Tuesday, 15 February 2011

Just one patient

Blood tests every morning. One arm then the other, then back to the first. Now it's my hand for some reason. And now it's the other hand. . .'You have lovely veins.' Thanks. I think.

On Friday I saw my consultant who said that he was happy for me to leave provided my INR - the level of the clotting ability of my blood - was over 2 for two days running. We had not had the results back from that morning's blood test, but he felt sure that it would be fine and I should be out on the following day. He shook my hand, as he always did, and away he went.

That night was particularly bad. The patient from across the corridor was being particularly persistent in his escape attempts and a collection of security men were called. They all looked like extras from The Sopranos - pale and wide - and I wasn't quite sure what their remit was. They seemed to simply be a human barrier between the tagged would-be escapee and the door alarms. They were like bouncer's outside a nightclub. Except the outside world was the nightclub and we didn't have the right dress code.

This particular patient came into our bay more and more during my stay. He was tall, well spoken, bald (scarred naturally) with a high distinguished forehead. He looked like a headmaster or a bank manager or a senior civil servant - or would have had he not been dressed in claret pyjamas. I woke one morning to find him standing over me. He looked like he was judging me and finding me wanting. It was a little disconcerting. Mainly though it was just sad to see a man who had clearly been a figure of some authority reduced to wandering the ward, lost - terribly, terribly lost.

Occasionally he would leave things - a carrier bag, a drink he had taken from a nurse - or borrow things, walking off in my neighbour's slippers one time. Another time he stood at the foot of the same man's bed - he had just had a large tumour removed from his head - as the nurse did his rounds. 'Will he race again?' he asked the nurse.

On one occasion he actually got into another patient's bed, much to the amusement of the nurses. But they were not spiteful laughs. They were so caring towards that lost man. And anyway - who could begrudge them a laugh on that ward. I should think you have to take the laughs when they come.

During my whole time there I never encountered a grumpy or jobsworth nurse. They all seemed totally committed to their jobs and superhumanly patient. More than that - they were simply kind. And can you train someone to be kind?

I was treated with the same seriousness as the far more critical cases around me and they in turn were treated with the same light and friendly touch as me. Even if a patient showed no visible signs of being aware, they still chatted to them and explained every procedure in the same way as they did with me. 'I'm just going to take your blood pressure, if that's OK,' they would say to a man who showed little sign of being conscious. There was something incredibly touching about that. I heard a nurse telling a colleague that she had felt pulled in too many directions the previous shift.

'The thing about nursing is this,' he said. 'You only have one patient - the patient you are with. That's what you have to remember. No matter how many other things are going on. You just have that one patient to deal with.'

I cannot see how I could have had better care from those nurses and their care of the more critical cases around me was fantastic. A man opposite me was being transferred to another hospital after a long stay. A steady stream of staff came in all through the day as shifts changed, all wishing him well and asking him to text them to let them know he he had got on. Another nurse told me she had called in at two in the morning because she couldn't sleep worrying about a patient she had left at three in the afternoon.

I was reminded of a recent piece in The Economist about the proposed sell of of Forestry Commission woodland here in the UK. They visited a forest and talked to volunteers. Wasn't the Forestry Commission an impersonal state bureaucracy? No, they said pointing to someone walking by, it's not impersonal - it's Colin. Well, for me the NHS was not impersonal either: it was Rachel and Silvia and Alison and Gemma and the others too numerous to name.

It was also the round of doctors who all to a man and woman treated me faultlessly, from my consultant to the junior doctor who seemed to be there all day and most of the evening and always - always - had a smile on her face. The registrar who dealt with me most often was great, glasses perched on top of his head, intelligent, professional but warm with it. Can you train someone to be warm?

They were all kind and reassuring to me and to my wife, making eye contact and giving the impression for that for those minutes I was their only concern. They explained everything and understood why that was important.

My father's care in hospital has not always been what it should be and there has been some justifiably bad press about the treatment of the elderly in UK hospitals. But I - still relatively young - had no complaints. I got the impression that the staff on the neurology wards enjoyed their work and found it fulfilling. But I never for one moment felt that I had stopped being me; that I had turned into a 'case'.

They deserve a great deal of credit for that.


  1. I'm glad you had a good experience of the NHS. I did too. My son's was iffier - but that was really to do with systems. Hospitals don't cope well if you need treatment from more than one department at the same time..

  2. Sorry to hear about your son's treatment. My dad's has been variable. Mine was excellent in the main. But it doesn't take much to knock it all off balance.