Friday 27 May 2022

BREAKING NEWS - UPDATE!

 I posted recently about my accident and what happened in the first week thereafter.  A number of people were kind enough to compliment the piece and even to ask if there would be a follow up, since there would still be three weeks to go in hospital after I'd come round from the first operation.  I thought about that and decided I would have a crack at it, but that it would have to be a different sort of piece - a bit more reflective perhaps - since much of what happened during those three weeks was dull and repetitive, which doesn't make for a great read.  So what follows is a bit experimental.  I hope that if nothing else it'll help get me back into writing!

BREAKING NEWS - UPDATE!

I open my eyes and look around.  Familiar surroundings.  As comforting as a dentist's waiting room can be.  But…I AM NOT IN THE DENTIST’S WAITING ROOM!!  Might have fooled me once but not twice.   There are the same masked figures scurrying round though and three or four other beds containing patients that I’m fairly sure haven’t been put there by the dentist’s inadequacies.  This is definitely the recovery room so I must have had my second operation.  Yes, look, a nurse is trundling her machine up to take my blood pressure – a procedure with which I have grown all too familiar in the last three weeks.  She says something about a sandwich.  ‘Low blood pressure?’ I enquire knowledgeably.  She nods.  ‘Yes, but not as low as last time’ which makes me wonder just how low it had been.

It's now a fortnight since my first operation which was itself a week after the accident.  I try to take stock.  Family and friends of course have been brilliant, as has the NHS in taking care of me thus far.  But beyond that have I learnt anything – about myself or about the system that has taken over my life?  When I dispensed careers advice in a former life – a former century even – I talked a lot about nursing and the information and advice I passed on may well have been sound.  But it was probably about the wrong things to a large extent, or – to be kinder to myself – not enough about the right things.  The reality of twelve hour shifts on a busy ward full of demanding patients.  The older nurse with back problems who nonetheless struggled to help me in and out of bed.  The man in a nearby room who constantly called ‘Help me, please help me!’ then when one or more nurses responded to his cries yelled at them to get out.  ‘Get out!  Get out!!  Bang!!’  Was he miming shooting them?  Probably.  Fortunately he was there for only a couple of nights but long enough for me to find out that ward staff didn’t enter his room without security being present.  And then there’s their unrelenting focus on bowels which featured in very few – if any – of my careers guidance interviews.  The observation is not mine – it was made to me by a senior nurse.  ‘Yes,’ she remarked, ‘to be a good nurse you have to be fixated on what goes in one end and what comes out the other.’  The truth of this was borne in on me one day when my daughter was visiting and a lesser deity than the one who had carried out the first operation swept into the room with a backing pantheon of would-be deities.  They looked like a 60’s pop group – think Billy J Kramer with the Dakotas but without the screaming.  There must have been five or six people clustered round the bed when the curtain was swept aside to reveal a nurse who – oblivious to all else – announced her presence in a voice which stopped Billy J dead in his tracks. ‘Have you moved your bowels today?’ she demanded. The truthful answer – yes, but with great difficulty and to not much effect – seemed rather too much information for the assembled company so I merely nodded weakly and assured her I had.

She was one of very many nurses and other ward staff I met and got to know who were of Afro-Caribbean descent, largely, I imagine, descendants of the Windrush generation.  At a rough guess a good three quarters were in this group whilst of the rest very few would have ticked the White British box on those ubiquitous ethnic monitoring forms everyone sends out.  The Royal London Hospital – and I suppose many others – simply wouldn’t function without them and they looked after me impeccably and for the most part cheerfully.  On the very few occasions they weren’t cheerful it was more than likely a reaction to my feeling at a low ebb.  But how could I fail to be moved by the nurse who attempted to take my blood pressure in the middle of the night without waking me up?  She almost managed it but not quite.  Or even more moved by the two or three who told me they would remember me in their prayers?  I have no doubt that they did.

I also learnt that hospital life consists of a very few flashes of elation, long periods of tedium and occasional moments when it would be easy to give in to despair.  The first of these followed the achievement of some landmark – an operation successfully completed or the first time I was able to take a few steps – white knuckles and all – clutching a Zimmer frame.  One small step for a man; one giant leap forward….  The body blow which was having the second operation postponed happened twice, both times late in the afternoon of the scheduled day.  The pre – operation routine started the evening before with nothing at all to eat or drink after about 9 o’clock and on both occasions I expected to be taken to theatre around lunchtime.  But the Royal London is a leading trauma hospital and patients coming in with life threatening conditions will jump the queue.  It sounds perfectly reasonable sitting here typing it but it feels a bit less so when you finally get the dreaded message about 4.30 or 5 o’clock, and realise that it’ll be another three or four days before there’s another chance.  As a result I stayed in hospital about a week longer than planned, but on the second occasion I was impressed to find that the senior surgeon made a point of coming to my room to apologise in person and explain what had happened.  It would have been easy to delegate that to the ward staff.  But on both occasions no meal had been ordered so it was back to sandwiches and chocolate bars.

I doubt if I learned as much from the periods of tedium as I might have done.  I was though surprised to discover that you can actually look forward to a trip to X ray as a means of breaking the day up, and also surprised that it’s not easy to make very positive use of the rather large amount of time you have on your hands.  Or, indeed, on your back.  Pain killers made sure I wasn’t in too much pain from the injury or the surgery, but didn’t seem to do a lot to ease the discomfort which comes from spending too long in bed – the back, the base of the spine and the bum are the pressure points which protest most vigorously and this of course makes it difficult to concentrate for any length of time on reading or writing.  Which doesn’t leave a lot other than emailing, crosswords and old episodes of Porridge and Yes, Minister – increasingly brilliant the older it gets – on iPlayer.  Oh, and my son kindly bought a subscription to BT Sport so I could compound my anguish by watching England’s Ashes humiliation.

Talking of Porridge, there’s an episode where the old hand Fletcher is schooling first timer Godber in the importance of savouring ‘little victories’ – small ways of beating the prison system.  Being in hospital for a few weeks is a bit like that – but in my case savouring moments of humour which puncture some of the unnerving intensity of being cocooned in an institution which largely runs your life for you.  I felt just like Fletcher, in fact, although the staff who dealt with me were much more benevolent than Mr McKay.  There was the catering lady who swept in early on the morning of a scheduled operation day to announce that she knew I was nil by mouth but what would I like for lunch?  Or there was the nurse who answered my call for assistance in the small hours of one morning when my back and coccyx were getting increasingly uncomfortable.  He did what he could to re-arrange pillows – I think I had five – and blankets to make things a bit more tolerable.  ‘Take it easy!’ he breezed as he left the room and I smiled at the incongruity.  For some time and because I was inactive I needed a daily injection in the stomach to prevent blood clotting.  The nurse who administered it would usually precede the injection with a bright smile and a ‘slight scratch coming!’, so it caused great hilarity when I said it for her one day although she was shaking with laughter somewhat alarmingly as the needle went in.  On another occasion though I did feel I ought to adopt a fatherly tone (grandfatherly?) with a young student who flashed the bright smile well enough as she had no doubt been trained to do but then changed the accepted form of words to ‘just a small prick!’  As gently as I could I suggested this wasn’t a good idea – I dread to think what Mr Get out! Get out!! Bang!! would have made of it – whereupon she momentarily looked blank, then seriously embarrassed and laughed nervously.  I was delighted that she turned up a day or two later saying she needed a witness statement from a patient for her training course and hoped I would provide her with one.  I decided not to mention the unfortunate choice of words.

One thing that had increasingly intrigued me was the question of how I was going to travel the couple of hundred miles to get home.  Unable to walk more than a few steps and then only with a Zimmer frame I didn’t much fancy the Hammersmith and City Line from Whitechapel, change at King’s Cross for the main line to Hull.  I mentioned this to one or two people who frowned and talked about how they would ‘repatriate’ me – a wonderful phrase that I thought they must have picked up at a seminar led by Priti Patel.  It turned out eventually that I was to be ‘repatriated’ by means of a fully equipped NHS emergency ambulance with a crew of two, all provided free of charge by the NHS.  Not only that, but I was to be repatriated with a perching stool and a commode that couldn’t be transported by the same ambulance and had to be entrusted to a separate courier.

Come the much anticipated day of the journey and I found out what it was like to feel elation, boredom, despair then elation again all on the same day and all at a high degree of intensity.  I hadn’t had to manage such powerful conflicting emotions since the days of parenting small children.  At first I was dressed and ready to be driven home quite early in the morning – real clothes after four weeks in hospital gowns! - then it was put back to eleven o’clock, then about two o’clock.  By about four o’clock and with no information as to what was going on – or wasn’t going on – I was convinced nothing was going to happen that day and that I was going to be stuck in hospital indefinitely with Covid numbers rising and staff shortages meaning that nobody would be available to take me home any time soon.  Murder was close to being done, but it wouldn’t have looked good to have to ask my intended victim for help in getting me out of bed first.

Then finally at about half past four and without warning a man and a woman showed up wearing the uniform of the Kent Ambulance Service.  They’d come to take me home, they said, although clearly didn’t know where Hull was and were a bit taken aback to find how far they’d got to go, a journey of fully five hours.  When we stopped at Watford Gap services the driver asked if I was in much pain and looked pleased when I said it was getting worse. ‘Oh good’ he said, and catching my look of surprise added ‘it’s just that if you are in pain my boss has cleared me to drive on a blue light.’  I’m sure he was pleased for themselves as much as for me, knowing that after dropping me they would have to drive the ambulance back to Maidstone in Kent, a journey of some 225 miles.  And so after four weeks I arrived back in Hull in a blaze of blue lights and with two tone horns blaring. 

‘It’ll give the neighbours something to talk about’ I said.

She smiled. 

‘It always does’ she said.

 

Friday 22 April 2022

BREAKING NEWS

 Hello

It's been a very long time since I last posted an edition of The Autolycan and I must say I've missed it.  When the pandemic struck I found it very hard to summon the enthusiasm to write the sort of stuff I generally do - in particular it struck me that whimsy might go down very badly if it arrived in someone's inbox in time to coincide with some truly dreadful news.  I was considering whether to restart the blog when something else intervened.  This is the story of that something else, how it began and where it had taken me after about one week.  I won't say I hope you enjoy it because it's not really that sort of thing - it's rather different from my usual style! - but I hope you find it interesting. 


BREAKING NEWS

I open my eyes and look around. I'm in the dentist's waiting room. Familiar surroundings. As comforting as a dentist's waiting room can be. A bit busier than usual. I wonder why. Someone in a white coat and wearing a mask bustles silently past with a clipboard, then bustles silently back again. Odd. The receptionist is always very chatty and not given to bustling anywhere. New? No matter. Must be some time since I last went to the dentist because procedures have clearly changed a bit. Don't remember them taking your blood pressure in the waiting room before, but another masked figure now looms up and does just that, looks briefly concerned, asks if I would like a sandwich and when I say I would says she'll see what she can do. I've never got that far before, not even with the chatty receptionist. More figures hurrying purposefully, some with clipboards or iPads, some with mysterious bits of equipment. What's that about?  Never mind.

She returns. 'I've brought you an egg mayo and a cheese and tomato.' She watches approvingly as I eat. As I do so I look round and notice for the first time that the waiting room is larger than I remember and there are several beds round the walls; some of the dentist's other patients occupy some of them. A man with a stethoscope round his neck approaches and asks if I'm feeling OK, nodding sagely when I say I am. 'Good' he says 'we'll have you back on the ward just as soon as your blood pressure has stabilised. It's been a bit low, you see. It's why we wanted you to eat something.'

At long last it dawns on me this isn't the dentist's waiting room and I try to think back through clinging fog about the last few days. It must have been a week or so ago – Friday 19th November - that Olwen and I had caught the train from Hull to London to go to see our daughter who lives in Croydon. This includes walking through from King's Cross to St Pancras to transfer to the Croydon train. Somewhere near the taxi rank I caught my foot, tripped and fell, my right side bearing the brunt of the fall. I felt a bit shaken up but there was no real pain. Had there been an ominous cracking sound though? Humanity sometimes gets a bit of a bad press for being callous or unfeeling but the admittedly small sample of it that immediately rushed to my assistance was anything but. One man took charge of the situation and wouldn't let others help me up until he'd satisfied himself that I wasn't in pain and was ready to make the attempt. Several strong arms then hauled me upright and supported me as I gingerly attempted to put weight on my right leg. I couldn't.

A wheelchair materialised from King's Cross and when we said we were on our way to St Pancras I was wheeled across to their first aid room. I had fallen between the two stations and a lively debate now ensued as to whether King's Cross or St Pancras should take responsibility for me.  St Pancras lost, whereupon King's Cross triumphantly demanded his wheelchair back. I was transferred from one wheelchair to another and began a long wait for an ambulance. Four and a half hours, they said, so it was a relief when one turned up after only about three and a half. Anything but a relief though as the realisation hit me that pain or no pain I was completely unable to move my right leg.

I liked the ambulance crew. Professional and sympathetic they splinted my right leg to my left and were alarmed by the way the right foot wanted to roll outwards. I got an accurate diagnosis there and then from those two. 'I don't think you've broken your hip,' one of them said 'I think it's something else. Could well be your pelvis.' I might have blanched a little at that, and he immediately changed the subject. 'By the way,' he went on 'I hope those aren't new or expensive trousers because the nurse who prepares you for X ray will probably have to cut them off.' But she didn't, and when I mentioned the crew's warning I was rewarded with a huge grin. 'They didn't know you gonna get Mary!' she chuckled.

Following an excruciating couple of hours when I was manhandled between wheelchairs and stretchers for X rays and a scan I was admitted to University College Hospital's A and E ward for the night, an enlightening experience had I been in the mood to appreciate it. A woman opposite spent most of the night groaning, calling for help and declaring that she was going to die. A young man in the next bed had a loud consultation with doctors in the small hours during which he confirmed that he'd been having intercourse when the accident happened. Involuntarily, I boggled. I boggled a bit more when they asked if there was a lot of blood and he agreed that indeed there was. It was then their turn to boggle when they asked if he was taking any prescribed medication and he replied 'yes, methadone.' Another young man in the corner who looked scarcely capable of movement of any kind was being closely guarded – well, guarded – by a couple of bored-looking prison officers who spent the entire time fiddling with their mobile phones.

Happily, I was soon moved from the A and E ward and wound up in a single room where the main distraction was a frequent loud crashing sound which could be heard at any time of the day or night and which I eventually discovered emanated from an ancient dumb waiter protesting at being coerced into service. Its joints sounded in worse condition than mine. I stayed there for a couple of days, during which time two young doctors breezed in, excitedly clutching a mobile phone . 'We've got your X rays here!' they announced, gesticulating at the screen in a most animated fashion. 'Impressive!' They pointed to what they claimed was my pelvis although it could equally have been a blurred map of the London Underground. They grew confidential. 'Fascinating,' one of them breathed ' you normally only see that as a result of high speed impacts like car crashes. Not from just falling over.' I had visions of being Stunna of the Week on the cover of The Lancet. They interrupted my reverie and brought me back to Earth. 'Sorry,' they added 'it'll be a long job.'

The hospital which specialises in this kind of repair work is the Royal London in Whitechapel and I was duly transferred. Think of the Blind Beggar pub just down the road - the haunt of the Kray twins who specialised in invasive procedures of an altogether different sort in the 1960s. Building work at the Royal London meant that the crew who took me were briefly unable to find the way in for stretcher cases and I spent some minutes on my back in the car park contemplating the night sky. Once they'd found the right lift – not easy in the Royal London – I was taken to my own room where a day or two later I was visited by a man who was clearly regarded in the hospital as some kind of deity. 'If you were going to do this you've chosen the right place to do it,' he intoned, as a row of breathless acolytes behind him took awe-struck notes. 'We are the leading hospital in the UK for this type of injury' he went on, not entirely modestly, 'and in fact get surgeons visiting from all over the world to see what we do.' I didn't feel especially lucky although in a way I suppose I was. He confirmed the ambulance guy's diagnosis. 'You haven't broken your hip' he said 'you've forced the femur up into the pelvis where it's smashed the socket' - he peered indulgently over his glasses, '- we call it the acetabulum – that it's supposed to fit into. We've developed a two stage process for dealing with this – firstly we go in and repair the acetabulum with plate and screws, but this will promote arthritis in the hip so to forestall that we go in again a week or so later and conduct a full hip replacement.' I hadn't previously realised that your head can spin and your mind go blank at the same time.

The first operation was scheduled to take place about a week after the accident during which time I could probably have come close to despair, not least because I was quite unable to get out of bed. I got through it thanks to constant love and support – and visits, COVID notwithstanding – from my family and seemingly endless messages from friends both in this country and abroad. My phone and my tablet became absolute lifelines. Olwen began clocking up the first few hundred of what must eventually have turned into a couple of thousand or more miles on trains.

Around lunchtime on 26th November – except it wasn't lunch time for me having been nil by mouth since the previous evening – I was wheeled down to the operating theatre. To my surprise I was awake until I was inside the theatre itself and could see the table, the lights and a battery of bafflingly incomprehensible equipment. A kindly anaesthetist ambled across for a chat and I recognised him as the one who'd come to see me earlier in the day. He'd stunned me then by asking if I'd like to be sufficiently awake during the operation to be aware of what was going on. I'd mulled that one over for very nearly a nano-second before telling him that I didn't think I was as brave as that and was relieved to discover that most people felt the same. He smiled. 'Look away now' he murmured gently as he slid a needle into the back of my hand. I did so and blinked.

I open my eyes a split second later and look around. I'm in the dentist's waiting room. Familiar surroundings. As comforting as a dentist's waiting room can be....