I am preparing for my twice-delayed repatriation on the 12 May. Despite my daughters’ and Swiss doctors’ remarkable efforts to inform the rehab hospital in Stanmore, according to some NHS regulation I must present first at my local general hospital, the Royal London Hospital (RLH), who must then refer me on to Stanmore. Furthermore, entry into the RLH is gained only through the A&E department. There is no reasoning against this ruling. Someone at Stanmore got quite stroppy with my lovely Scarborough-born doctor when she tried. It’s like being caught within a computer algorithm, a byte-sized insignificant serf to the system.
Sitting in my Balgrist room with its view over a smart area of pristine, well-ordered Zurich, thinking of London. What will be the biggest shock? The litter-strewn streets? The sullen disinterest of the public servants? The multicultural mêlée? Probably the chaos of an overcrowded A&E at the RLH. This is the very hospital Donald Trump referred to as ‘a war zone’ in his speech to the NRA. I imagine a large room, vandalised seats fixed to the floor, strip lighting, crack-heads staggering zombie-like through the door, stabbing and shooting victims spilling blood, shouting obscenities and clamouring for attention from the overworked and stressed staff. I think of the reception to the Balgrist, with its polite, multilingual receptionists, plush seats and café where they serve frothy cappuccino, cake and prosecco with mercantile efficiency. And I yearn for the happy hit-and-miss messy compromise that is London. Odd.
Uschi has offered to accompany me on my repatriation voyage. She says she wants to visit London in any case, but I know a gesture of pure kindness when I see one.
I try to imagine this diminutive and meticulous nurse, used to Swiss conditions, in the RLH A&E; these mental scenarios often end with Uschi in a faint. I begin a programme of expectation management; she says it sounds just like a hospital in Austria where she has worked.
I miss saying goodbye to the head nurse, who is called away at the crucial moment. I find she has left me a note in which she calls me ‘der Musterpatient’ – model patient. I feel pride; I’m not sure why this is a deadly sin.
It is Melena who helps me finalise my preparation for the repatriation voyage; a neat symmetry as she was my first nurse in Balgrist who quickly reassured me with her calm professionalism. She takes her leave in the taxi and I promise to come back next year to walk in the Rhineland with her (yes, she is one of those who benefitted from my rendition of ‘die Lorelei’). Too Germanic and professional to play along, her response suggests the unlikeliness of this scenario.
The taxi-driver to the airport is a first-year medical student. He tells me not to give up hope, walking again should definitely remain my objective. I’ll take that advice. The man’s practically a doctor.
Two months into my experience of being paraplegic, and I finally see a positive side: air travel. Special check-in treatment, no queuing for security or passport control, extra baggage accepted without argument, individual transport to the ‘plane – and then the same in reverse on arrival. OK, there’s an awkward bit with wheelchair transfers, but otherwise it’s like flying by private jet.
At Heathrow the pre-ordered taxi is driven by a man called Tom, a huge mountain of a fellow who asks Alice if she enjoyed the flight. Alice says she was not on the plane. “Just sherping, then?” says Tom, nodding at the cases Alice is wheeling. We remark that he has excellent reviews on the web. “That’ll be my brother” says Tom. “He’s active like that.” I feel like hugging him – where else but Britain would you get quality banter from your newly-met cabby?
As instructed we turn up at the RLH A&E. Thanks to a bit of reconnaissance carried out by Alice’s Tom, we go straight to the Resuscitation unit, where a team of consultant, junior doctor and 2 nurses are waiting, all dressed in green pyjamas. The place is enormous and looks like an advanced engineering workshop – for F1 cars, for example – with various sizes of square, brightly coloured baskets hanging from the walls labelled ‘green canullas’ ‘medium swabs’ and so on. There are many machines beeping. It is not busy and as I wheel forward and introduce myself, one of them (slightly incredulous) says “so you are the patient??” Another adds “we were expecting something far worse”. I apologise for disappointing them.
The consultant admits to not knowing much about my case, at which point I produce the copy of the medical report prepared by the Scarborough Balgrist doctor – she knows the NHS; he gratefully goes off to read it.
Meanwhile the young, Italian nurse with the shaved head asks me to undress and puts me in a hospital ‘pyjama’. With a feeling of foreboding I transfer from the wheelchair to the narrow bed in Resuscitation Bay 6 and he begins sticking sensors all over my upper body and adds a blood-pressure armband and oxygen/pulse finger clamp. It all seems odd, considering that I just arrived in a taxi from Heathrow.
Then he reaches for the bucket marked ‘really big and scary cannulas’ and pulls out something the size of a knitting-needle, the bezel-ground end of which reflects the light menacingly. He takes an elasticated tourniquet and, ignoring the holes and buttons its manufacturers clearly intended to be used for carefully-judged tightening, pulls it super-tight and ties it up with a granny-knot. My lower arm begins to pulsate and bulge. He picks up the knitting needle, swabs the protruding veins at the inside of my elbow joint, and chooses a suitable blood vessel.
“Are you sure this is quite necessary?” I squawk, nervously, “why not just take some blood? You don’t need a long-term cannula, do you?” I babble on about how those days are past, we’ve moved on, and he replies “this is a gift we give to everyone who comes to A&E”. He is not unsympathetic, just obeying routine. He grasps the cannula and begins to line it up with my trembling arm. Just then the consultant returns and, waving the doctor’s report, says “Oh, I don’t think Mr Carter needs one of those.”
I am allotted a bed in the trauma ward. During the 4-hour wait for this to be prepared, Isabelle, Alice, Otis, Tom and I play cards, drink Sauvignon Blanc and eat kettle chips in the Resus unit as around us, presumably, lives are saved. The blood-pressure cuff on my right arm inflates every 15 minutes. I wonder what Bay 6 would have been used for if we hadn’t been there playing rummy.
Ward 12D. Through a grimy window one can see the other tower of the building, a turquoise/blue block of plate-glass. Not quite the Zuricher See but I’m not complaining. My room is enormous, with a single bed and its own huge bathroom.
I am to get an X-Ray. The porter, a man of strange authority in the ward, won’t take me until I have a wrist band. The nurse prepares one for each arm – red as I have an allergy (to NSAID painkillers, following the Novalgine experience). Later I inspect these identifiers and see
Name: ZULU BKL Unknown
NHS no: 000 000 0000
As I write, three weeks later, I still have these wrist bands. No doubt I owe my easy-to-remember NHS number to my great age. I quite like my new name, and am thinking of using it, as a friend suggested, as my nom de plume.
The lady from Stanmore visits. She is very thorough, quizzes me on my Swiss experience and observes my transfers etc. She can see I am Stanmore-ready. Rehabilitation is my need. On an acute trauma ward, I am in the wrong place. Everyone knows that. She calls her colleague in Stanmore. Two months is the estimated time before a place will be available. I am a bed-blocker.
Briefly they consider taking me to my (wheelchair inaccessible) house, carrying me inside, and leaving me there in my study. I would be quite unable to leave the room, but would get daily visits for washing and lavatorial needs. I dub this the ‘house arrest’ solution.
Someone else needs the single side-room more than me; I have to move to the bigger, 4-bed ward – from which I have occasionally heard shouting and swearing and generally abusive voices raised. ‘The view is better from there’ says the friendly nurse. ‘And you won’t be lonely’.
Opposite me in the general ward is a young man who has been shot, with a sawn-off shotgun. Extensive injuries to the shoulder and head. ‘I’m lucky to be alive’ he says. He doesn’t seem to me to be a gangsta. He seems very nice, as do his ‘baby-mother’ and toddling daughter. I lend him my shoes to permit him to go outside ‘for a breath of fresh air’. Later I realise that the inhalation of tobacco or other smoke might have played a role in his sortie. He waits three days for his surgery to remove the shotgun pellets. “I’m definitely going to change my life now” he tells us afterwards. Maybe he is a gangsta after all.
I awake to the sound of a police radio keeping us informed of all manner of crimes in real-time as they are committed. I struggle from bed into my chair to go to the bathroom. I pull back my curtain to reveal a bored-looking police officer, fully kitted out in stab-proof vest with a hefty black belt-full of instruments of suppression. The new occupant of the gangsta’s bed is a man so badly beaten I cannot tell his age or race. He is here because his own son did him this damage. The police are here to protect him in case the son comes to the hospital to finish the job.
As the policeman helps me with the bathroom door, his radio recounts an exciting pursuit of suspects and the location of victims. I ask him if this is the most boring duty he could possibly have been assigned. Later, we watch the royal wedding together on my iPad.
Albert, a Windrush generation man for sure, fell down the stairs at home and broke some bones. He is also confused. Although I have overheard him, under the impression he was working here in the RLH, asking the nurse how on earth he got the job (‘I have no medical qualification, you see’) – he tells me he is a retired station manager on the underground. He speaks in very precise, clipped West-Indian tones. When his family visits there is a dozen, of all generations – none of the nurses has the heart to point out the 3-per-bed maximum. At kicking-out time they hold a family prayer. It’s enough to turn you Christian.
The young physiotherapist comes to manipulate my legs and stand me in the machine. She looks tired. It’s Ramadan. She is small and her lovely face is enhanced by the brown head-scarf she has loosely wrapped about her hair. She is a true Londoner, Whitechapel born and bred. We discuss the boy she has met – he spotted her at a family wedding three months ago. She does not trust boys and speaks positively of arranged marriage. I feel a bit sorry for the boy, who – as far as I can tell – has done nothing to merit her mistrust, apart from diligently seeking her out since seeing her at that wedding. I tell her she should take it as a compliment, that the ‘date’ he is asking for does not involve any commitment. I don’t think she’ll take my advice, but if she does I hope to hell that the boy behaves himself.
The doctor on the morning round tells me that Stanmore is for next week. Tuesday the 5tth June. This is the latest of a long series of conflicting possible transfer dates, and is not confirmed on Alice’s weekly call to the administrator at Stanmore. Still, I’m believing this one.
I waited for Tuesday to send this; I’m still in the RLH. No-one, except me, is surprised. My money’s still on my being in Stanmore this week sometime. After all this, it had better be good.