How the NHS failed me and mine.
What it did, to the most important person
in my life and how it could happen to you unless
we do something about it!

Thursday, 23 February 2012

Loss of Innocence ( 7 days in June).

(Part One)

For one of quite some age such as I, it was strange to lose my innocence. The events were so profoundly life changing that I was caught up in a whirlwind of doubt, dysfunction and misery. My career, what was left of it, my control of events and even my very life became threatened by a calamitous and traumatic sequence of events that came to pass, at the hands of the NHS.

I had until that time had some respect for that bastion of Healthcare, probably because I had used it infrequently and when I had, my expectations were quite low because that which was wrong with me had little in the way of a cure. Osteoarthritis, glaucoma and cataracts can be ameliorated but completely cured, no. I never expected it and Healthcare did not let me down, especially when it came to the cataract, that was made worse by lens implant. Posterior Vitreous Detachment it was called, made all the worse by that short window before it's occurrence when I saw real colour's for the first time in years. Such a revelation; the world was so bright and vivid, well for 48 hours anyway. Then it hit, and from that day and henceforth, life was to be viewed through a mist; a fine net curtain, obscuring detail and it's recognition.

I was already quite depressed at that time, with my life already falling apart at the domestic level, as it had been for years, but I had ignored it by immersing myself in an arduous routine of work and more work, not wishing to address the pain because that way it wouldn't hurt. I did decide that any further eye surgery would likely be counterproductive so I settled down to live with what was left, and then tried to address my life before the remainder slipped through my fingers.

And I did; I found a sort of happiness, that gradually replaced the pointlessness I had felt that slowly swelled and for the first time in more years than I remembered, plans started to form. The NHS; well they had made a mistake, but it wasn't life threatening and we all make mistakes after all. I didn't bother complaining very much and accepted the explanation that PVD was always possible when ultrasound is used to remove the old lens. Pity no-one had informed me it was possible, but hey-ho them's the breaks.Then,one summer day in June I learnt that the NHS's hubris (and mine) had consequences that can reverberate throughout your life, and that colossal mendacity is practised daily, along with cognitive errors that can only be judged as incompetence (or stupidity).

She, with whom I will end my days, was off in front, pushing on up the hill, pedals whizzing round, whilst I paused, foot on the ground, gasping for the air that effort had stolen from my lungs. Then, with graceful ease, almost in slow motion, she fell from the bike and landed heavily on her side. With increasing fear, I dropped my cycle and staggered over to her, my breathlessness no longer from effort but panic. She was white with pain and emitting low screams. I tried to help her up but the pain was too great. I made her as comfortable as possible with my jacket under her head. Her pulse was racing, breath coming in short pants; she was definitely in shock. Fumbling with the damn (not so) 'smart phone' I cursed it's stupid step logic, but finally got through to the Ambulance Service and told the story almost screaming for help. It seemed a lifetime in arriving and all I could do was to keep her warm and still and feel inadequate.

I suppose I knew already what was wrong. Foot turned out, unable to move her left leg and in great pain, it had be a femur fracture and worst; probably at the top, the dreaded hip fracture. It took three of us to get her into the ambulance using a crude device of a blanket to help immobilise the joint and with blue's and two's slowly drove down the hill (yes that hill) to A&;E. All throughout the journey I found myself praying to a God I didn't even believe in, for her to be alright, that it could be a dislocation, that she would be home tonight or tomorrow at worst. I was of course wrong, and no God was listening to my prayers, as always.

At last ensconced in a cubicle, her ordeal began. It took nearly three hours for an X-ray, just after she got some Paracetamol (Acetaminophen; as if that was going to be of much use). More than four hours to even see a 'doctor' (some FY1 child), who didn't really say much, partly because her English was somewhat poor, and partly because she was out of her depth. The notes got lost, then they were the wrong ones, as I pointed out that J' was not a teenage male with a broken arm. This caused some consternation and after that I never saw any notes in evidence. Some four hours in, she was given IV morphine but not until (apparently) she had an ECG; this came to light only after perusal of the notes some six months later, but as neither I nor her witnessed any such event I very much doubt it. Also she had a 'ghost' chest X-ray, of which she has no recall as no machine was placed over her chest only her pelvis, but again that only came to light much later.

After some six hours from admission, some nurse or other (we had seen a few) informed us both that J' had a broken hip which by this time the cleaner could have diagnosed. What type she did not say. She did say that an operation would be needed to 'fix' it, but again did not say what type. So ill informed and bemused we were shown up to a ward. Through what seemed miles of corridors and one lift journey we arrived and I was placed on a chair at an unlit corner of the nurses station to ponder and stress about what was to come. My brain was racing through the likely short and long term outcomes and I was searching my memory for long forgotten learning of the human anatomy and biology from nearly fourty years before. I filled in the admission form for J', ensuring I noted her problems (she had a 'stiff' arthritic left knee from a riding accident from twenty years before) and intake of any med's, which was only a high Omega 3 supplement. An hour later, which seemed forever, I was summoned to her bedside through the darkened ward bay and into the curtained area that surrounded her.

She was in tears. Without me there to support and question anything; J' is primarily an Accountant, with no knowledge of anything remotely related to Medicine or Health, she was confused and distraught. And yet I had been excluded whilst some Surgical 'on call' FY2 had explained some of what was needed for her operation and had asked for a signature of consent. Being presbiopic and without her reading glasses she had then requested my presence, which is likely the only reason I had been called at all. She asked for my help and passed the form to me to peruse. I clearly recall it as being one sheet of paper simply requesting consent for anaesthesia and little else, this was to turn out to be critical but by that time 2 am, with no food and little water, up since 6.30 am the previous day, we were both somewhat 'punch drunk'. The very young (and very beautiful) black woman who faced me explained in halting English, what was to occur in the morning. It was garbled, almost incoherent but the word 'hemi' kept coming out. I didn't have a clue. After some patient questioning by me it transpired she meant that J' needed a half hip replacement which was some sort of repair. Thinking, in my orthopaedic ignorance, that half was better than whole I suggested that we had little choice than to concur and J' signed.

I then spent half an hour with her, before they decided to kick me out, clinging to her, not wanting to say goodbye, with a sense of doom coming over me. I left my contact details with the nurse on duty and took the number to contact the ward stating that they must let me see her before the 'op'. I know how capricious a general anaesthetics effect can be, but despite my advice J' had said she did not want to be 'awake' when they sliced her thigh open. I explained she would not be awake as such as she would be liberally plied with tranquilisers as well as the regional anaesthesia but she would have none of it. That, I had to admit made me a little resentful (sic), but it's her body and I knew she was quite squeamish, so I pressed her no more.

I wandered through the long corridors and found an exit eventually. I found the car I had illegally parked in the empty disabled car park, with my Police ID prominently displayed on the dash. The parking Gestapo had consequently ignored it and I made my escape; well I tried to. I was so wound up, so preoccupied (and knackered) that I went round the perimeter road twice before I found an exit to the real world; where people could walk, laugh and get drunk, which is what I wanted to do, right then, more than anything.

I entered the empty flat and went straight for the Rum. I hardly diluted it at all, just tipped a small slug of Cola into the half full glass. I sat in the window, with it wide open, staring into the night, or what little was left of it. An impending sense of doom was all I could feel. Thus far my experience of the Hospital was one of confusion and incompetence; like a ship steering through a storm with no-one at the helm. I was frightened that my sight of J', in that bed might actually be my last. And I now had little confidence that the outcome would be good, whatever happened. I felt like the last man on the Planet, and I was scared, no terrified, that I could be losing her after years of letting her down. Had I let her down again? In the next few days I was to find that was the least of her problems. Because the NHS was much more adept in that than was I. And what was that the paramedic had said, "how do you control your diabete's?", what the hell was that about?

Note to reader; this is too hard for one instalment, even after three years. It would also be too long. You will find some of it so unbelievable that I could not make it up. 'On the Ward' will be posted soon.

2 comments:

  1. the a&e charge nurse2 March 2012 at 11:27

    Just came to your blog (via jobbing doctor) - I'm very glad I did - thanks for the education

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    Replies
    1. Thanks for the kind words. There's lot more to come yet; I hope you find it equally interesting. Please also remember that my rants are not directed at all within Healthcare, I have many friends who are, for whom I have high regard. But, I do feel even some of the 'good guys' have forgotten the real goal of 'do no harm'.

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