I’m both a heretic and a traitor. Or perhaps I should rephrase: I despise the NHS and everything it stands for.
That’s as close as one can come to either heresy or treason in today’s Britain. I don’t know how this situation arose.
When I moved to London 35 years ago, the people had already been brainwashed to regard nationalised medicine as a distillation of virtue, both sacred and profane.
Everybody complains about the NHS being underfunded and therefore inefficient. I always say that the NHS is inefficient not because it’s poor, but because it’s socialist. Any giant socialist (which is to say bossy, megalomaniac and unaccountable) enterprise always ends up serving itself, not its proclaimed end user – to this law of nature there are no known exceptions.
Since I detest socialism in all its forms, I’d steer clear of the NHS even if it were the paragon of efficiency. Since it’s hopeless in that department, you can understand why I’ve been paying exorbitant amounts every year for private medical insurance.
But man proposes and the NHS disposes. Its good offices can’t always be avoided even by conscientious objectors like me. Hence, for reasons I won’t bother you with, I’ve had to get into the ring with NHS hospitals three times.
The first time was some 10 years ago, and that round went to the NHS: if it failed to finish me off, it wasn’t for any lack of trying (I wrote about it then: http://www.alexanderboot.com/how-the-nhs-tried-to-kill-me/). Let’s just say it beat me on points without quite landing a knockout blow.
Then, a couple of years ago I was delivered to the same hospital straight from Fulham Road, on whose pavement I had collapsed unconscious. That gave me an occasion to find out that ICU patients are treated much better than the general population. One round each then.
Yet today the NHS has moved ahead on the scorecard again.
In Britain, one needs a GP referral to see a specialist. Hence, when I felt a stone moving about my kidney yet again yesterday, I went to see my local NHS practice. Since I was in pain, I didn’t have to wait the customary week to get an appointment.
A very nice young doctor examined me and said I needed a blood test and a CT scan. I asked for a referral letter, but instead she said she could arrange those tests at that same hospital with one phone call.
Since she was young, competent and good-looking in spite (because?) of her face mask, I couldn’t say no. And what do you know: one phone call was all it took for her to make the necessary arrangements.
At 9 am today I presented myself as ordered to the Ambulatory Care unit – and almost felt like taking back all the nasty things I had ever said about the NHS in general and Chelsea & Westminster hospital in particular.
The receptionist could actually speak and understand English, which isn’t to be taken for granted. She instantly found my name on her list, ascertained with just two questions that I wasn’t an impostor and told me to wait. She also called me alternately ‘sir’ and ‘Mr Boot’, rather than the egalitarian ‘Alex’ NHS staffers tend to favour.
The wait took just minutes, and I had to rub my eyes to make sure I wasn’t dreaming. A nurse wheeled in a trolley, and went to work on my extremely fickle veins. Yet she was so good that she got in at first attempt and I hardly felt it. Brilliant, reassuring and unexpected.
She then inserted a cannula into the same vein for her colleagues to inject the contrast medium necessary for the CT scan. And – like wow, man, as my American friends used to say – another nurse took me to Imaging straight away, sparing me the trouble of negotiating the hospital’s labyrinthine corridors.
By then my eyes were red from constant rubbing, but things instantly went back to normal (which is the NHS for SNAFU). The imaging receptionist consulted her list, and I wasn’t on it. Not to worry, she said. It would take them up to two hours to get the results of the blood test anyway, by which time everything would have been sorted out.
For the next two hours I read my book, asking the girl every 15 minutes or so if there had been any progress. Every time, she patiently explained to me that a scan had to be requested by Ambulatory Care or a urologist, and no such request had been made.
I kept showing her the cannula sticking out of my arm. Ambulatory Care put it in, doesn’t that qualify as a request? No it doesn’t, was the courteous but firm reply each time.
Out of the kindness of her heart she agreed to ring Ambulatory Care and find out what was going on. Once she got through she was put on hold, waited for 15 minutes and hung up.
Would it help, I asked, if I went down to AC and posed the question in person? It might, she said.
Down I went, and all the nurses were apologetic and solicitous. They desperately wanted to help, but the system wouldn’t let them. Has my blood test come back at least?
Yes, it has, sir. But there’s a slight problem: the computer couldn’t read it. What on earth do you mean? My blood, unlike my handwriting, has always been legible.
The young lady didn’t say “shit happens”, but her facial expression did. Yet she didn’t have to prick me again: she could draw blood through the cannula. Another two hours’ wait then? No, they’ll do their best.
At about 1 pm a young urologist turned up, asked me a few perfunctory questions and promised to sort out the mess quickly. That he did, and half an hour later another nurse took me to another imaging department, not the one where I had already bored everybody.
There things went into high gear, and I was loaded into the tube within minutes. However, it turned out that the scan I needed didn’t involve any contrast medium, which meant I didn’t need the bloody cannula in the first place.
Another hour or so later, the urologist appeared bearing good news. Apart from the stone which I’ve had in my kidney for years, all my tests were reassuring. So what about my persistent pain then?
Oh well, he could get me in touch with the NHS clinic where I could be investigated properly. The wall clock was showing 2.30. I thanked him, walked out and rang my GP to ask for that private referral letter.
I spent five-and-a-half hours at the hospital. The two tests plus two chats with the urologist took about 15 minutes. The rest was, well, the NHS. Score another round for them then.
Perhaps the NHS’s seemingly inefficient performance is part of an intricate, existential endeavour, to compel patients to confront their own mortality. To pass through the 5 stages of grief right there in the waiting room. So that, hopefully, the tardy prognosis (whatever it may be) is met with serene indifference.
Medically, you’re in good company. Michel de Montaigne also suffered from ‘the stone’.
Yes, but he was a bloody atheist. What did I do wrong?
The process is the punishment? All bureaucracies aspire to this.
What you (probably) did wrong, Mr Boot, was to drink too much red wine over too long a period. Oxalic acid (and perhaps other substances) crystallise out as they are concentrated in the kidneys whilst being excreted. Very poisonous in large quantity; excretable in small, but prone also to come out of solution and form stones. These may be passed in the urine (painful!) when small or accumulate and damage the kidney tissue when larger. Definitely to be avoided!
This problem started when I was in my late teens, living in a country whose preferred liquid refreshment was vodka, not red wine. Yet there I had kidney stone attacks every year on the dot, while in my almost half a century of drinking red wine in the West they happen only about once a decade. I realise this is an insufficient sample to reach overarching conclusions, but still… To be fair, renal physicians agree with you, which is why I avoid seeing them whenever possible.
Of course the common stones of your teenage years may have resulted from some other ingested cause, eaten or drunk. Hardly possible now to explore that. But that is not a rational reason for not avoiding a known cause now, especially as your history shows that you are among the “at risk” minority. Complete avoidance of red wine is probably not called for; just complete avoidance of. over-indulgement.
My overindulgence years are behind me now — unfortunately.
Three or four weeks ago, one of my oldest and best friends was taken to a hospital in the USA because he was suffering a heart attack. He had to wait ten hours in a queue before he was even seen by a doctor. Once he was seen by a doctor, he pretty soon received the necessary surgery, and is now hanging on to life at home, as one of the 12% who survive such an attack. (Perhaps more would survive if they didn’t have to wait ten hours?)
During the hours when he had an 88% chance of dying instantly, he was constantly lectured about how his refusal of a COVID vaccine was a risk to his hospital carers’ lives – even though he’d tested negative for COVID on admission.
He now has at least nine months of outpatient therapy to look forward to, during which I expect he’ll constantly be told that he’s risking his therapists lives.
The NHS is odious, but perhaps there are even worse hells on earth.
There certainly are, and what you describe is downright infernal. Medical care in the US must have changed dramatically since I lived there.