Do British doctors actually understand female anatomy…?

My opinion of the Britain’s National Health Service, from experience, is that, like all large bureaucracies, it is an utter, incompetent mess.

But my opinion of doctors and nurses working within the NHS is one of sky high admiration.

My opinion of the GP (General Practitioner) level of the local NHS, though, is somewhat lower. And this has not been raised by my chum Ariane Sherine‘s recent experience.

She shared this – jaw-dropping but totally true – on Twitter this week…

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(Ariane Sherine’s latest book is The How of Happy… The 51st way to be happy might be: “Don’t talk to your GP…”)

Medical update. Genetic testing, maybe “unexpected results” and Red Bull…

I was hospitalised for a week in May 2020 and – again for a week – in July 2021. On both occasions, my calcium level had suddenly sky-rocketed to a dangerous level which resulted in my kidney function plummeting to a very, very dangerously low level.

The only positive thing to come out of it was that the second hospitalisation resulted in a seven-day series of fairly dramatic blogs. I await offers for the TV sitcom or Netflix movie rights.

Both times when I was hospitalised, after a week of (I think) basically just saline drips, my calcium/kidney function levels returned to non-dangerous though still abnormal levels.

But the doctors had absolutely no idea why the levels had, without warning, suddenly gone mad in the first place. 

Subsequently, it was impossible to treat the problem because the cause was completely unknown.

Multiple scans, X-rays, blood tests and bunging radioactive material into my blood stream has failed to find any cause. But it happened twice. Without warning. I am taking no medication to stop it happening again nor to normalise my levels because, with an unknown cause to treat, there can be no treatment.

To add to the confusion, in February 2022, according to a blood test, without warning, my calcium level suddenly returned to pretty-much normal and my kidney function – although not 100% right – became reasonable, not dangerous and it seems to be stable. My kidney consultant said, at first, he thought he had been given the wrong patient’s results. He and my calcium consultant told me the cause of the suddenly-improved results were a total mystery to them.

The latest idea to try and find out what is going on is that I am going to be given a genetic blood test. Apparently this costs the NHS “a few thousand pounds”.

I seem to have a main kidney consultant and a second, associated, kidney consultant. In a video call yesterday, the latter told me:

“There are some genetic tests we want to do. You’ve been through every test in the book and no-one’s figured it out. It would be a useful thing to do. We’re just looking at a certain panel of genes.

“The thing about genetic tests,” he added, “is  they can sometimes throw up unexpected results or sometimes unwanted results. It’s unlikely in this case, because we’re not looking at everything; we’re only looking at things to do with calcium – the panel of genes that control calcium.

“But, even then, we have to warn you that there’s a possibility it could throw up unexpected results, OK? Theoretically that could have implications for family members.”

I am uncertain whether or not this means I could discover I am related to Adolf Hitler or that I am a member of a previously-unknown alien race.

“The results,” the doctor told me, “could take ages: it could take six months, something like that. It’s not going to be fast; and then we’ll take it from there. It’s going to be very exciting to try and find the results. You’re only the third patient I’m doing this on.”

I’m not sure whether I should be gratified or worried by that.

One thing no-one seems interested in is that I felt ‘light-headed’ – a sort of woozy, floating, uncertainly-balanced feeling inside my head – in the lead-up to my first hospitalisation in May 2020 and this continued until roughly New Year this year, 2022. 

In March 2021 – in fact, for a few months – I had occasional, very serious vertigo – having to hold on to the walls or anything static to avoid falling over while the world whizzed around me. This went away after a few months but the slightly unbalanced and unbalancing feeling inside my head continued until…

In around October 2022, on a whim, I started drinking a can of Red Bull in the morning. 

As soon as I started doing this, the wooziness in my head decreased then stopped and, since then, I drink a can of Red Bull every morning with breakfast. My balance is better; in fact, my balance is now fine.

I never drank any Red Bull between the lead-up to May 2020 and October 2022 (remember I was hospitalised again in July 2021). So the Red Bull could not have contributed to my problems but, bizarrely, it seems to have helped alleviate some (I guess side) effects. 

I think I have read that Red Bull – basically it’s caffeine and sugar – can be dangerous because it speeds up the heart. But, as my heart beats quite slowly – in the low 50bpm when resting – this might not be a bad thing.

Now the UK National Health Service wants me to attend a nuclear facility…

My last blog was about the reliability of the NHS – You can always rely on their organisational arrangements to be in total chaos.

Basically, I was told that a Renal hospital appointment I never had was being moved to a date which doesn’t exist. I was told that the new appointment was on Tuesday 20th November – but 20th November is actually a Saturday. 

The same message also said I should attend the “Kidney & Urology Dept on Wednesday”… with no time nor date mentioned.

Neither the previous non-existent appointment nor the previous non-existent new date were on a Wednesday.

None of the above has been sorted out yet.

So imagine my lack of surprise when I got home around 8.00pm last night to find I had received a letter about a totally different new hospital appointment unrelated to the other two (or it might be three) previously confused appointments.

I have ongoing calcium level and kidney function problems which put me in hospital last May and this July. 

The previous confused communication had been about the hospital Renal (ie Kidney) Dept and the Kidney & Urology Dept.

This new missive was about a forthcoming appointment with the Nuclear Medicine Dept at the same hospital with which, on Monday 29th November, I now have an appointment to have a Spine and Hip Bone Density scan or, as the letter says, “Bone densitometry DXA”.

This scan has never been mentioned before at any of my chats with my Kidney Man and my Calcium Man – and neither have my spine nor hip been a source of interest – but I’m prepared to believe it’s a legitimate part of the search for what’s wrong with me. I had a PETscan at the same Nuclear Medicine Dept in August this year. A PETscan is the one where they inject radioactive material into you and then (as I understand it) look at it circulating in the body.

I have been told by two separate consultants that I am a “man of mystery” because no-one has any idea what on earth the cause or causes of my calcium/kidney problem is/are.

This means, among other things, of course, that I cannot be treated because they have no idea what they should be treating. They know the result of my problem but they have no idea of its cause.

The actual doctors seem efficient and thorough.

But the NHS bureaucracy – like all large bureaucracies – is a catastrophe of incompetence.

More UK National Health Service chaos: my life is in their incompetent hands…

In hospital in, erm… who knows when?

As long-suffering readers of this blog will know, I was in hospital for seven days in May last year and again for seven days in July this year with a very high calcium level and (as a result) dangerously low kidney function.

No-one has been able to find out the cause. So I keep seeing consultants, mostly kidney and calcium men.

My kidney/calcium levels are pretty-much but not-quite back to normal now. But, still, no-one has any idea why they twice went dangerously haywire.

I wrote a blog in August this year when I simultaneously got three completely self-contradictory and chaotic letters about NHS hospital appointments.

Doctors, of course, like to use posh names, so ‘kidney’ staff are usually called Nephrology or Renal staff… and ‘calcium’ staff are usually called Endocrinology staff. In what follows, I have anonymised the hospital names as Hospital A and Hospital B.

In September, I was told my next appointment with the Nephrology team (my Kidney Man) would be on Monday 13th December at Hospital A.

Then, this afternoon, I got a text from Hospital B, which is part of the same group as Hospital A: 

Renal means Kidney.

The message concluded:

“Please attend Hospital B, Kidney & Urology Dept on Wednesday. TO RESPOND please follow this link…”

I did and responded:

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I’m confused. Can you clarify?

I have an appointment to see Nephrology at Hospital A on 13th December at 10.30. (See attached letter.)

I had no appointment to see the Renal Dept at Hospital B on 16th November. 

And the ‘new’ date you give – Tuesday 20th November – does not exist (20th November is a Saturday).

You also seem to ‘confirm’ I should attend a Kidney & Urology appointment at Hospital B “on Wednesday” (no time given but presumably either Wednesday 10th November this week or an unknown Wednesday in December).

Could you tell me if the ‘new’ Renal appointment on Tuesday 20th November (a date which doesn’t exist) is the same as the Kidney & Urology appointment I have never previously heard about at an unknown time this Wednesday 10th November?

If I do have to attend Hospital B this Wednesday, could you give me a time for the appointment?

John Fleming

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I await a reply with open-mouthed interest but little hope of efficiency or factual accuracy… It is always a tad worrying when your life and death is in the hands of large impersonal bureaucracies… All large bureaucracies are inherently incompetent…

My difficulty in self-isolating before a minor hospital operation during Covid

(Photograph: National Cancer Institute via Unsplash)

I am probably going to have a minor operation at a local hospital next Friday.

I say ‘probably’ because, when I was phoned-up at around 8.30pm last Thursday night (three days ago), I was told the operation could not be 100% confirmed until Tuesday (two days from now).

I say the ‘probable’ operation is at a ‘local’ hospital though, to get there, I have to travel on two trains.

Anyway, because I am probably having this minor operation on Friday, on Tuesday afternoon I have to go to the same hospital and have a Covid test – just for safety. The result will be known two days later.

After having the Covid test on Tuesday afternoon, I will need to self-isolate for the rest of that day and for the whole of Wednesday/Thursday before turning up for the operation on Friday morning.

This is, of course, to avoid my being infected by anyone between having the presumably negative Covid test and the operation.

Which is fine…

Except, of course, that, after the Covid test on Tuesday afternoon, I will be taking two trains to get back home.

And, on Friday morning, I have to turn up at the hospital by 08.00, which will involve me travelling on two fairly-crowded early-rush-hour trains to get there.

So I will be potentially exposing myself to infection.

A slow UK handclap for the continuing bureaucratic incompetence of the NHS

A standardised NHS container designed for taking the piss

As regular readers of this blog – particularly some recent blogs – will know, I have a very high opinion of the medical staff working in Britain’s NHS.

Equally, I have a very low opinion of all large bureaucratic organisations, of which the NHS is one.

This year I have written several blogs about the NHS’ wild incompetence.

I currently have high calcium level and low kidney function problems which have been going on for over a year – since at least May last year. And the doctors have still got no idea what the cause of the problems is.

That is fine. They are trying.

But it means I have to have dealings with the bureaucratic side of the NHS.

Yesterday I received three letters in two envelopes from the NHS, all dated four days before.

I have had a longstanding appointment to see a kidney specialist in my local hospital at 1030 on Monday 20th September.

The first of the three letters was from my local hospital and cancelled that appointment.

The second letter (contained in the same envelope as the first) was from the NHS Trust/Group to which my local hospital belongs. It said I should ignore that first letter cancelling the appointment. The appointment, it said, was not actually cancelled. I had been put on a waiting list and the appointment would be rescheduled.

The third letter, also from my local hospital and dated on the same day as the previous two, said I now had a confirmed appointment at 1030 on Monday 20th September.

The eagle-eyed may have noticed that is the same time and day as the original appointment which had been cancelled. Sorry! Not cancelled but to  be rescheduled.

I am not 100% certain if the first and second letters are referring to the third letter and the appointment no longer exists.

Or if the third letter refers to the first and second letters and it is rescheduling the appointment, which is now confirmed to be once again on Monday 20th September 2021 at 10.30.

I live on the outskirts of London. All three of the above letters from my local NHS hospitals were posted to me from the NHS in Bristol. 

I have no idea why and, I suspect, neither does the NHS.

The many-headed Hydra of mythology (The Farman Collection, 1987, via Wikipedia Commons)

 

Seven days in an NHS hospital: Day 7 – Agony, staring and coitus interruptus…

(DAY 1 OF THIS HOSPITAL BLOG STRAND STARTED HERE)

Tuesday 27th July

At some point in the middle of the night, a nurse came round and took everyone’s blood pressure. General Davide was fast asleep. The nurse looked at the Friends of the Hospital woman sitting at the foot of his bed and at the security man and said quietly to them: “I do not think it is a good idea to wake him…”

She left the ward without waking him.

I woke from a DEEP sleep around 7.00am with noisy chaos around me. It turned out to be in the bed next to me, which was curtained-off. All I could tell was that there were several nurses’ voices and a man in a lot of pain.

At the staff shift change-over, the nurse in charge overnight went through the details of each patient but, with General Davide, she added: “…and there is the aggression problem which is why he (pointing at the security guard) is here.”

The man in the bed opposite me had a strange look yesterday. He was totally silent and staring. His eyes were wide open and staring blankly, seldom blinking, but he didn’t seem to be focusing on anything… and there was something oddly twisty about his mouth. Like the top half of his face was solid but the bottom half of his staring face had no bones, just muscles and flesh which floated randomly. Like he was chewing but he was chewing nothingness. He seemed very young, maybe in his twenties or thirties. His was propped up, looking ahead, wide black eyes staring, but maybe sightless.

This morning, there were two nurses and a doctor round him. he was less propped-up, his head lying back on the pillows. So his pointed chin was up and his neck was exposed. He looked like an ancient man, 120 years old, drained of life. He looked like some Egyptian mummy, raised from the dead in some 1950s Hammer horror movie.

He was refusing to eat or drink, but silently. The doctors and nurses were trying to get him to respond. But, from him, no words, no moans, nothing. Alive. But just silent resignation to something. I have no idea what.

The new nurse in charge of the day shift is a man. When he injected me, I said: “You’ve done that before, then…”

“I’ve been doing it for thirteen years,” he said.

The young female nurse today is his half-sister. She is a trainee nurse and this is her second day on a ‘real’ ward. She has kind eyes.

“We have the same father,” the male nurse explained to me.

He is Indian. His half sister is Pakistani. And, as it happens, the security guard today is Bangladeshi. The half-siblings both speak Urdu, the Bangladeshi guard does not. But they are very very friendly. In English.

The Friends of the Hospital woman was no longer at Davide’s bedside when I woke up. She must have left during the night or at dawn.

Davide is in a lot of pain now.

In the course of the morning, the man in agony in the bed next to me was removed and replaced by another man in a lot of pain.

The old/young/old man opposite me was left alone, silently staring ahead.

And then I was discharged from the hospital.

My calcium level was down, though still above the normal band of acceptability.

My kidney function was up though was not doing as well as my calcium level and the kidney function’s level had ‘plateaued’ at its abnormal level.

So all is not well, but I was told my conditions were no longer ‘dangerous’.

I and my bed could be released and I can, from now on, be treated as an outpatient. For my slightly damaged kidneys, my calcium level and the mark on my arm which might or might not be Lyme disease and which has now turned into a red smile on my skin.

Though the doctors still have no idea what caused my calcium/kidney conditions last year or this year.

That narrative continues.

But all the other people over the last week are left behind in freeze-frame. Like a narrative coitus interruptus. Like life, this story has no climax. When you die, the narrative just continues without you. So it goes.

I will never know if Michael’s brother arrived to take him away or, if so, where he went and what happened to him. 

I will never know if the man who swallowed his false teeth and the cancer man died a few days later.

Nor will I ever know what happened to blind Italian Claudio or to the boy/old man with staring eyes in the bed opposite me.

As I left the ward, the last I saw of Davide was a glimpse of him walking slowly the short distance from his bed to a chair in the bay window of the ward, which overlooks the entrance to the hospital. It was raining outside.

A tall, thin man with only one arm.

As I left, in my peripheral vision, Davide stopped and the top half of his body bent slightly forward in pain, his head bowed. I think he was carrying a bag of his own urine, but I could be wrong. 

It’s not important.

It’s all in the past, just memories now.

Just like – as Rutger Hauer said – tears in rain.

“The mark on my arm… which has now turned into a red smile on my skin…”

Seven days in an NHS hospital: Day 6 – The one-armed African liberation leader

(DAY 1 OF THIS HOSPITAL BLOG STRAND STARTED HERE)

Monday 26th July

During the early hours of the night, the curtains on the interior windows and the main ward doors were closed while a dead body was removed along the corridor from another ward. A nurse told me they didn’t want patients to see it… nor any staff who might have incidentally interacted with the now stiff. So it goes. 

The ward aggro today kicked off slowly at 4.30am when Michael started getting up and roaming the ward like a caged animal, pacing back and forth and touching objects around the ward as if checking where reality started or ended. Sometimes he was up and pacing, sometimes he was lying in bed; sometimes he was up and pacing, sometimes he was lying in bed; this went on for maybe an hour.

One of the male nurses is religious (a Christian) and he told Michael: “Tell them to go away”.

Michael lay on his bed for a time, repeating: “God, tell them to go away. Please God, tell them to go away.”

He refused to have his various daily medical checks, verbally abusing the nurses, randomly saying he couldn’t get to sleep and that he could only sleep.

Around 7.00am, he started grabbing, pushing and tussling with the security man to get out of the closed door of the ward. The security guy, of course, could only passively resist.

After the shift change-over, Michael told one of the new nurses he wanted to phone 999 because he didn’t think he was well and wanted to go to hospital.

“You are already in hospital,” she told him gently.

“No I’m not!” he snapped.

Michael now has four Covid masks hidden under the pillows of his bed, given to him over several days. He asked for each one. He is worried he might have Covid and, I suspect, he thinks that simply owning the masks shields him from the virus. He has never put on any of the masks (and is not required to). 

The ward has twice-a-week rapid Covid tests on Tuesdays and Fridays.

When the Calcium Man came round with his two two junior doctors and found I had had the constant drip on Saturday but no drip at all on Sunday, he was not a happy man.

“I asked for the drip all weekend. What’s the point of coming in for treatment if he doesn’t get treatment?” he said to his underlings.

So I will be back on the drip again after he sees the blood tests which have not yet been done.

Michael now thinks I am watching him. 

Michael to nurse – “Everybody’s watching me.”

He then went to the loo but came out and asked where the toilet bowl was and complained he couldn’t see any toilet paper – There are two big rolls in a bright blue dispenser fixed to the wall, where they always are.

A nurse showed him the toilet bowl and the toilet paper.

About ten minutes later, he asked again where he could get toilet paper. The security man had to show him the bright blue dispenser fixed to the wall,

Michael is probably leaving today. He asked where one of the nurses lived. She told him. About two minutes later, he said to the same nurse that today he was being taken by his brother William to (the town where she lives).

A young Buddhist nurse talked to him about his life – he told her he used to work in large hotels on Park Lane in London. I switch on the recorder on my iPhone.

He asked her about Sri Lanka, where she came from.

“Michael,” the young girl asked him, “have you enjoyed your life?”

“Nah,” he replied. “Do you have children?”

“Yes,” she replied. “A daughter.”

“Married?” 

“Yes.”

“Your husband’s from Sri Lanka?”

“Yes.”

“Have you ever been married, Michael?”

“No.” Michael said. “Are you happy?” 

“Yes… Don’t think about anything, Michael, just relax your mind.”

“How can you relax your mind?”

“Just forget everything,” she told him.

“You can’t forget everything,” he said, “you just can’t.”

“It’s very hard,” she said, “but you need to get better before you go home. So don’t try to fight with everybody. Just relax.”

“I can’t do it though. I’m not that type of person. I wish I was.”

“You need to relax and have a good sleep.”

“I can’t sleep. I keep going through Who wants me? and that type of thing… What do you do at your college?”

“I am studying nursing. I am still studying.”

“I’m still shaking,” Michael told her. “I can’t relax. I wish I could relax like you. Do you do the Buddhism every day, do you?”

“Yes. I am listening to the sermons.”

“What are they like?”

On her phone, she played him a soothing Buddhist Society sermon about ‘the four ways of letting go’.

Eventually, after about five or six minutes, Michael got up and asked the security man, “Why are you doing this to me? You know what you’re doing. Why are you doing it?”

The security man said nothing.

“You’re a liar!” Michael snapped at him. “It’s too late for me to be a Buddhist!”

At 1.25pm, the cancer man was taken away to the other, bigger hospital for radiotherapy.

The ambulance men who were here on Friday and today are from a county out to the south east of London but are subcontracted to this county to the north west of London because this county doesn’t have enough vehicles. The ambulance men drive their vehicle up here each morning and back each night. I guesstimate it must take them at least 90 minutes each way. Longer if the M25 motorway is clogged with traffic.

While the ambulance men from another county are moving the cancer patient to wheel him out, Michael is asking nurses how to work the shower and demanding attention.

By now, Michael has taken to wandering round in a maroon jacket on top of his NHS pyjamas and carrying a green plastic bag containing, I think, some ad leaflets and postcards.

After excessive rudeness from Michael, the security guard took to sitting outside the ward door instead of being inside.

Michael accepted this situation for about ten minutes then (I think) got lonely and went out to talk to the already overly busy Receptionists.

I think he is maybe trying to fill the loneliness gap. Complaining and being angry/paranoid means you are never alone.

“They want to examine the rash on my arm…”

I am told I am going to be kept in at least tonight because they want to examine the rash on my arm which one of the Calcium Man’s junior doctors spotted a few days ago. They think it might be Lyme disease.

Later in the day, the cancer man was brought back from his radiotherapy. About an hour or so later, after seriously dramatic vomiting, he was given more morphine and a suppository.

After this, Michael started offering to help the staff with their medical duties and offered to buy the Buddhist nurse a beer at the bar. He seems to have confused the Reception desk with a pub bar.

Michael in his self-absorbed dementia reminds me of many a stand-up comic I know.

Two beds away from me, one nurse talks with the wife of the almost-certainly-dying man who swallowed his own false teeth.

Across the ward, another nurse is dealing with Claudio the blind Italian in the toilet. 

And Michael is obsessed with what time his evening meal will arrive and I think offering to take multiple nurses out for a restaurant meal tonight. 

He offers to buy the security man a pint of bitter in the non-existent bar.

My unused monitoring screen (top left)…

At around 6.30pm, at 15 minutes notice, the doctors decide to move me to another ward because they need a monitored bed and mine is the easiest one to get.

There are only three monitored beds in the ward. The one occupied by the almost-certainly-dying false teeth man. The one with the almost certain-to-die cancer patient. And my one. And my monitoring screen is not being used.

So I am now moved to a new four-bed ward in another part of the hospital.

One of the beds is occupied by the one-armed African liberation leader Kofi Davide – the tall man from a small African country – who got booted out of my previous ward for hitting a nurse. (All names in this blog have been changed)

He now has a hospital security man sitting permanently by his bed or in the ward’s bay window presumably in case he decides to hit another nurse.

As I arrived in this ward, a Russian nurse – or, at least, one with what sounded like a Russian accent – was berating the one-armed African liberation leader for “losing” the cigarette she gave him yesterday.

When the shifts changed, he asked a couple of nurses, separately, if they had a cigarette. When they said they didn’t, he said, “Go away!” curtly.

In the early-evening, another nurse came in and she started talking with him about the former leader of his country.

She asked him: “Where do you live now?”

There was a long pause while he did not answer because he obviously did not want to tell her exactly where he lived… then he said: “In the world. In the world. I am a citizen of the world.”

In mid-evening, a black woman (could be British but with a slight African accent) from the Friends of the Hospital took him – apparently out of the building (with the hospital security guard) – and they came back with takeaway food.

He told the very attentive Friends of the Hospital woman that his wife is flying in tomorrow, though it is unclear from where. He told her that his wife is flying in from England.

The Friends of the Hospital woman said to him: “I am going to stay here all night to make sure you are safe.”

And she did. She sat by his bedside all night.

(CONTINUED HERE…)

Seven days in an NHS hospital: Day 5 – “He was punching him in the stomach”

(DAY 1 OF THIS HOSPITAL BLOG STRAND STARTED HERE)

Sunday 25th July

When you twice miss the vein with the needle…

During the night, I woke up to find Michael grappling with a male nurse, trying to push him back with his outstretched hands. The nurse was trying to calm him down by making light of it as if it were a dance. Michael and the male nurse were surrounded by three female nurses and a male security guard trying to calm him down.

I had to go to the toilet. When I came out, the grappling was over. The male nurse was washing his hands and a new security guard was there. He was a stand-in while the night’s main security man had a one-hour break. Michael was back in his bed.

Four or five times during the one-hour break, Michael got up and made a dash for the door of the ward and was silently tussled (reactively – not in an aggressive way) by the security guard.

By the time the main security man came back, Michael was quietly sleeping in his bed.

A bit later on, I was woken by Michael facing-up to the security man who was on his own in the ward. Michael made a lurch at the security man. Michael started punching him in the stomach. There was probably no power behind the punches, but they were still punches.

The security man managed to calm him down by talking to him in a firm but quiet voice.

In the early hours towards dawn, the cancer man asked for and got a double dose of morphine. 

Today, a Sunday, there was no 1-1 nurse care for Michael, just a security guard; there were not enough nurses to spare one full-time to constantly watch over Michael.

The black machine and drip bag on their frame

After the nurses’ shift handover in the morning, I was told that, today, I did not need to have the drips in my arm, but I should drink a lot of water. This made it easier to go to the toilet, because I didn’t have to drag with me the whole wheeled drip apparatus attached to my arm.

Michael was told he could go ‘home’ tomorrow if he allowed them to give him a COVID Rapid Test. At this point he was meek and quietly allowed it.

And for most of the day he was fairly quiet. I figured this was because he had been told he could leave if he behaved. He was fairly quiet. But, mid-afternoon, another possible cause was revealed. He had had diarrhoea all day.

Michael, as most days, was alternating between meekness and aggression but today meekness had the upper hand..

I read a piece in today’s Observer newspaper online:

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Pay for nurses and other NHS staff in England will have fallen in real terms by more than 7% since 2010, even if they accept the latest offer from the government, according to new analysis that will fuel rising anger about public sector pay deals.

Figures produced by the TUC show that remuneration for nurses, community nurses, medical secretaries, speech therapists, physiotherapists, paramedics and radiographers will have dropped by between 7.3% and 7.6% in real terms in just over a decade, even after factoring in the 3% rise offered last week.

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The nurse in charge of the ward yesterday was telling another nurse that, when she goes home at night, she has to sleep with her legs on five pillows and her head on two pillows. She has a shoulder injury. If she didn’t sleep like that, she said, she wouldn’t be able to come in to work and function properly.

What on earth poor blind Italian Claudio makes of all the current shenanigans in the ward, heaven only knows. Lots of unknown voices around him in a language that he only has a passable not good knowledge of. He has had to learn the words Left, Right and Straight when he is guided by a nurse to the toilet with his Zimmer Frame.

At 4.00pm, Claudio started saying he is going home tomorrow. He isn’t.

He must have picked the idea up from Michael.

And, ironically, Michael has decided that he does not want to leave and go to “that place” tomorrow and is trying and failing to get his brother William on the mobile phone to cancel it.

Michael has now taken to occasionally either curling up on his bed in a foetal position or sitting on the edge of the bed, head bent, gnawing at the fingers of his clenched hand like a caged bear going mad.

Around 6.30pm, after a quiet day, Michael started sniping at other people claiming they were conspiring against him.

At around the same time, there was discussion among the nurses because a Covid non-believer was going to be brought in to a neighbouring part of the ward and had refused to take a Covid swab test before admission. 

One of the nurses said that, although she would, she didn’t really see why she had to look after “people like that”.

Another said: “I’m in the 13-to-24 age group, so I will do it.”

Presumably this is also happening elsewhere in the country and it must put the nurses in a moral quandary – they have to treat all patients even if the people they treat may cause a risk to them by reckless behaviour.

We seem to have two, maybe three security guards tonight.

(CONTINUED HERE…)

Seven days in an NHS hospital: Day 4 – “You’re doing it on bloody PURPOSE!”

(DAY 1 OF THIS HOSPITAL BLOG STRAND STARTED HERE)

Saturday 24th July

I was woken up from a deep sleep at 07.00am to have my blood pressure checked. 

This is significant because I actually had some real sleep last night. Michael settled down after two or three hours last night and I don’t think caused chaos by wandering around, talking in rambling forgetfulness etc etc.

It is potentially a big day for him today as his brother William is allegedly coming to pick him up at 2.00pm.

No 1-1 nurse care for Michael today, just a security guard; they don’t have enough staff to spare a 1-to-1 nurse.

This morning, Michael didn’t get up until 8.45am, making a staggery break for the door to get out of the ward but not wearing the bottom half of his pyjamas. He was caught and re-directed to the toilet. 

At around 9.20am, there was an almighty crash of crockery, cutlery and loud sundries as he threw (well, I think maybe kicked) his breakfast off his trolley/wheeled table onto the floor. One plate was broken; the rest bounced.

The cancer patient in the bed next to me told the male nurse that there seemed to be blood on his (the cancer patient’s) pyjamas. It turned out it was jam from his breakfast.

At 10.45am, Michael started complaining that he was hungry and had not been given breakfast today. 

Round about midday, without warning, I was taken in a wheelchair to some imaging unit – a slightly-better than X-ray place. I had no idea why. A porter pushed the wheelchair and a nurse accompanied us.

All three of us wore Covid masks. 

Reception at the imaging place said that an appointment had been made by my Calcium Man but at no specific time. So no spot was booked. After about five minutes of the nurse and the receptionist discussing this, a woman coincidentally came along with the paperwork. It turned out the appointment was to look at my liver.

When we were waiting outside the actual imaging room, another patient was waiting with us. He either was – or was the spitting image of – a middlingly-famous actor in British B-movie gangster films. He told me he had been put in a ward with mad people. No sleep at nights for him because (like Michael) they were speaking all the time.

He mentioned the name of the ward.

My nurse said: “Yes, that’s a dementia ward.”

“They said it was the only bed they had free,” the maybe-actor replied.

My liver was said to be OK and I was taken back to my ward.

The grand daughter of the cancer man was in for a one hour visit. She had travelled up to North London from Brighton.

Normal visitors are not allowed in the hospital but a close blood-relative can come in to be with an end-of-life relative. The man has incurable cancer. They are going to start giving him radiotherapy treatment. It will not cure the cancer but it may (or may not) stop it spreading further. 

The man with cancer and his grand daughter talked about what was going to happen after he died. Cremation. No church. Money in a Cyprus bank account. 

Simultaneously, Michael was complaining to a nurse that the chain in the ward toilet had been taken away. In fact, it never had one. It is just a handle-flush toilet.

The grand daughter was telling the man with cancer: “No, we won’t forget you.”

Michael’s brother William arrived at 1.15pm and said, in fact, he isn’t taking him home but that it has now been arranged that Michael will be “released on Monday” and “taken to a hotel” for “consultation, to see what you want to do”. 

I think this means he is going to be taken into a care home. My iPhone voice recorder is a wonderful thing. (All names in this blog have been changed.)

William: Well, you been here about two weeks, haven’t you?

Michael: No! About three months… four months… It’s driving me mad. I’m very nervous, very anxious.

William: Yes, I would be, too. 

Michael: How you doing?

William: Well, Carol, my son’s wife’s got cancer, you know. This is the hospital where you were having the cancer treatment done, wasn’t it? But you haven’t got cancer.

Michael: Well, they say that. They say that.

William: They told you you haven’t got cancer. You’re definitely leaving Monday now. I’ve booked it. You’ve only got one more day, tomorrow, here. It’s Sunday tomorrow and you’ve just got one more day. You’ve only got tomorrow. On Monday, I’ll be here to sort it.

Michael: I get about three meals a day here; that’s all. It’s not worth the money.

William: Don’t worry. Everything’s free in the hospital. It’s just one more day here.

A couple of hours later, Michael phoned the police and said he was in Hospital and was imprisoned, unable to go home and do what he wanted and it was “like being in a concentration camp”. They said they couldn’t help and told him to talk to the staff.

“Did you just call the police on us?” a male nurse asked gently. “Why did you do that?”

“I can’t go anywhere. I can’t do anything.”

“We let you move around,” the nurse said. “We listen to you.You can talk to us as often as you want. You should be speaking to your family, not talking to the police.”

“I never see my brother,” said Michael. “He doesn’t come here.”

Michael again refused to take the eye drops prescribed by the doctor then, later, complained about his declining sight and that he was going blind. That is his latest obsession:

“I am going blind and need to see a doctor about it!”

The nurse offered again to put the eye drops in, but Michael yelled: “Eye drops ARE NO USE! I’m GOING BLIND!”

Meanwhile, in the bed next to him, Claudio the Italian actually IS blind.

Michael’s thoughts about going blind seem to have started when Claudio arrived.

“What do you put in the eyedrops?” Michael was saying accusingly to the young nurse. “They make my eyes bloody worse. I don’t know what you’re doing, do I?”

“Please, please?” the young nurse said.

“I’m diabetic,” Michael told her.

Later, a soft-voiced young Asian nurse came to give Michael his nightly medication. 

“Take your tablet now… Please.”

Michael pretended to take the tablet with water but threw it on the ground.

She noticed.

“This is not fair,” she told him reprovingly. “This is not fair, Michael.”

He bent down to pick the tablet off the floor.

“I will give you a different one,” the nurse told him. She gave him another tablet and watched him take it.

“Why are you doing this to me?” he asked her. “What have I done?”

In today’s nursing shift, coincidentally, one of the black male nurses and the Indian security man speak Italian.

Occasionally they talk to Claudio in Italian. He talks happily to them. His English is very weak.

Sometimes the person Claudio is talking to in English has to deal with something elsewhere in the ward and, without telling him, they wander off. Blind Claudio does not realise this, so carries on, believing he is having a dialogue but actually he is talking into the nothingness in front of him.  

With the Italian-speaking security guard, Claudio was (I think) sharing his life. He was talking animatedly about Roma, the Pigalle and Hertfordshire. 

The security guard went off to attend to something else and Claudio carried on unknowingly talking to no-one for about 5 or 6 minutes. He eventually realised there was no-one there and sat back in his chair looking into space, a sad smile on lips.

After a while, the security man came back and said a few words to him. Claudio replied but the security man wandered off again. Claudio again kept talking into space and eventually sat back again, his fingers feeling the smooth plastic surface of his wheeled trolley.

Meanwhile, the cancer man got more morphine.

At about 9.00pm in the evening, Michael threw a wobbly.

“I don’t know what I’m doing. I want to get out. My brother is  coming to see me.”

“Michael,” a male nurse said, “He came at lunchtime. I need to take your blood pressure…”

“Come on, then.”

“…and I will give you your eye drops.”

“I want to get to see my brother. Get away from me! Please, hurry up, come on… You do it on purpose. You do it on purpose. My brother’s coming today… Come on, you’re doing it on bloody PURPOSE!”

“What?”

“You’ve done it on purpose, yes you did!”

“Did what?”

“Ive already had the eye drops today.”

“What time?”

“Earlier on. I don’t want them again today. I’m getting out. I’m getting out of here. My brother’s coming. I don’t want to stay here! Get out of it. Stop it! STOP IT! STOP IT! You do it on purpose, don’t you?”

“Do what, Michael? Why are you fighting with me?”

“I want to get out and see my brother! He won’t come here.”

“What,” another nurse asked, “is your brother’s name, Michael?”

“Michael,” he replied then, after a slight pause, “William… William!”

“Why don’t you call him on your mobile phone? Phone him and ask him what time he is coming.”

Michael left a message on William’s home answerphone. 

A couple of minutes later, someone (I guess William’s wife) phoned back. I heard only Michael’s end of the conversation:

“I’ve just given you a phone call. What time is Will coming today?…… He’s been? He hasn’t been here. I haven’t seen him yet…… No, but I’ve seen him yesterday. Today I’m seeing him…… No, I didn’t see him today! I didn’t see him! I didn’t see him at all today…… He hasn’t seen me…… (STARTING TO SHOUT) He DIDN’T see me today! He HASN’T!…… So what now?……Hello? Hello, it’s Michael. Hello?”

A few minutes later, Michael said to a nurse: “No, I’m not going anywhere because I haven’t found him. (STARTING TO SHOUT) No, I HAVEN’T FOUND him… No, I haven’t seen him today. I haven’t seen him. He said he’d be about eight-ish o’clock. That’s now. I don’t know what to do. I know, you’re laughing at me. You’re bloody laughing at me. I can see you. Why did you say he’d seen me? He hasn’t seen me.”

Michael crossed the ward to another nurse.

“Bloody liar,” he said to her. “Bloody liar.” And he walked away from her.

Ten minutes later, William phoned him.

Michael said: “So you’ll see me Monday again. What do you mean you saw me today? I didn’t see you…… You didn’t see me…… Yeah, well, no, what’s the day today anyway?……Saturday? That was yesterday, though…… Look, I don’t want to spend it in a place like this, Will. I hate it, you know? I don’t want to spend my last days in a place like this. I hate it Will, you know?…… Well I probably won’t see you Monday anyway……The people here are trying to stop me coming out…… Monday, yes.”

(CONTINUED HERE…)