Wednesday 30 November 2011

Off the grid

A couple of weeks ago I left my London flat to go to a meeting.

Five days later I got home, with a scar, a large dressing on my abdomen and a strong feeling of dislocation. Things looked the same, but they were not. I had been somewhere – mentally, physically and spiritually. I had been ‘off the grid’.

In physical terms my journey was not a long one – psychologically I travelled far.
I’m not special; just spectacularly lucky. A middle (!) aged woman with interesting friends, a healthy income, a rewarding life and all her own teeth. I’m a slim, fit, vegetarian with good eyesight. I swim, travel, write, make films – and generally behave much as I did 30 years ago. The fact that my body has generously allowed me to do this without retaliating is an arrangement I have never questioned.
Then, about a year ago I began to feel unwell. Not ‘ill’ – but definitely ‘not well’. The symptoms were vague; headaches, constipation, bloating, sickness, nausea, lower backache and an occasional burning sensation in my upper abdomen.

I don’t smoke, but am in routine denial about ‘units of alcohol consumed’ so addressing this was my first move. My second was a visit – the first of many – to my GP. During the months that followed I was prescribed medication; proton-pump inhibitors to control production of gastric acid; antibiotics for infections; fluoxetine for stress/depression and paracetamol for pain. Eventually I was sent for an endoscopy.

Fear of this procedure haunted me for weeks. I have worked in war zones which fazed me less. Sadly it revealed nothing that would explain my symptoms – and probably reinforced the GP’s suspicion that my malaise was nothing more than textbook hypochondria.

The slow erosion of ‘wellbeing’ is hard to describe; like some vital essence quietly draining away. I moved more slowly, I felt sluggish, fuddled, depressed. I slept a lot.

After my last trip to Afghanistan (during which I enjoyed an unexpected respite from these symptoms) I turned to Dr Google. At least he didn’t turn a baleful eye and ask if I was worrying about anything . . . but the internet is a fickle friend when it comes to self diagnosis and I was reluctant to accept what I was finding; a range of choices from appendicitis to bowel cancer.

I struggled on, convinced that maybe my (very real) symptoms were perhaps no more sinister than indigestion.

But if the medical fraternity was losing interest in me, my friends were not. A collective chorus of indignation, and a bout of sickness that kept me bedridden for a week, prompted my return to the GP. Although the diagnosis was yet another ‘mystery tummy bug’ she ordered blood tests. Weeks passed. I felt a little better – and then the sudden, cholicky pains began. This time it hurt to walk and I became aware of a localised tenderness on the right of my lower abdomen. All the usual suspects arrived – constipation, bloating, nausea, burning pain, headache, backache, sickness - and I resolved, once more, to brave the surgery . . . if only to collect my test results.

The fact that they were ‘clear’ and described a person in rude health did not auger well for my announcement that I was once more ‘unwell’. After a brief abdominal examination my GP looked at the clock; already I was trespassing on the next patient’s time. We had the exchange: The one that goes “Well - what do you want me to do?” followed by “Well - I don’t know, you’re the doctor!”

We locked eyes. I gripped my bag ready to leave. She sighed. “I can book you a scan . . . but that will take 8 to 12 weeks. Or I can send you to A&E.” Apologetic for presenting so many unsatisfactory symptoms I was about to accept the CT scan offer and limp back to work with my ‘hypochondria’ when the doc made a sudden decision and picked up the phone.

It was a defining moment. Ten minutes later I was in a taxi en route to A&E; 48 hours later I was recovering from emergency surgery having lost an appendix and part of my bowel. I also underwent something of a catharsis.

The time that passed between leaving home on foot for my GP’s appointment and being returned, in a friend’s car, five days later, changed my view of myself, my neighbourhood, the NHS, my colleagues, immigration laws, the media and the human spirit. Like Scrooge, I have been returned to a world that will never look quite the same again.

OK, I’m a journalist – and for five days I was a scared one. The ‘this can’t be happening to me’ monologue was a constant accompaniment. It began when I was tagged, debagged and tested in A&E.

Our clothing defines us. I arrived in tight black jeans, a figure hugging lycra top and a scarf: I left for X-Ray wearing an androgynous floral gown, a wristband and a canula; what was left of ‘me’ stuffed into a plastic Tesco bag that the triage nurse supplied.

For 48 hours I was Nil by Mouth in anticipation of surgery that never took place. My reprieves both came in the evening when kindly staff advised me that ‘food had finished’. A slice of white bread and a yogurt scavenged from the nurses station kept me going for two days. Only later did I recall that a friend had brought me crisps and biscuits that had disappeared into the depths of my bedside locker.

Here beginneth the 1st LESSON.

WAITING

Large London hospitals feature a lot of waiting. This process involves shepherds and sheep. Sheep far outnumber shepherds and can be identified by their haunted faces, glazed eyes and flapping clothing that reveals their bottoms. Sheep are often cold (who wouldn’t be, wearing a theatre gown with at least one of the ties missing!) and uncomfortable. Discomfort is exacerbated by the provision of hard metal chairs. Sheep loiter aimlessly but rarely stray further than the nearest WC or coffee machine. Those in obvious pain or discomfort are absorbed in their own distress. Some moan, vomit or chat to their police minders. Others play obsessively with mobile phones, sharing details of their domestic lives with all who care (or don’t care) to listen.

Example: “I told you, I’m in A&E; I can’t feed the f*****g cat. Where the bloody ‘ell are you anyway? So who’s gonna pick the kids up from school? Not your mother that’s for sure!Lazy cow, never done nuffink for us she never . . . "

Shepherds on the other hand wear ID cars, reveal no embarrassing areas of anatomy, move purposefully and with authority. They greet one another with bonhomie and are a great source of information about other members of staff.

Example: “You know what he called me? He called me ‘pondlife’. That wasn’t very nice was it. Stuck up git. Swannin round here like he’s somebody. He’ll get his eventually. I was upset, like. Know what I mean?”
My first stint in the waiting pen enabled me to identify both ‘pondlife’ and ‘git’ which made the subsequent conversation much more meaningful. I made a kindred connection (‘Chest Pains’) after initial processing from A&E but we were soon separated. (Good luck with the photography course by the way!).
When my turn came to be examined my morale was low. When the doctor who first examined me had finished, it was even lower.

Here beginneth the 2nd LESSON


AGE &GENDER

Junior doctors are, in the main, YOUNG. Women over 40 are OLD. Women of my age are INVISIBLE. There was some reluctance to accept that I was on no medication, had no allergies or ‘conditions’ and had never had surgery. My given name has never been used so failure to respond to it with due alacrity was seen as evidence of confusion and I was provided with a second wristband.
While doctors A and B argued sotto voce about whether ‘IT’ was, or was not, appendicitis I began to fantasise about food. So did my already rioting stomach until a further discussion ensued about whether to send me for an ultrasound or a CT scan.
Example: “Because of the radiation we don’t usually send younger people for CT scans, but they do reveal more than the ultrasound. I think we’ll send you for a CT . . .




TO BE CONTINUED . . .