Casualty

Last weekend a friend I was spending the day with was suddenly taken ill.  She advised us that she felt unwell and was having palpitations but said that if she sat quietly for a while, she would be fine.   Eventually she admitted she was actually feeling worse and could we go to her local Accident and Emergency department.  Jill refused to let us call an ambulance and insisted we get a taxi.  Throughout the journey we managed to restrict the number of times we asked if she was OK, but kept a careful eye on her. I had a feeling of dread, as much for myself as for Jill.  Jane, also with us, is about 15 years younger than us, but heart attacks are on the increase for women over 50, i.e. Jill and I.  

The taxi driver overshot A&E and took us to the main entrance, a short walk from A&E, but a bit of a struggle for Jill at that time.  To be fair to the cabbie, we had just asked for St Thomas’s hospital, it had seemed too dramatic to ask for A&E.  Now I look back I wonder why I worried about being ‘too dramatic’, and how severe her condition would have to have been for me to overcome such reserve. 

I had expected reception to be full, but there were only about 5 waiting to be seen, unless casualties travel in groups, but it still wouldn't be more than a dozen.  It was nothing like I had imagined it would be, possibly because my imagination is fuelled by television programmes.   There was no blood, gore, drama, cries or screams for help.  It was like a dentist’s waiting room, lots of magazines and people looking slightly apprehensive. 

Jill was registered quickly and then called in by a nurse for an examination and an ECG.  She was soon back out.  As she walked towards us we could see she looked better.  Her face had lost its deathly pallor and she walked with ease.  She said that a doctor was going to talk to her but that she was already felt much better, if not yet 100% normal.   She was worried she had wasted their time, but we pointed out that she was not given to over-reacting and it was better for her to be seen. 

A young man came and told her that her heart was ‘almost perfect’.  Jill was surprised, the young man said ‘you seem disappointed, surely that is a good thing’.  We couldn’t help but laugh, as much with relief as with anything else.  We then had to go to the Emergency Care Centre. Jane and I were again disappointed at the caliber of casualties.  The nearest to ‘obviously injured’ was two people limping, but other than that nobody even looked unwell.  You can see why television producers need more drama, even George Clooney couldn’t get much excitement out of treating the ‘not obviously hurt’ brigade.

The doctor who Jill saw told her she had most likely had a panic attack and Jill said the doctor had described her symptoms perfectly.  I have read since that heart attacks in women, particularly in their early 40s and 50s, can be misdiagnosed as panic attacks as the statistics results are compared against were compiled from tests on men.  But Jill was thoroughly checked out.  Fears of a heart attack were not unfounded, we could both have a more healthy lifestyle and are each a carer for our mothers.  I don’t begrudge the role at all, but I know it impacts my mental wellbeing and am sure the same is true of Jill.

The reality of A&E is much calmer and more reassuring, than the hustle, bustle and hysteria of fictional hospitals.  Once you get there you just think you are in the right place and, whatever happens, something can be done.  I had envisaged a four-hour wait surrounded by the drunk and the dying.  The NHS constantly receives bad press, but it shouldn’t.  The medical teams and administrative staff do an excellent job, whilst juggling constantly changing and contradictory policies, to be managed out of an ever reduced budget.  Everyone Jill encountered was reassuring and efficient.  We were all surprised that the Emergency Care centre receptionists were volunteers.   If we can pay £10 billion a year for PFI costs, surely we can pay staff who actually provide a service?  The ultimate cost of PFI is estimated to be around £300 billion (Telegraph online July 2012), with some NHS contracts predicted to cost 12 times the amount originally borrowed.   It costs around £70,000 to train a nurse and up to £500,000 to train a doctor (NHS Health Eduction May 2013).  You could fund a lot of both and pay administrative staff properly with that £300 billion.  We could also fund proper dementia care, not remove every last scrap of self-respect sufferers have by removing their life's savings and homes along with their minds.  If we lose the NHS, we will still be repaying the £10 billion per year.  We just won’t have anything at all to show for it.