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01 January 2017

Close Encounter with the NHS

An Appreciation of the NHS in Malton & Scarborough.
For most of my life my heart and I have been on good terms. It has faithfully pumped its way through life’s journey without complaint or incident. A few days before Christmas it ruined its reputation having suddenly realised I’d just had a 79th Birthday. It didn’t like it. Sitting in front of a troublesome computer one day, my heart decided to remind me of my age by starting a hundred-metre sprint all on its own, leaving me feeling light-headed and decidedly unwell. I was thankful at least for the fact that I was experiencing no pain.

I got myself home and my wife got out her faithful blood pressure machine from which we discovered my blood pressure (normally good) was through the roof, and my pulse rate was 135 per minute. That didn’t sound (or feel) like a good scenario.

Malton Hospital
My wife drove me to Malton Hospital – a small local hospital just 8 miles away – where they have a walk-in centre. I was seen immediately by a Nurse Practitioner who started a series of tests. There was a “safety-first” kind of assumption that I had had, or was having, or would have, a heart attack, and with the attendant danger of a stroke. Soluble aspirin and a GTN spray under the tongue were administered.

She decided I should be in a bigger hospital, either York or Scarborough. There had been reports of a serious incident on the main road to York so it was off to the seaside for me, and an ambulance was ordered. It arrived quite soon. I was trundled into the back of it and hitched up to monitors. This was but a short visit to Malton Hospital, but within five minutes of my giving the receptionist my details and reason for being there I had been seen by an attentive Nurse Practitioner, a provisional diagnosis made, early treatment administered, and my next destination organised.

The Ambulance

The three paramedics were caring, good-humoured, and meticulous about what they were doing. I couldn’t have asked for more care and attention. This was my first experience of an emergency ambulance, and whilst the equipment and the medical treatment afforded was beyond reproach, the experience of lying on one’s back, seeing nothing of the outside except the sky through a roof light whilst negotiating corners, roundabouts, speed bumps, stops and starts, provided a less-than-ideal travelling experience. I asked the lady attending to me how many patients they had to treat for travel sickness. She replied, “Quite a lot!”

At some stage on the journey, with my heart still sprinting and my blood pressure high, we pulled off the road so that an injection could be administered. Approaching Scarborough we came up against heavy traffic with little movement. My paramedic looked at the traffic stretching out in front of the ambulance and said to the driver, “Let’s do this properly”. The driver flicked a switch and an electronic voice came from the dashboard .. “999 Mode engaged”. I heard the sirens start, and saw glimpses of flashing blue light reflecting off surfaces. Suddenly we were moving quite fast, and before long we’d arrived outside Scarborough Hospital’s Accident & Emergency Department, and I was being trundled into the corridor leading to the A & E cubicles.

Scarborough Hospital
As we have (sadly) come to expect these days, there was a queue of trolley-bound patients along the corridor (though it was good to see the queue was not too long). Nevertheless, after the paramedic had had a word with a staff member I was told we were jumping the queue. I found myself in a cubicle, cannula inserted, drip connected, pads and wires slapped all over my chest, all plugged into a monitor; temperature and blood pressure taken; a junior doctor sitting herself down beside me asking for personal details and the symptoms that had led me to my current position.

Another junior doctor came along and asked me a series of questions clearly designed to see whether there had been any impairment to my brain functions:
“Remember this address .. 42 West Street, then please answer some questions ..”
What’s your date of birth? What’s your name? When did the 2nd World War end? Can you count from 20 down to zero? What’s the name of this hospital? Roughly what time of day do you think it is? What was that address I asked you to remember?
“42 West Street”. Sighs of relief .. especially from me!
After about an hour of monitoring and observation I was transferred to the Coronary Care Unit and placed in a ward of four beds. I was offered a set of pyjamas, but by this time, my wife, who had returned home from Malton and picked up all the stuff I would need, provided the necessary attire. A nurse re-wired me to a monitor by the bed and remarked, “Oh I can see why you’re here” as the heart monitor began registering about 130 beats per minute.

Now, as to the little problem of one’s personal bodily functions and their needs I was quite happy to pull the curtain around my bed and use one of the bottles provided, but for a more serious need – which was beginning to exercise my mind – I would insist on getting out of bed, unplugging myself, and walking a short distance down the corridor. This provided grounds for serious concern for the nurse assigned to my care; she was perfectly charming but adamant that anything could happen in the toilet and there’d be no monitor to say why! She was clearly very worried, and I could see the litigation papers in her eyes, but I had to insist as politely as I could, even offering to sign a disclaimer, that I had my wits about me and knew what I was doing. I reminded her there was a nice big emergency pull-switch in there, and in any case I would rather die in the toilet than use a bed-pan!

I was happy to note that my heart rate eventually slowed down to about 80, but by the time I’d returned from a call of nature and plugged myself back in again, it was back to about 110.

During the periods when I felt well enough I laid there and enjoyed the banter between the three other men in the room. They had more serious conditions than mine but were cheerful and kept themselves entertained with their own little stories. The four of us passed some of the time watching each other’s heart monitors, with their pulse rate displays fluctuating between 55 and 125. It was more exciting than watching TV.

I was seen by a very pleasant Cardiac Consultant who shook my hand and introduced himself. He said I was presenting something of a challenge, because my heart appeared to be beating normally .. just too damned fast! Moreover I had no pain. It soon became clear I was to be there overnight, with further assessments in the morning, after blood tests and a chest x-ray.

A lady came round with a menu sheet so I could choose my evening meal. It was a good selection.
The staff became used to the idea that from time to time I was going to unplug myself from the monitors and take a walk along the corridor, then plug myself back into the mothership on my return to the ward.

After a night’s sleep interrupted several times for injections, blood samples, temperature and blood pressure checks, I was provided with hot water, flannels, soap, towels, toothbrush and toothpaste. Breakfast was brought in later, consisting of cereals, toast, marmalade and other spreads, and a choice of tea or coffee. Strangely, a “Full English” fry-up was not on offer!

After another day, and a second night of tests and observation, a second (equally pleasant) heart Consultant had concluded that I had suffered the symptoms of Angina (something caused through age-related hardening of the arteries, or clogging of same, and not always causing pain) and I would probably be allowed home late afternoon of the third day with appropriate medication, but subject only to my passing a physical test on a treadmill. By this time my heart rate was at a more respectable level.

In due course I was taken to the physio room and I was wired up to two computers and invited on to a treadmill which would put me through three stages of exercise over a period of about nine minutes. I started three minutes of easy strolling on the level, then an inclined walk at a faster rate for another three minutes, concluding with a very fast walk “uphill” for another three minutes. I didn’t fall over and I passed with flying colours. My Consultant came in to check the results, and told me I could go home, armed with a shed load of medication, and he would arrange to see me again in Malton Hospital in a couple of months’ time.

Apart from breakfast, the menu choices were surprisingly extensive. The food was of good quality, tasty, well cooked, and hot. (Well, apart from the salad dishes!) I’ve had much worse in some cafés.

Hygiene was exemplary. There were dispensers of anti-bacterial foam at the end of every bed, and in every doorway. Each morning, two or three very cheerful ladies (one of them singing enthusiastically) completely stripped the beds, disinfected the mattresses (top, underside, sides and ends) then all handrails etc., then re-made the beds with fresh sheets and pillow-cases. (The beds themselves were hi-tech with press-buttons to lower or raise them, raise or lower one end at a time, or indeed convert them into a giant chair.) After all this the floors were cleaned.

The Staff
Where do I start? From Consultants, Junior Doctors, Nurses, Health Care Assistants, to Catering and Cleaning, I encountered nothing but harmonious efficiency, good humour, kindness and compassion.

On my last night they brought in an elderly man who was a severe dementia case. He was constantly distressed, constantly on the move, talking nonsense, and trying to get out of bed. Watching three nurses attend to him was a master-class in good humour and kindness, demonstrated most eloquently by one nurse who was left standing at his bedside for about an hour, holding his hand, talking to him, calming him, and keeping him in the bed rather than out of it. Later another nurse
marched in and cheerily announced to the rest of us that it looked like being a long night, before handing round blindfolds and ear plugs!

I hate applying ethnic labels to people, but sadly it appears to be how the world wants to work. For example, how relevant is it that the nurse calming down the poor old guy with dementia was black? How relevant is it that the two junior doctors who first saw me in A & E appeared to be Chinese? How relevant is it that one of our ward nurses (all of whom appeared to work long shifts) might have been from the Philippines? How relevant is it that one of my heart Consultants might have been a Pakistani or an Indian? How relevant is that other nurses and doctors were just Yorkshire lads and lasses (or to coin a phrase used on survey forms, White British?)

You see, I’m using phrases like “appeared to be”, and “might have been” because really I don’t feel the need to find out. They just made up a brilliant kaleidoscope of multi-ethnicity: colleagues working together with smiles on their faces, and treating their patients like human beings in a manner that human beings normally like being treated.

So, the only relevance of their ethnicity was simply this: what I experienced was a microcosm of the way the World Outside ought to be! Should any members of such prejudiced groups as the British National Party, or Britain First or perhaps the more extreme members of UKIP fall ill and be thrust into the care of somewhere like Scarborough Hospital, they might just stop banging on so much about immigration! Or am I being naïve?

My final thought is in regard to the NHS itself. There are two opposing extreme views: (1) it is the ‘envy of the world’ .. in which case one might be forgiven for wondering why the rest of the world hasn’t copied it .. or (2) it is a bloated, inefficient, badly managed bureaucracy, in need of privatisation. But as usual, nothing is that black or white (except perhaps black and white), and although we all know of examples of some dreadful NHS hospitals, they are a minority. I am just grateful that having paid my taxes throughout my life I have always been able to receive good medical care as and when needed, free at the point of delivery.

So, I’m grateful to Malton Hospital, Yorkshire Ambulance Service, & Scarborough Hospital.

©Lionel Beck
29 Dec 2016