We Are All Individuals

“I’ve seen you, before haven’t I?” asked the friendly Scotsman. I smiled.  In any other circumstance I would be flattered.  On this occasion he was leading me down a brightly lit corridor and into a broom cupboard.  There he would be giving me a local anaesthetic, so I could have my left shut for good.  Finally.

The anaesthetic was administered, and Alana arrived.  She would be performing the procedure.  We were on first name terms now, which in a hospital setting, is not necessarily a good thing.  The surgery was performed without a hitch.  After a complimentary cup of tea, biscuits, an epic wait in pharmacy and a penalty tram fare, I was home.  Phew.

After a fantastic week in Devon I was back on my home turf, the eye outpatient clinic.  It was more packed than usual.  Maybe the raised chocolate consumption over Easter led to more eye issues?  Who knows? Although my appointment was for 1:30pm, I was called through at 2:15pm, which meant I could watch Doctors, which is a guilty pleasure of mine.  So, I arrived in the examining room in quite a good mood.

However, the doctor wasn’t Alana.  It was a tired looking registrar who clearly hadn’t read my notes.  An interrogation ensued, and it was quite clear that I wasn’t giving the right answers.  It revolved the medication I was on which I had forgotten to bring with me.  I’d be damned if I could remember the names of the stupid things.  I just put them in my eye.  End of.  She wasn’t happy.  I was spat out and told to wait for when Alans was next free.

I sat in the waiting room feeling like a right numbskull.  I was easily the youngest in there.  How would my older compadres cope in such an interrogation?  Then I twigged it.  I was at fault because I was individual.  My older compadres fitted neatly into their boxes for glaucoma, cataracts, you name it.  They could be sorted.  Me?  Well I was way too individual for that.

I smiled and thought of one of my favourite films, Life of Brian.  Brian, somehow becomes seen as The Messiah.  In one scene, he opens his curtains, walks onto his balcony, fully naked, only to be greeted by a mob of people shouting “Messiah! Messiah!” Once he has put his clothes on, Brian confronts them telling them that they are all individuals and should believe what they want to believe and not follow him.  The crowd chant back what he says.  His message gets lost and the crowd begin following him wherever he goes.

I felt a bit like Brian with that doctor.  I was trying to tell the doctor my individual condition.  She was repeating it back to me but not really listening.  She was trying to find a nice comfortable box to put me in so that she would know what to do.

It’s very easy to label and box people.  It happens all the time and our tick box culture does not help.  Listening is such a powerful skill and is rarely used.  Patients aren’t listened to.  Parents aren’t listened to.  Children and teenagers aren’t listened to.  Doctors and nurses aren’t listened to.  Sadly, the list gets ever longer.

I finally saw Alana.  She was happy.  My ulcer was smaller, and she prescribed some weaker antibiotics.  I also a week off from going to the eye clinic.  Things were looking up.

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Well Eye Be Damned

“Oh God! Why do the ALWAYS show boring drama programmes in here?” lamented the Kevin the teenager standing behind me in the queue at for the reception at the eye clinic.  His mum mumbled something to him.  I was about to turn around and extol the virtues of Doctors when it was my turn to do my pre-flight checks.  One I had finished, Kevin had disappeared.

After my eye check, I was led through to the main waiting area.  As always it was packed.  Whole families seemed to be there to find out about Nana’s or Grandad’s cataract or glaucoma.  On the goggle-box was some weird Australian drama set in the 1960’s.  It reminded me of those Australian dramas in the late 80’s like The Sullivan’s and Sons and Daughters were more attention was paid to write a catchy theme tune rather than on any plot.

I was trying to get my head around about what was going on, when a doctor I had never seen before, called me through.  I walked in the room and sat down.  He sat by the computer and started to read my notes.  The door was still wide open.  I got up and shut it.  I had a bad feeling about this.  We sat in silence as he spent a good five minutes reading my notes.  Five minutes is a long time to be sat in complete silence.  He examined my eye.  It was clear he wasn’t happy.  He asked me who I had seen in the eye clinic.  I listed practically half the doctors in the eye clinic.  He frowned, He informed me that the doctor who had closed my eye was in clinic today so maybe it would be better if I saw her.  Pass the buck.  Nice.

Back to the waiting room I returned.  It was now that daytime stalwart Escape to the Country.  The budget was £1.5 million.  Completely realistic to the patients in the waiting room at the eye clinic.  I was midway through being shown a six-bed detached house in Cambridgeshire, complete with indoor and outdoor swimming pool, when I was called through, I have a good relationship with this doc.  It’s very professional and she is very efficient in what she does.  She wasn’t happy.  The ulcer behind the part of my eye that was sewn up, had gone.  However, in the part that was exposed, the ulcer was worse.  She asked if I was OK if the Prof had a look.

Prof 2 came in.  He’s very calm and serene, just what you need in someone who is fiddling with your eye.  He had a gander and spoke to medical gobbledegook to my doctor.  From my viewings of various medical dramas, I understood snippets.  Samples had to be taken for cultures.  He left, and the doctor checked if I knew what was going to happen.  Vaguely.  She clarified by saying that they would be taking samples of the ulcer for testing.  They were also going to give me much stronger antibiotics.  I would come back in a weeks’ time and if I hadn’t got better, I would be admitted to have antibiotics intravenously.  Crikey.  We had gone up a notch.

After the samples were taken and I had waited for an hour in pharmacy for the antibiotics, I arrived home to a letter from Prof 1 at the Marsden.  He had written to me, my GP and my oncologist to let them know what was happening.  He said that it was a pleasure to see me.  Could I use that as a reference on my CV, I wondered?  He also said the R-word.  He said the I was “in remission on maintenance Herceptin”.  Yes, I’ll take that.

Eye we go again…

The following week I was back.  I was running low on antibiotics.  As I checked into eye casualty, the cheery nurse who saw me last time walked past.

“Good to see you again, Anna!”

It’s never good, to be on first name terms with the triage nurse, no matter how lovely she is.  After about an hour I was called through.  The doctor was obviously a bit intimidated with my brush with the professor.  He gave me a prescription for more antibiotics and the professor’s secretary phone number.  I was to call her and chase up my appointment with him.  I needed to see him pronto.

This is the thing that shocks people the first time they encounter healthcare for the first time.  The emphasis is firmly on you to chase up appointments, know what medication you are on, when your last scan was and the result of it and a whole myriad of information about you.  It becomes a bit of a test.  In every appointment there is always one bit of information that I have forgotten.  It’s when you see the doctor roll their eyes at this that it hurts a little bit.  I’m not bothered though.  In fact I feel a little flattered that the doctors have shared me a little into their secret world.  It’s the people like the woman I saw in eye casualty walking with two canes.  She was with her son, who was about my age and with obvious learning difficulties. They both needed to see doctors in eye casualty.  It’s those vulnerable people that you worry if they can keep track on what is going on.

The next day, I tried the secretary.  Voicemail.  I left a really long annoying voice mail.  If I was the secretary and heard the message I left, there would be no way I would call back that crazy woman.  I needed another plan.  The next day I decided to call every fifteen minutes until someone picked up.  After the fourth phone call, she picked up.  I told the sorry story in complete grovelling mode.  It worked.  The prof had a slot in his Wednesday clinic.  I was squeezed in.

On Wednesday I went prepared.  The last time I had seen him, he had been an hour late.  So I was armed with a Costa latte, a chocolate cookie and a magazine.  I was in for the long haul.  I had just made myself comfortable when I was called through, ten minutes before my appointment time.  This was most irregular.  It wasn’t the prof, but a doctor I had seen before during my forays into eye casualty.  She looked in my eye.  It wasn’t good.  My eye needed to be closed permanently to clear the ulcer.  This needed to be done asap or I could lose my left eye.  She said she would talk to the prof to admit me for day surgery as soon as there was space.

On the way home I missed a call.  The voicemail left told me that I was to have this surgery the following Monday.  Crikey.  Fasten your seat belts people.

Monday rolled around.  Over the weekend I had contracted an awful cold/flu/cough virus thing.  Although I didn’t have temperature, I had a hacking cough and no appetite whatsoever.  What would happen?  Would they turn me away?  I turned up at the Eye Day Surgery Clinic bang on 7:30am, like everyone else who need day eye surgery that day.  What was clear was that I was by far, the youngest in the waiting room.  Because of this, I was eyed with suspicion.  I was called through by the nurse.  She went through what was happening and reassured me that my cold/flu/cough thing wouldn’t affect anything in the slightest.  As she showed me back to the waiting room, we saw the doctor I had seen in the eye clinic.  She would be performing the surgery not the prof.

“Because you are the youngest person, I’ll be doing you last this morning.  So you can go, have breakfast and come back here at 10:30am.”

Grateful for my slight reprise, I skipped out the clinic onto the joys of Costa.  I checked the time.  It was 8:30am.  Two hours to kill in the hospital.  What to do?

After having a very slow latte and micro reading the day’s paper, I slowly ventured back to the clinic.  They were relatively happy that I had come back.  I saw another nurse and signed the consent form.

“Would you like to go the waiting room with the TV in?”

I said I would.  When we got there, there was indeed a TV showing the Winter Olympics, but also a stressed looking man.  Turned out unlike me, he hadn’t been given a freedom pass and had been stuck in this tiny room, not knowing what was happening.  He was also younger than me.  I told him what I had been told about my age and he rolled his eyes.

“Why couldn’t they have told me that?  That would have been better than hanging around here for the last three hours.”

And that my friends is the problem.  Communication.  If we, as patients are told what is happening, stress levels are reduced.  This poor man had been too scared to even to go to the loo for fear that he would miss having his name called.  I gave him permission to finally go and once he had been, we both chilled out to watch the bobsleigh.

I can’t say how long I waited in that tiny room but eventually, I was called through.  The surgery didn’t take that long.  About half an hour.  But there was something missing.  It was only afterwards, when I was having my post op complimentary cup of tea and custard cream (thank you UK taxpayer) that I realised what it was.  When I had had similar surgery last year, the radio had been playing in the operating theatre.  The song that was playing was Rod Stewart “If You Think I’m Sexy…”, quite possibly the most inappropriate song for such an occasion.  Yet this is what was missing.  There was no distraction.  Just medical gobbledigook between the doctor and her med student.

“You look a bit sad.”  said the nurse, as she handed over my drugs and follow up appointment.

“I’m fine.  Just glad it’s over.”

Eye Don’t Believe It

So, it was all set up.  Eye appointment at nine o’clock on Wednesday morning.  Cover for my classes was in place and sorted.  Then the phone rang.  I missed the call but there was a voicemail.  It was from a nameless woman who was Professor E’s secretary.  Could I come in at three thirty instead of nine to see the Professor?  Oh goody!  I had been bumped up.

I arrived at the eye clinic feeling a bit washed out.  I had woken up with a stomach bug although the worst of it had passed by the afternoon.  I performed all the pre-flight checks and eye tests without fuss and sat awaiting my date with my second professor.

My first professor is at the Marsden.  He’s an outgoing chap who is charm personified.  His confidence is highly contagious.  You leave an appointment with him feeling like you could take on the world.  What would this Prof be like?

I was called in and met a quiet, methodical man who was with an eager registrar who seemed keen to please.  We went about all the checks.  He gave nothing away, yet you still felt that confidence. He may not have been as brash as my Marsden Prof, but it was there.

There was a slight pause.

“I’m afraid Mrs Read you now have an ulcer in your eye.  But there is no infection.”

The registrar and I looked at each other.

“I have a proposal on how this could be remedied.  When babies are born, they are born in a sack…”

I looked nervously at the registrar, he nodded as if to say, “stay with him on this…”

“What we now do is take this sack and dry freeze it.  I can use a fragment of one of these sacks to become a membrane over your eye.  This will stop further ulcers forming.  Once we have completed that, you can have further surgery to put gold weights in you left upper eyelid to weight that down, so you can blink properly.  I want you to come back in three weeks to discuss this further.  Any questions?”

I was taken aback.  So much to compute.  Baby sacks over my eye? Gold weights? I merrily nodded my consent and left to confirm the follow up.

Then it got worse.  I couldn’t read.  I didn’t realise how much I relied on reading in everyday life.  My job revolved around reading.  Reading students’ work, reading text books, reading handouts.  Sadly, I still could read emails.  Bit annoying that.

So back to eye casualty it was, and boy was it busy.  Only one doctor on and a psychotic episode in reception.  Yes, it was quite bad.  But there was a chink of light.  While waiting, I ended up talking to a woman who was there with her daughter and two-year-old granddaughter.  The two-year-old was fabulous.  She was speaking in the way two-year olds do, by repeating phrases she had heard from those around her.  “Nana, put that down! Good girl. Don’t do that!” it gave a weird insight into what her family life was like and it all sounded good.

Speaking to Nana, the two year old had had problems with conjunctivas.  They were back in to see if the medication had worked.  Of course, the reason why I was there cropped up.  I gave an edited version.  They took it quite well.  But then Nana hit me with a story that was more remarkable than mine.

Her eldest daughter had been born with no soft spot.  This meant that her skull was formed and didn’t have the space for the brain to grow.  As a result, her daughter as a baby, had to have her skull opened from ear to ear to create this space.  Her daughter was perfectly fine afterwards and has just had a daughter herself.  However, Nana had to got in public with a baby that had a huge, angry scar across the top of her head.

“I would get looks, even comments. What has she done to that poor baby? But you know what?  I couldn’t have cared less.  Fear.  That’s what fuels them all.  They’re all scared in case they catch it.  Well, boo to them.  You got out with your eye taped up and drool as much as you like, duck.  You’re fabulous whoever you are.”

Her granddaughter was seen, and the infection had cleared up.  I was seen and given antibiotics. We joked we hoped we never saw each other again.  But the morning proved that there are gems lurking in those hospital waiting rooms.

Red Eye Kitchen Nightmare

It all began last Wednesday.  I was running late for work.  I jogged the dog round the block for her morning toileting.  When I got back, my husband was long gone so I grabbed my bag and ran.  It wasn’t until lunchtime that I noticed.  I had left the eye ointment that I have to apply to my left eye every two hours, on the kitchen worktop, next to the dog lead.  Still, I wasn’t in any pain, so maybe I got away with it.

The next day it was clear that I hadn’t.  I went into ointment overdrive, trying to overcompensate for the mistake I had made.  It was too late.  The damage had been done.  With a heavy heart I called eye casualty.  Just keep applying the ointment and if it gets worse, pop in said the nurse.  No one ever pops into casualty.

My eye got progressively worse during the week.  We tried taping it up at night, applying ointment every hour to no avail.  Casualty beckoned.  On my way to the hospital I began to listen to Desert Island Discs on Radio 4.  The person who was shipwrecked was Angela Hartnett, a top chef who was a protégé of Gordon Ramsey.  Kirsty Young was trying to get her to comment on why they were few top chefs that were female.  Angela was quite guarded about this but said the situation was improving.  Her time with Ramsey sounded brutal.  Although she had kind words for the man himself, the hours were a killer.  She worked from 6:30am until midnight for six days a week with half an hour for lunch if she was lucky.  The rest of the chefs took bets on how long she would last.  The top one was three weeks.  She stayed for a year.  So much energy for a plate of food.

There was a long queue for the reception when I got to eye casualty.  I wasn’t feeling optimistic.  After about half an hour I was called through by a glamourous looking nurse.  We did the usual pre-flight checks.  To my surprise she knew all my medical history. Yes, she knew of the facial nerve surgery and the surgery in October.  She was also horrified I was expected to apply the ointment to my eye every two hours.  This was a first.

She sent me round to have photos taken of my eye and led me to another waiting room.  The TV was showing the US version Ramsey Kitchen Nightmares.  My second encounter with Mr Ramsey that morning.  His target was a seafood restaurant in New Orleans owned by two warring brothers, each blaming the other for its woes.  Ramsey was doing his usual, but I noticed something.  He wasn’t doing that much.  He was a rope provider and getting those who ran the restaurant to hang themselves on that rope.  They were just about to close the kitchen down, when I was called through for my pics to be taken.

Once they were done, it was back to eye casualty where I rather enthusiastically announced my arrival to the receptionist. I took my seat to await the doctor’s verdict.  After fifteen minutes I was called through to see a consultant.  She was surprised to learn that my next outpatient appointment wasn’t until March and bumped me up to go in next Wednesday.  She also gave good advice on how to tape up my eye and apply the ointment more effectively.  In her opinion, the October op hadn’t worked, and my eye would needed to be stitched up again.  But my consultant in eye outpatients would have the final call on that.  I wasn’t too downhearted by this.  I just wanted not to keep getting red eyes.

When I left, I checked my watch.  I had been done and dusted in less than two hours.  The NHS can work, if you see the right people who know how to solve your medical issue.  The problem is that we are losing these right people.  The fact that they are usually working the hours that Gordon Ramsey and co worked at their peak, may have something to do with it.

Old Red Eye Is Back

It started on the Sunday.  There was no denying the slight pinkish tinge to my left eye.  I ignored it.  It was bound to be something to do with the cold snap.  Icy winds or something like that.  By Tuesday, the pink had turned to an angry red.  I couldn’t deny it.  It was getting worse. I followed the herd and asked Mr Google.  Mr Google informed me that there was an eye casualty department at the QMC, but it was advised that I seek the advice of my GP if it wasn’t an emergency.  Was it an emergency?  I wasn’t in pain and I could see fine.  I booked an appointment with my GP for the following day.

Husband came back from work.  He was shocked at the state of my eye.  I told him about the GP appointment.

“What!?! Call eye casualty. NOW.”

So, I did.  I spoke to a lovely nurse who said I should come in tomorrow as it did sound like a case for them.  One nil to my husband.

The next morning rolled around.  Thankfully I wasn’t teaching that morning, but I was teaching in the afternoon.  A flurry of WhatsApp messages were sent between myself and my colleagues.  The plan was that if I wasn’t seen by 11:30, my afternoon class would be cancelled. I arrived bang on nine when the department opened, and the wait began.

I was first called in to see a nurse.  She was the same one who I spoke to on the phone.  She was sympathetic.  Rather bizarrely, her husband, thirty years ago, had a tumour in his mouth that, like me, originated from his pituary gland.  He had a huge operation to remove the tumour where they worked slowly to preserve his facial nerve.  He had radiotherapy, like me, and for thirty years had been cancer free.  Lucky him.

After her, I saw another nurse who actually looked in my eye.  He surmised that it wasn’t a dreaded ulcer, but a scratch on my eyeball. I had caught it just in time.  Phew.  Now I had to wait for the doctor to get some treatment for it.

Twenty minutes later, I was called in by the doctor.  It was the usual set up.  Doctor, petrified looking student doctor and bored looking nurse.  The doctor’s surname was something like Vitalas which made me think he was Latvian or Lithuanian maybe?

He asked me when I first noticed it.  Sunday, I replied.

“It is Wednesday.  Why have you waited until now?”

I was dumb struck.  He sighed.  While he was sorting out the prescription, he gestured to the medical student to have a gawp at my eye.  He was very eager and got me looking in all directions.  Soon my prescription was ready and off to pharmacy I went.  All the while I was cursing.  Cursing the fact that it had all been done by eleven.  I would have to teach my lovely afternoon class after all.  The joy.