the Dental department of Guy’s Hospital in London.

She has had painful problems with a wisdom tooth for, I guess a couple of years. A couple of weeks ago, she was told by a very amiable doctor at Guy’s that the tooth could be taken out but, as it was close to a nerve, they would first have to take a cone beam mandible CT scan to see exactly what any potential problems might be.

Good.

It might take six weeks to arrange the scan.

Well, OK.

So it was a surprise when my friend got home yesterday night to find a letter from Guy’s Hospital telling her the appointment to have the scan was arranged for yesterday morning.

She had been away from home for a couple of days.

The letter from Guy's Hospital - bad timing

The letter from Guy’s Hospital – bad timing

The letter for a scan at 10.00am on Friday 15th February, dated Thursday 7th February, had been sent second class on Monday 11th February. In theory, this should have arrived on Wednesday 13th February. If you trust the Post Office.

My friend was at home on the Tuesday, away Wednesday/Thursday and returned at 2300 on Friday night. She missed the scan appointment at 1000 that day. The letter, we think, may actually have arrived on Thursday, one day before the appointment.

In the minds of the no doubt amiable and well-meaning people creating the letter on 7th February for an appointment on 15th February, that was enough notice. But then the letter was not posted until 11th February. It was sent second class so – even if the postal system worked effectively – it would not arrive until 13th February and there was no thought of someone being away from home on two consecutive days.

So well-meaning people bumbled into incompetence.

At the bottom of the letter, it says: “If you are unable to attend your appointment please contact the Department giving 48 hours notice… If you do not attend an agreed booked appointment your form will be returned to the referring Doctor and you will need to contact your Doctor for a new referral.”

So, even if my friend had received the letter on Wednesday 13th (with the mail being delivered late-morning) she could not have re-arranged the appointment with 48 hours notice.

And now, because she did not know about the appointment, she will have to go back to her GP, get another referral, get another appointment to see a doctor at Guy’s, get that doctor to make another appointment for another scan, wait for the system to arrange another scan and then hope she receives a letter in time to know she actually has a scan appointment.

400 - 1,200 patients killed at Stafford Hospital

Stafford Hospital – where 400 – 1,200 patients were  killed

In some parts of the NHS, of course, patients die because of lack of care.

A couple of days ago Lord MacDonald, a former Director of Public Prosecutions, was calling for police to investigate the “needless deaths” of between 400 and 1,200 patients at Mid Staffordshire Hospital between 2005 and 2009.

Five days ago, NHS Medical Director Sir Bruce Keogh announced that nine English hospital trusts were to be investigated because of abnormally-high death rates:

– North Cumbria University Hospitals NHS Trust

– United Lincolnshire Hospitals NHS Trust

– George Eliot Hospital NHS Trust

– Buckinghamshire Healthcare NHS Trust

– Northern Lincolnshire and Goole Hospitals NHS Foundation Trust

– The Dudley Group NHS FT

– Sherwood Forest Hospitals NHS FT

– Medway NHS FT

– Burton Hospitals NHS FT

My experience in Hertfordshire and my friend’s experience in London are of course – in comparison – wildly trivial. But they are a sign that, even when well-meaning people try their best, the NHS (perhaps like all large bureaucracies) is a mess.

In the case of the NHS, though, it is not just inconvenience which is caused but, in my friend’s case, continuing pain and, in many other people’s cases, death.

From tiny, slightly deformed acorns do vastly warped oak trees grow.

My friend phoned the number on the letter this morning and got no answer.

“It rings and rings for ages, then cuts off,” she told me.

So she then phoned the main telephone number at Guy’s Hospital.

“You get a voice recognition computer which asks for the department you want,” she told me, “If you ignore it, it gives you operator. The operator told me the Appointments Department is only open weekdays.”

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Britain’s National Health Service: Sod’s Law. What happened to me yesterday.

NHSlogo

Mostly amiable but badly organised

I have said it here before. What’s the point of having a blog if you can’t have a moan?

My mother had the eye disease glaucoma. So did my father’s mother. And so, I think, did my mother’s cousin. It is hereditary.

If you get it and the doctors catch it early, you can be cured. If they catch it late, there is no cure. You will go blind.

So I have regular eye tests.

After the last eye test, my local optician said the pressure on my right eye (always my weakest eye) was slightly – but only slightly – abnormal. So she sent me for more tests at the Ophthalmology department of my local NHS hospital. I went yesterday afternoon.

I am not going to name the hospital because the people who dealt with me were well-meaning people and trying to do their best. But, as in most of the rest of life, meaning well gets tsunamied by Sod’s Law and everything goes arse-over-tit.

When I eventually got an appointment, it was not in a letter. I got a phone call last Friday (the 8th) from a computer with an automated voice. It told me I had an eye appointment at my local hospital on Thursday the 14th at twndthee.

What?

Twndthee.

I phoned the number a couple more times and, as far as I could tell, the automated voice was saying “twenty to three” but I was only, perhaps, 65% certain. It might have been twenty past three or something else to do with three. Or possibly two. If it was, indeed, saying “twenty to three” they had, presumably, programmed the computer to say that phrase as it is friendlier than saying “two forty”.

A good intention. But the result was less clear.

I decided to wait for the inevitable letter.

This arrived on Monday confirming that, indeed, my appointment was at 2.40pm.

On Wednesday, I got a phone call from a genuine and very polite human being asking if I could come a little earlier – 1.30 instead of 2.40.

No problem. All agreed. Earlier appointment at 1.30 was confirmed.

Yesterday morning, my eternally un-named friend asked me: “Are you going to drive there?”

“Ah!” I said. “I had forgotten about that. I think they put eye-drops in and warn you not to drive.”

I looked at the letter.

“There’s nothing in the letter about it,” I said.

So I phoned up the telephone number on the letter.

“What is your reference number?” I was asked by the very amiable man on the other end of the line.

I read the reference number on the letter.

“Not that number,” said the very amiable man. “I need the reference number.”

“That is the only number I have,” I said.

“What is your NHS number?” he asked.

I read it off the letter. There was a pause.

“…and what is your password?” the very amiable man asked.

“Erm…  I don’t know,” I said. “I didn’t know I had one.”

“It is on one of your reference sheets with the reference number,” said the very amiable man.

“I only have one sheet,” I replied.

“I cannot process your request without a password,” said the very amiable man. “The reference number and password are on the referral letter sent by your GP to the Hospital.”

“I don’t have any copy of that,” I said. “I only have the appointment letter sent to me by the hospital.”

“I need a password to process your request,” said the very amiable man.

“I am having eye tests at the hospital in a couple of hours for glaucoma,” I said “and just wanted to know if I was allowed to drive. I wondered if they might be putting eye drops in which would mean I shouldn’t drive.”

“I cannot speculate on the answer,” said the very amiable man, “but sometimes they put eyedrops in. I cannot speculate on what they may do without access to your medical records, which I cannot access without your password.”

So, yesterday, I got a bus to my local hospital for the 1.30pm appointment. I arrived early and had a cup of tea. Then:

1.20pm – I turn up, present my letter to the receptionist and point out I have been asked to come for the earlier 1.30 appointment. No problem. I am logged in.

2.25pm – I think it best to check. I politely asked the receptionist if he can double-check what time my appointment is. Much fiddling on computer. “Two forty,” he says slightly aggressively. “Ah,” I say.

2.35pm – I am called in to the very amiable nurse, who makes the first tests on my eyes, photographs the back of my eyes and tells me she doesn’t think there’s any real problem, but I will be having two more sets of tests by other people and then seeing the Consultant.

"Wait in here," I was told

“Wait in here…” I was told by my first very amiable nurse

2.50pm – She takes me to another examination room and says, “Wait in here. You may have to wait a bit of time for the other tests.” I sit down. She leaves.

2.59pm – Another very amiable nurse comes into the room to get something and is surprised I am sitting there. I tell her why and I describe the nurse who left me. This second very amiable nurse takes my name and goes off saying “I will check.” I tell her: “The other nurse told me I might have to wait a bit.” The second nurse tells me with a smile: “Don’t worry unless it starts to get dark.”

3.06pm – The second very amiable nurse comes back into the room again to get something, looks surprised again and asks, “Any luck yet?” I say , “No.”

3.11pm – The original very amiable nurse comes into the room to get something, looks surprised to find me there, and says: “Oh, you’re not supposed to be in here: you’re supposed to sit outside” (in the corridor). I go and sit on a row of seats in the corridor.

3.17pm – I hear my name being called about 15 feet to my left, in the original waiting room. It is a very amiable Consultant. He examines my eyes.

The end result is he says I have no signs of glaucoma. “Your nerves are way too healthy,” he tells me. “When I look at them, they’re lovely and pink, lots of nerve tissue there. You’ve got thick corneas so, when they test your pressure, particularly with the air puff machine, they’re going to get false, high readings. The most important question is Is this pressure damaging your nerve? and the answer is No. Your nerves look 100% healthy. They’re lovely.”

“So I can put my nerves into the 2016 Olympics?” I ask.

“Yes,” says the Consultant.

Everyone was very amiable.

The organisation was a mess.

No one person was to blame.

That is life.

Sod’s Law.

I guess death in the NHS is much the same.

So it goes.

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The sick state of British healthcare

Back in November, I blogged about having to get a Wellington boot cut off me with a pair of scissors in a shoe shop and, towards the end of December, I was moaning about how my foot still hurt – as did my shoulder, which was broken in an accident in 1991.

They were both still hurting quite badly a couple of weeks ago, so I went to my GP to see if I could maybe get an X-ray done at the hospital. I have no real belief in traditional Western medicine – they rely on drugs to mask the symptoms without curing the cause – but, if nothing else, I thought maybe an X-ray might help my osteopath: he could see what was inside my foot/shoulder.

But the clue to British GPs is in the name. They are General Practitioners. By-and-large, they know a little about a lot but and a lot about nothing: they are (now) highly-paid generalists not specialists; their job is to filter out all but the most serious cases.

A year or so after my 1991 accident, for maybe two-thirds of my waking hours, my shoulder was still giving me a lot of pain – it was like a knife was being shoved in my shoulder and turned. My GP said:

“That’ll last for the rest of your life. What painkillers do you want?”

Instead, I went to a high-profile Chinese doctor, knowing that Chinese medicine is not fast. It aims to cure the causes, not to mask the immediate symptoms. He gave me Die Da Wan Hua oil to rub on the shoulder. I knew, if it worked at all, it might take months or a year. Within three weeks, the pain had gone. That was twenty years ago. Until this past December, the shoulder pain recurred only mildly maybe only twice a year for a few days, usually if I put too much pressure on it; even now, it is nowhere near as bad as it was in 1991 – maybe a tenth  – and only sporadically.

Inevitably, despite telling my GP a couple of weeks ago that the pain in my foot had been going on for two months and the pain in my shoulder for a month, the guy (whom I had never met before – you get whoever is free at my GP practice) pooh-poohed and refused to get me an X-ray and gave me simple painkillers, saying the painkillers would clear up the problem in “a couple of days”.

So, two weeks later, I am thinking of going to a Chinese doctor after I try some Die Da Wan Hua oil myself.

Harold Shipman can’t be the only GP to have killed patients. His only uniqueness lay in the fact he did it intentionally.

Last week, a friend  told me a doctor she knows confided to her there is an unwritten rule-of-thumb (not mentioned to patients) that, unless something is obviously very seriously wrong, GPs only refer patients upwards to specialists if they come complaining three times about the same problem.

Yesterday, mad inventor John Ward (who designed and made the Malcolm Hardee Comedy Awards) told me a story of his long-ago youth when he was “in the engineering game a few years after leaving school…

“Three of us new lads,” he told me, “were asked to go and see the local doctor to have a ‘check up’ to see if we were ‘fit’ due the nature of the job we were going to do – lifting heavy metal and so on…

“When we got to the surgery, we found someone who looked like he was out of Last Of The Summer Wine – a very old, whiskered barnacle of a chap with a stethoscope dangling around his neck.

“He asked us: Do you want the ‘long drawn out’ check-up or the ‘short to-the-point’ one?

“We opted for the short one, natch.

“This consisted of him using what he called his CSF Method.

Right lads, he asked us… Can you Cough? – Can you Spit? – Can you Fart?

“In his book, if you could achieve all three of these acts unaided, you were OK to proceed with your life. We said we could do all three.

Then you can bugger off now! he told us. I have to play golf this afternoon and you’re holding me up!

“With that, he let the three of us out, lit up a fag, got in his car and went off to the golf course.”

John Ward has just been told he is “borderline diabetic” but, a week or so ago, he read in the Daily Mail (which is oddly forever printing diabetic stories) that a woman had also being told she was diabetic but plainly was not.

“Apparently it’s a common ploy,” John Ward tells me. “Starting back in the Tony Blair years, it became a scam for doctors to put folk down as diabetic because they got/still get a ‘commission’ on each one they refer. It’s not a bad little earner for them but apparently the figures suggest most people referred are not diabetic. The nurse I am seeing at the moment says that, despite my GP being ‘absolutely sure’ I am ‘borderline diabetic’, the tests say I absolutely ain’t.

“I’m now on four different pills prescribed by the doctor. I didn’t touch one type of pill prescribed for me but, interestingly, I was told that my recent blood tests confirm that these pills (the ones I am not taking) are ‘doing me good’.”

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I think my body may be starting to fall apart. Perhaps leeches are the answer.

Yesterday was a hotchpotch of a day, starting with the unsettling news that North Korean leader Kim Jong-Il had died. There may be more about this in my blog in four or five months time.

I have been hobbling a bit every since a humorous incident last month in which my left foot got stuck in a Wellington boot in a shoe shop and the Wellington had to be cut off me with a large pair of scissors. Before that, there had been much pulling by various people of my toes and heel with the result that the outside edge of my left heel has, ever since, been painful when I stand on it in my bare feet, though not when I wear shoes. But it has now started to occasionally be painful in shoes, too, so I guess I will have to go to my GP and maybe try to get it X-rayed. Two visits to my osteopath have not cured the problem, which he thinks is caused by problems in my toes, not my heel.

The humorous Wellington boot incident happened on 10th November; it is now 20th December. I have had problems ever since.

When you are younger, you think old people move slower because it is in their nature. As you get older, you realise it is often because of pain or the anticipation of pain.

Now there is something for me to look forward to.

Well, it seems I don’t even have to look forward. It is here.

My left shoulder is also giving me occasional pain after a visit to an osteopath (not my own) who was going cheap in a Daily Telegraph offer. She poked and prodded the flat stretch between my left shoulder and neck, which was damaged when I was hit by a large truck while standing on the pavement in 1991 – or was it 1990?- I can’t be bothered to check – and it has been more painful since then.

I think I was born too early.

The 19th century was all about mechanical inventions. The 20th century was electrical and electronic advances. The 21st century looks set to be an era of biological discoveries and advancement.

I was born too early.

John Ward with some Malcolm Hardee Awards for Comedy

I was thinking this yesterday lunchtime and then mad John Ward, designer of the three annual Malcolm Hardee Comedy Awards and eccentric inventor of bizarre contraptions, e-mailed to tell me he had designed the ultimate bird table and I could see it on YouTube.

I think it has some echo of the villain’s lair in The Spy Who Loved Me crossed with the Martian tripods in War of The Worlds – someone else who saw it just thought it might attract foxes.

Perhaps the 21st century will not be all biology.

Perhaps eccentricity will proliferate.

I then had to go to hospital to have a minor operation: the surgical removal of two growths – well, OK, two little bobbly things were cut off my skin by a highly-trained and I presume highly-paid consultant with a scalpel. He is, in all seriousness, professionally called a ‘Lumps & Bumps’ consultant and, like 50% of doctors, has a good sense of humour.

One of the lumps – well, as I said, it was more like a little bobbly thing of soft flesh – has been growing on the side of my neck for a couple of years or so; the other has been growing, mini-mushroom-like, on the inside of my upper left leg like my body was trying to grow a second, more impressive penis (not difficult) beside the original one.

I don’t know which was more embarrassing: having the two bobbly things sliced off or having the consultant comment unfavourably on my bright yellow socks.

As this happened in a private hospital, we (my accompanying friend and I) were given tea and two Quality Street chocolates afterwards by the very amiable Irish nurse who told me that, if you give blood in Edgware, they give you cup of tea, a sandwich of your choice and crisps. As I have shamefully not given blood for about three years, this is tempting.

Blood transfusion centres used to just give you a cup of tea and a selection of biscuits. Things are looking up, though my friend opined she has never fully understood why doctors stopped using leeches and ‘bleeding’ patients on a regular basis.

For hundreds of years, people seemed to think that it was an effective and positively healthy thing to do. Can they really all have been wrong?

She may have a point, but where can one get leeches nowadays?

On a more 21st century subject, she discovered her O2 dongle does not work with Apple’s new Lion operating system because O2 have not pulled their finger out and updated their system. The Lion OS has been in use for months and O2 has sold customers dongles that no longer work. There may be biological advances in the 21st century but one thing seems likely to remain the same – all British telecom companies are equal.

‘Incompetent wankers’ seems to be the suitable phrase which covers this.

When I got home after the (admittedly not what anyone could call major) operation and the major trauma of realising O2 is selling products which do not work, I was almost immediately phoned by Adrian ‘Nosey’ Wigley: always a cheerily uplifting experience. I do not think we have talked this century, though I did mention him at the end of a blog a couple of months ago.

I booked him on a few TV programmes in the 1980s and/or the 1990s to showcase his impressive talent for playing Spanish Eyes on an electric organ with his nose.

His nose has not lost its musical ability and I am surprised he has not popped up on Britain’s Got Talent.

He lives in Brownhills in the West Midlands which, when last I heard, was home to several Guinness world record holders.

I think it’s the tedium that gets to them.

I hope, in the 21st century, it is eccentricity which proliferates.

Life can be so uneventful.

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What happened when I was admitted to a mental asylum when I was newly 18

I was born on Friday 28th July.

Just after my 18th birthday, on Friday 11th October, I tried to kill myself because of a girl. I have blogged about it before.

Obviously I failed and after I got out of hospital – as was not uncommon then – it was suggested I should go into a mental asylum. It was at Goodmayes, Ilford, in East London.

On Saturday 19th October, I wrote to a friend in Wales about it:

________________________

I never was any good at chemistry in school – I think I once managed to come next-to-bottom instead of bottom. I got out of King George’s Hospital on Wednesday afternoon. My underpants and one black sock had disappeared mysteriously while I was in there.

On Wednesday evening, I went in voluntarily to Goodmayes Hospital (the nuthouse) because I knew I wanted a rest and they thought I wanted help.

I was only there for one day because, on Thursday evening, I discharged myself, much to the annoyance of a point-nosed grey-haired man – a charge nurse – slightly balding, who filled in all sorts of forms and kept muttering about the extra work.

There was a secretary to the point-nosed grey-haired charge nurse – tall, thin and always reading intently – who laughed nervously at anything. He laughed loudly and shrilly. A really shrill laugh. He seemed like a patient, but he was one of the staff. The difference between the staff and the patients was that the patients walked slower.

Anyway, this charge nurse bloke was giving me what sounded like a prepared and rehearsed lecture on how I should not discharge myself and, at the same time, he was rolling a cigarette, looking down at it while he rolled it.

“You’re not reading it from the cigarette paper, are you?” I asked.

“Now why do you say that?”

“Hallucinations?”

“Well, it could be…”

I think that was why he was not too keen on letting me out.

He thought I might be seeing little green point-capped and grinning goblins crawling out of cracks in the walls.

When I had arrived at Goodmayes Hospital on Wednesday night, I had been very depressed. Very in the pits. They gave me a pill which gave me a surge into emotional elation. I did not really want to be elated but I had no choice. It was like a rocket taking off inside my body after I took the pill. Phwoeeeeeeehhh! Mindless happiness. I had trouble getting to sleep so they gave me two sleeping pills. The difference between the staff and the patients was that the patients walked slower.

The next morning, a doctor interviewed me at his desk in his room.

“You seem to explain it very well,” he told me. “I am talking to some students tomorrow. You can come and talk about your feelings to them so they can understand how someone like you thinks.”

The last thing I wanted to do was to talk to a room full of students like some academic lecturer. I wanted a rest. I did not want an audience. I wanted to be away from people. I realised they were not going to let me alone. I wanted a rest and they thought I wanted help.

I was in a ward with about ten people.

There was a queer bloke with glasses and smiling, intent eyes who had not had a shave that day. He kept going on about masturbation and had I ever let anyone do it to me and how good it would be. He was one of the nurses. He had started as a nurse in Goodmayes Hospital seven years ago, then left and been a clerk and a book-keeper and all sorts of things but then he came back.

“I came back to take care of people like you,” he told me.

When he heard I was discharging myself, he looked me deep in my eyes and told me:

“You’ll be back. People always come back. They think they won’t. But they come back.”

Also in the ward, there was an Irishman who read books about three inches from his nose and held them tightly with both hands and never looked at anyone, avoiding any eye contact with anyone else.

Then there was the hairy man with a torn pyjama jacket who lived in a triangular padded room at the back of the ward. They let him out for meals. He walked oddly, like he was doing it in slow motion. He would say: “Charles the First said it would happen,” and “Charles the First said he would never indulge it. He said he would never indulge it,” and “Harold Wilson Harold Wilson Harold Wilson Harold Wilson.”

And then there was the 20 year-old boy in the wheelchair who said he had a jaw disease.

“I’m in here because I have a jaw disease,” he told me.

He looked backward but I don’t think he was.

He kept talking about how he used to go mountain climbing and bog exploring.

“I used to like to go to quiet places and old ruins where I was completely alone,” he told me. “When I was outside. Before I came in here.”

He told me how he wanted to go camping and hiking. How told me how he threw cups and plates and bottles up in the air and liked to see things destroyed.

“I like to see things destroyed,” he told me.

He did nothing but cut out pictures of the athlete Lillian Board.

He was making a large Olympic chart backed by hardboard, covered with pictures of Lillian Board.

When I told him I was leaving that night, his eyes were like the sea without waves. He told me his girlfriend Evie, who used to live in Chingford, could not visit him very often.

“She has gone to live in Exeter,” he told me.

I gave him my address. I told him to write to me and promised to visit him.

When I left, the queer bloke with glasses and smiling, intent eyes was telling him about an isolated shed in the gardens outside the ward.

“You will be in here for a long time,” the bloke with glasses and smiling, intent eyes was saying to the 20 year-old boy looking up at him from the wheelchair, “And I will be in here too.”

_________________________

After I got out, I never wrote to the boy in the wheelchair. He never wrote to me. Other things happened.

Two years later, the athlete Lillian Board died of bowel cancer, 13 days after her birthday. She was 22.

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