The Lockdown Diaries 11: Chemo-Lad VS Fear

Observatory

As the ultimate nerdy child who could end up in A&E after tripping off a kerb with a book in one hand, I sensed I would enjoy a lifetime peppered with doctors’ visits. The annual vaccines were a staple, of course; polio, dypyheria and others that left giant permanent scorch patterns on the upper arm. There was a permanent awareness of tuberculosis, whooping cough, chicken pox, measles and mumps, all of which ‘could go the wrong way’. Balancing this was the better British diet (locally sourced fresher food, free milk and juice) and healthier, more active lifestyles. Who drove their kids to school?

When I step into hospital every morning at 9:30am, I’m always surprised by just how shell-shocked many of the patients are. Some, like my brother, have never been inside one in their life. For decades the NHS needed a radical overhaul. Instead, in came layers of middle-managers and outsourced private units, and the unworkable and now abandoned NHS patient record system which has so far cost the taxpayer nearly £10 billion, with the final bill likely to be several hundreds of millions higher.

The resulting Frankenstein’s monster of a health service became a Kafkaesque system of endless meetings, projections, targets and holistic refinements that could not work for the simple reason that illness cannot be so easily labelled, rated and ratified. Hospitals have to think on their feet because nobody ever plans to get sick. As the population ages departments are added on which are no longer organic to structure. Hospitals became physical and mental mazes.

A patient suddenly admitted into hospital for the first time faces a comprehension test that’s not been revised for; you’re being dropped into grid of obscure rules with one way of doing things, the details to which you are not privy. At least nobody makes you try to pay up front – or pay at all. When I ran out of options at the start of Lockdown I tried to have one of my tests handled privately and was told by the doctor, ‘You’re better off going to the NHS, they have more expertise.’

And it’s true. The frontline staff draw on their reasons for choosing this career, and are extraordinary. Getting sick is a double shock. 1. You feel terrible! 2. You’re sitting in a corridor full of really sick people and have no real idea what’s going on! But once you’re over that you can start to reassess your feelings.

It’s working. You’re being seen. The slowest wait times occur when you’re outside the system trying to get in. The pandemic is changing the system fast. The NHS has a long history of lateral thinking to get around government cuts so it can turn on a penny and refresh the way it works. Triage is the key. Admittance counters are computerised so everyone on your case instantly knows where you are. Instructions seem chaotic and off-the-cuff but work if you follow them.

I’m not especially brave, but I have some form in this area, and fear is 4/5ths of the problem. Illness, like dreams and photos of dogs, is intrinsically boring. Worse, it can come to define you to the point where people dread asking how you are. There’s a sort of treatment one-upmanship with other patients that occurs too. ‘How long’s your chemo?’ ‘Six weeks.’ ‘Oh. Mine’s only four.’ ‘And I’m having radiotherapy.’ ‘Oh, as well? That’s serious. Bad luck.’

Which is the point where I get out my book and bury my nose in the pages again.

 

12 comments on “The Lockdown Diaries 11: Chemo-Lad VS Fear”

  1. Jan says:

    Chris re for decades the NHS needed a radical overhaul. Trust me in about 10 days this March it certainly got one..

    As an example the complete ‘re modelling of DCH without the main A+E even shutting down was gob smacking just completely amazing. A covid A+E unit was + created major clinics relocated. Minor operating theatres plus a few major theatres converted to ICUs. I honestly didn’t think we could have ever achieved this. Happened though.

    I hope everything is progessing well with your treatment. Am working fair bit @ present have not got round 2 writing . Keep chugging along. Just finished “Strange Tide” had forgotten how funny it was.

  2. brooke says:

    Sweetie, the NHS Frankenstein monster you describe is US healthcare in spades–and we didn’t even have to pay consultants –just insurance companies –at lot.

    Did some time in one our hospitals in 2019–learned to take kindle and ear buds so no one would talk to me.
    Hugs to you and your spouse. Take good care.

  3. admin says:

    I nearly took my iPad and headphones until I realised that I’d probably miss my name being called!

  4. Administration, how much of it does the NHS need? You have N thousand sick people, you treat them. How much cost control does that require?

    Waiting lists, why do we have long ones? If people become ill at X hundred per week, medics have to see that number per week – even if they have to wait 6 months for the appointment. Of course, a long wait may shorten the list, if the patient recovers, dies or goes private in the meantime.

    I hope that the powers that be learn from the present crisis that the NHS is fundamentally a wonderful organisation. It should be allowed to do its job: smart people playing doctors and nurses to make us well. There are other lessons: the disaster of abandoning manufacturing industry and self-sufficiency, but I go on too long.

    And please don’t mention stepping of kerbs! I twisted my ankle doing it outside the V&A. It took only two years to recover passable function.

  5. SteveB says:

    Polio was a sugar cube I was so happy there was one without needles! Actually 2 sugar cubes because there was a booster a year or two later.
    I am the same age as Admin more or less and there was still smallpox vaccination, that was a deep scratch I remember.
    Scarlet Fever and Whooping Cough I think were the others.
    Tb was the one that left the blister, we had that at 12 of 13 I think.
    No MMR we just got the diseases, in my case I got Rubella (“German Measles” back then) twice.
    Things were simpler then…
    On the other points I agree on the diagnosis but not the underlying causality. I’m quite familiar with the German health system and the comparisons are interesting.

  6. SteveB says:

    PS a film about an Exam with a blank paper, I’m going to look that one up. And Tone Hooper’s first film was easily the best, the career in reverse like Orson Wells

  7. snowy says:

    ‘Exam’ is quite good despite being a micro-budget, It feels almost like a ‘Play for Today’, where the idea is more important than the production gloss.

    [Jan, if you fancy an older example of re-purposing; Brighton Pavilion was turned into a hospital for Indian troops during the Great War, it was thought, in a sort of well-meaning way that the architectural setting would provide comfort.]

  8. Ian Luck says:

    I found an old Betamax videotape in my room with ‘Britannia Hospital’ written on the label. I have the novel of the movie somewhere. My evil side wonders if you could have got away by telling someone gullible that it was an NHS instructional video? I reckon Trump would think that it was real.
    “Why always the negative vibes about Trump, Ian?”
    “Because I think the man is an utter C**t.”
    “Fair point.”

  9. Anne Billson says:

    Ian – Britannia Hospital is coming out on Blu-ray next month.

  10. Helen Martin says:

    Translink is asking people to wear masks on buses and SkyTrain. All vehicles are being wiped down inside for sanitising and people are to space themselves in vehicles. Worksafe B.C. are checking all worksites. Why do I find the head of Translink’s Aussie accent annoying? Can you imagine classrooms with teachers wearing masks? There’s a lot of change in all our systems and I am so glad that Dr. Bonnie Henry is the one who is talking to us about all this, ably backed up by the provincial Minister of Health. Not that she has all the answers, or any ultimate answer at all, but she keeps us from panicking, which is much of the battle.

  11. Ian Luck says:

    Anne – thank you for that. I shall order a copy immediately.

Comments are closed.