Monday, 10 June 2013

An emergency

Olympic Games Opening Ceremony 2012

This morning an emergency. Behind our house, off the road, is another house that used to be the shambles or slaughterhouse when our house was a butcher's shop. After it was a butcher's shop it became a successful restaurant, but after that restaurant moved and another took its place, the shambles and the barn, together with the land between, was divided from the restaurant and sold separately, which is when our elderly neighbour, let's call her X, bought it and started constructing a beautiful garden. We arrived some years after that.  Once that restaurant had also moved on, a third took over and failed and, when that was gone, the house became a gift shop. We bought the house as a failing gift shop.

We got to know X quite well. She is a little reserved and shy but has led a pretty full life and has lived on her own for many years and, even at ninety, is an independent, intelligent woman.

But being ninety she is not altogether well and has had some emergency runs to hospital in the past, so Clarissa has made it her business to look in regularly, to take her shopping when X wanted to go, or to bring her some items when she didn't.  It has been a very good relationship: she is fond of us and very much wants us to stay, and we are fond of her. She gave us a flowerbed in her garden, next to our house and since having got rid of her last car has allowed us to park ours in the gated drive.

This morning Clarissa noticed her curtains were still drawn, so she rang. The phone kept ringing. So she went to knock. She then tried the key we have been given but the door was bolted inside. She could hear X making her way very slowly down the stairs and slide the bolts. X had a great bruise on her head, had clearly had a fall, and was in shock, quite incoherent, unable to speak or answer questions. Clarissa sat her down in a chair and X did not move or recover, so she rang me and I came in.  Doctor or ambulance? Clarissa tried the doctor first. The reception was not keen to disturb the surgery and said best wait till the surgery was over in a couple of hours or so. In the meantime X would go on the priority list.

But X was getting no better. There was no external bleeding so it was hard to tell the extent of her injuries. Clarissa suggested I wait in the house in case the doctor called and she stayed with X. It was better for X to be with a woman now, especially one she saw regularly. She was still deeply disorientated, incapable of speech, merely groaning. I wondered about ringing the ambulance instead. I wondered - we both wondered - if this was a stroke. but Clarissa had described the symptoms to the doctor on the phone so the surgery knew as much as we did. Then we waited.

And waited. One hour. Two hours. Three hours.

Three hours after the call, at 1pm,  the doctor arrived. By this time we were deeply worried about X. And as soon as she had had a look at her, the doctor - a very nice woman - called an ambulance.

The ambulance took 22 minutes to get here.  It was about another ten minutes before they took X away.

Tonight, early evening, the hospital called to say that X was seriously ill and that we should call her daughter in Australia.

I had marked out tonight to attend a reading by two poets I know in Norwich. Should we still go? We discussed it briefly and decided to go ahead. There was nothing we could do here except think about it.

It does indeed make you think.

Three and a half hours from the time Clarissa found X to the time she was taken where she ought have been taken much earlier! Of course we are not doctors and can only guess at the problem, but this was clearly much more than a fall. Maybe it was TIA. Clarissa's father used to suffer from such attacks. Whatever the case I would have thought X's condition constituted an emergency.

Three hours and then a half! I repeat it again. That is time for a great many things to go wrong, possibly for ever, even perhaps for a person to die.

Is this what health care is like in this county? In this country? God help the old in twenty years time - that means us, of course.


Carrie Etter said...

The extent of the gap in care for the elderly seems the biggest problem facing the NHS, and no solution will be attractive, as it will require far more money, ideas launched and failed, many frustrations. I struggle to know where to put my efforts.

My best wishes go to your neighbour and my thanks to you and Clarissa for your care for others.

George S said...

I do see that, Carrie and it is hard to know where to put one's efforts. It would not be surprising if eventually there emerged a three=level system: the entirely private; the extra insurance on top of National Insurance Basic Plus service; and the in emergencies only, tough-luck-if-you-die free - meaning Nat Ins funded - service. A dreadful prospect. Well, C and I are not determined to hang around that long.

In the meantime it is useful to keep an eye on the service as it touches us. I suspect it is right that far too much time is spent on bureaucracy, targets and what is quaintly called put-through, that murderously inefficient form of efficiency known as managerialism.

Thank you for the good wishes. X is in hospital now and may be there some time - if she survives. Her children are rushing back from Australia and Canada on medical advice.

havantaclu said...

George - please keep us posted about the condition of your elderly friend. I live in a Close where several residents are older than self and OH and we try to keep an eye on them, but sometimes it's difficult. Many resent the 'surveillance' and, I suppose, rightly - but it's hard to keep to a line between surveillance and checking.

And your comments about the delays experienced are, I'm afraid, only too true. Here, our ambulance service has been 'outsourced' and the number of people complaining has risen considerably. I'm a member of a local U3A and two weeks ago, was hearing one 92-year-old talking about having to wait for three hours when she phoned for an ambulance for a sick friend - the friend died.

I'm frightened for those who are going to grow old and will have third class care in the future. I know there is a crisis with an aging population but we seem to have done nothing about it in the past, although we knew it was coming. Now it's on us.

Thanks for looking out for your neighbour. I do hope that she will live to see her home again.

Gwil W said...

These incidents are easier to deal with in retrospect. I think I'd have immediately phoned for an ambulance.
On the other hand you know the lady and you know her doctor and you trust her doctor's judgement, although how she can allow 3 hours to pass is a little baffling to put it mildly.

George S said...

Ringing for the ambulance was the first thought, but we felt a certain reluctance to despatch her there - she had been in hospital before and didn't like it. For old people hospitals are all too often inhuman deathtraps. In any case, she had got down the stairs by herself - stairs without a handrail - and had no external bleeding as far as we could see.

Then again she had her doctor and we thought the doctor would be out much sooner. Once the surgery had been rung it was hard not to feel that it was out of our hands. How often are we told that we're wrong to guess at problems and should let them, and them alone, decide what's what.

I did think after a while of the ambulance again, but one keeps thinking the doctor will come, probably just as the ambulance is arriving.

People trust the medical profession. Me, not so much. I haven't had decent human experience of a doctor for something over twenty years, probably longer, chiefly because I go very rarely, always at my wife's prompting, and am always dismissed with contempt as soon as I arrive. As a result I have grown a dislike for them, seeing them less as healers than a bunch of patronising car mechanics.

In my more sanguine moments I realise that can't be the case. Then this happens.

Not that this was this particular doctor's fault, I suppose. She is in surgery and can't come straightaway, or feels she can't, and there is no-one else on hand. The system is under tremendous strain of course.

It's our fault really for being ill, I often think. Being a doctor would be so much better if there weren't all those sick people about.

Gwil W said...

I well remember my first 'adult' visit to our family doctor. I was 17 or 18. I had a winter cold I couldn't shake off. He was an Irish saint dressed in tweeds and brogues and was a blend of Seamus Heaney and Dr Finlay. There were never queues. His secretary, his wife, gave you a nod and you tapped on his surgery door and went in. He waved his hand towards a winged leather chair and you sat on it.
That day I went he fished up a whisky bottle and half-filled two tumblers. We drank them out. I went out completely cured. He was no drug pusher. He had the old bedside manner as you'd call it. I don't suppose there are many of his ilk left. Maybe on Aran or some such place in West. We live in the times of records and duplicate forms and triplicate charts and quadruplicate statistics. We are suffocating in our own demise. The nursing home is the new growth industry. Our food is full of antibiotics and other such crap and strange genetic materials. We've just about had our chips. It'll take a miracle to save us. Good luck to the patient and bravo to her independent spirit. I like them like that.

Imogen F said...

Everyone should have such neighbours.

In Brussels the other week, our friend developed pneumonia. Prompt appearance of an ambulance at our hotel, English-speaking paramedics, a week in hospital and many tests she thought she wouldn't have had here. Nothing but good things to say.

So let's hope we don't lose our EU medical privileges by accident.

I hope X is comfortable. Your account of your houses was delightful.