Sunday, 23 September 2018

I don't know about the rest of the NHS, but Hammersmith Hospital has improved beyond recognition since the late '80s

I experienced two week-long stays at Hammersmith Hospital about 30 years ago, both as a result of  attacks of acute pancreatitis. I'd suffered at least six previous attacks over a number of years, but a variety of GPs had misdiagnosed every damned one of them, whereas the Irish nurse who collected me from reception on my first hospital visit simply asked me where the pain was and immediately said, "Oh, that'll be pancreatitis". My experiences of Hammersmith back then were so depressing, I've always dreaded the thought of having to go back to hospital for an extended stay. On both occasions, I was stuck in an enormous, positively Dickensian, dormitory-style ward with between 25 and 30 other patients...

... of both sexes (extra genders hadn't yet been invented) up to half of whom were geriatrics suffering from dementia. Cleaning was rudimentary at best, and consisted of a daily visit by a truculent third-worlder with an old-fashioned mop and a bucket of filthy water, whose sole purpose seemed to be to spread germs around. The nurses ranged from gormless to slovenly to borderline sadistic: it was only by behaving badly and demanding to see a doctor that I was able to procure proper pain relief for pancreatitis - a notoriously painful medical condition (the nurses were convinced two paracetamol would do the trick - the doctor immediately injected me with a shedload of pethidine and instructed the nurses to give me dihydrocodeine tablets whenever I asked for them - bless him!).

The food was disgusting. Sleep was out of the question, thanks to the dementia patients' penchant for going for a wander in the middle of the night or bellowing out the names of long-dead relatives and acquaintances or yelling in pain. Making up for it by dozing in the evening was out of the question, because the television room, situated just off the ward, had no door, the old folk who populated it had the volume permanently set to max, and the nurses were remarkably lax about enforcing the 10pm TV curfew (they were lax about everything except their entitlement to lengthy breaks). For some strange reason - perhaps just general exhaustion - we'd all drop off to sleep around five or five-thirty in the morning, only to be woken up an hour later by nurses switching on lights and swishing back curtains and... well, I can't remember if there was any other point to the exercise except depriving us of sleep.

My third stay at Hammersmith, which lasted for 19 days and commenced last month on the 20th August, was an entirely different affair. I was in an all-male, four-bed gastroenterology ward. Almost every nurse was efficient, pleasant and helpful, and there were plenty of them. The ward was astonishingly clean - the cleaner seemed to be there for at least 90 minutes every day. Bedclothes were changed on a daily basis.  Proper pain relief was available as and when I needed it (within limits, obviously). Visiting hours were relaxed, and there was a day-room with a television across the corridor where patients who were well enough could take their visitors. As for the food (provided at Charing Cross and Hammersmith by the French company, Sodexo) it was astonishingly good - varied, flavoursome, and piping hot (just avoid the flabby fish and chips): when my appetite eventually returned, I actually found myself looking forward to hospital meals! Apart from the disappointing fish and chips, the only other problem was the tea, which tasted horrible and instantly produced searing heartburn. My own gastric problems may have been partly to blame, but the situation improved after my wife brought in a box of Taylors of Harrogate Hard Water Yorkshire tea-bags.

As I was writing the above, I received an email from a GP friend, who said that the nursing profession pulled itself together about five years ago, and that the NHS had improved vastly over the past ten years, partly thanks to more precise diagnostic machines and "a leap in understanding of some fundamentals in genetics and immunology" which have increased doctors' confidence, which has in turn lead to an improvement in staff morale. (He does however also point out that I might not have received the same level of treatment at Wigan General as I did at Hammersmith.)

My only real criticisms are that patients are still being woken up at 6am, albeit for a variety of readings, and then left to twiddle their thumbs until breakfast at 8.30; that I found myself being asked questions by doctors which I would have thought the nurses would have been better placed to answer (it's a bit hard to recall just how much vomit one has produced over a longish period in the middle of the night, or whether the latest in a series of approximately one hundred blood sugar readings was within the normal range); and that it takes a ridiculously long time to be discharged after a senior doctor has told you you can leave - apparently, pharmacology is invariably the hold-up, which suggests the system needs tweaking: and I didn't much appreciate spending ten hours not eating solids because my operation had been cancelled at the last minute without either me or the doctor on our ward being informed, or being able to find out anything because nobody was answering the bloody phone - I only learned what had happened when a hospital porter materialised at the foot of my bed at nine the next morning and told me that they were now ready for me! It just strikes me as odd that an organisation which employs so many administrators can't put systems in place to ensure that patients aren't left for hours wondering what the hell's going on - it just isn't what people need when they're feeling lousy.

Still, if I'd had to score my experience as a patient back in 1988 as 2/10, my experience at Hammersmith this year was an 8/10. Given the horror stories one hears about many provincial hospitals, it makes me feel quite relieved that we never got round to moving out of London.

One or two snippets to finish with:

I was genuinely touched by how supportive towards each other the chaps in our four-bed ward were. I was aware of two of the other patients telling me to "Hang on in there!" when I was being as sick as a dog, and the bloke in the bed opposite coming over afterwards and placing a welcome towel soaked in cold water over my sweating brow, and muttering "Bad luck!" - I almost cried. The little African in the next bed shuffled downstairs every morning and returned with four copies of the latest Metro - one for each of us. And when it came time for the man suffering from chronic pancreatitis (who'd had a hell of a time of it) to go home, he presented each of us with a farewell gift of a bag of chocolates.

I had an interesting experience when it came to how nurses should address patients. A trainee nurse kept calling me "Mr. Scott" or "Sir"! After a couple of days of this, I explained that, while there were probably several patients called Mr. Scott in the hospital, I wasn't one of them, and that, while I enjoyed being addressed as "Sir" by policemen and hotel and airline employees, it sounded weird coming from a nurse. She could, I said, either call me Mr. Gronmark or Scott - and as we'd been acquainted for several days, I'd recommend Scott. Took her a while to stop the "Sirs" and "Mr. Scotts", but she got there eventually. After about a week, one of the black nurses took to addressing me as "Scottie!" in  an American accent - I've no idea why, but I rather liked it.

There's a pidgin version of English which all ethnic Londoners and young, indigenous white Londoners seem to understand, but which is utterly incomprehensible to anyone of my age. For instance, I listened to the tiny, possibly Filipino tea/food lady at Charing Cross discussing the breakfast menu with a young Englishman in the next bed (the one who'd undergone a lumbar puncture the previous night). They were laughing and joking, and he evidently understood every word she said. When she got to me, however, she might as well have been speaking Venusian. Not a single syllable made sense. Eventually, armed with a menu, I asked for toast and jam. She nodded, and then asked a supplementary question. I presumed she wanted to know if I preferred white or wholemeal bread, so I said "white" - not because I preferred it, but because it would be easy for her to understand. She didn't. I kept saying it. No progress. She jabbed at the "toast" part of the menu. In sheer desperation I practically shouted "wholemeal!" "Okay," she nodded. "Good."

I wasn't really up to receiving visitors in hospital (apart, obviously, from my wife and son). Most of the time, I was either comatose, or feeling sick, or being prepared for an operation, or recovering from one. But there was one afternoon when I found myself on my own, staring out the window, quite alert, and wishing I hadn't suggested my wife skip a day. I didn't want to read or listen to the radio and I wasn't yet strong enough to go downstairs for a vape. A casually-dressed man suddenly appeared, announced himself as the hospital chaplain and said that a mutual friend had suggested he pop in to see me. He stayed for 45 minutes and we had a delightful, stimulating chat (I found it so, at least, and he seemed to enjoy it). Funny how things often work out that way.


  1. Glad to see you are posting again, Scott. Hope this means you are feeling a little better and that the medication is doing its job.
    My own memory of a hospital goes back to the early 1940s when, aged about 4, I was in a children's ward having had my tonsils out. I can't vouch for the cleanliness but a woman did come to sweep. She had only half an arm on one side, and I used to watch her, rather horrified, as she swept, holding the broom handle in one hand, while she pushed with the stump. Good for her!
    A boy who had had his appendix out was not allowed to move for weeks and had to call the nurse every time he wanted to turn.
    Eventually Matron came to announce that the mayor would be visiting the hospital and, if we had been really good, we would each be given a banana in honour of the visit. By my standards, I was really good, but they decided to discharge me the day before the longed for day. I don't think I even knew what a banana was, but I certainly wanted one, and can imagine being dragged away from the ward, still protesting my right to stay on one more day for the banana.
    Nowadays they seem to allot at least one dementia patient to each ward, plus those with a urine infection, which temporarily amounts to the same. I suppose if they put them all together in one ward it would be impossible for the nurses but, yes, it is hard to get a good night's sleep in a hospital.

    1. ... which prompts me to say I had my tonsils out in 1960 at the Victoria Hospital in Tite St. "Can you count down from 100", said the anaesthetist as he put a rubber gas mask over my face. "Of course I can", I said to myself and next thing I know there's a nurse telling me to spit, which I thought was rude. No banana, I was given a Meccano set, all part of the treatment or perhaps because it was my sixth birthday and I remember being surprised at the doctor who did ward rounds, Dr Shakespeare, a dwarf who had to stand on a platform to examine his patients.

  2. Good up beat post - very interesting.
    I would say the tea/food lady was almost certainly a Filipina. I can understand their American twang but they never seem to understand me unless I use words like elevator, side walk,or french fries. Now there's a thought!

  3. You could try a bit of Tagalog.
    White bread is 'puting tinagay.'

  4. Good to have you back posting. I laughed out loud a couple of times reading through this...hope I was supposed to!
    I've only been in hospital once and that was for a long ago circumcision; thankfully I don't remember too much about it. I do vaguely recall the anaesthetist standing over me, asking me to count backwards from ten.

    BTW I think your nurse referring to you as "Scottie" in a cod American accent, is probably channeling the old Star Trek series when Captain Kirk of the star ship Enterprise says to his chief engineer "Beam me up Scottie."
    Hope you're feeling a little better.

  5. Oh God. The 6am wake-up call, the undrinkable tea, the blaring's all coming back to me now. I am glad to hear that things have got better for hospital inmates since I last did a stretch.

  6. To add a positive bias:
    I have had a couple of light skirmishes with the NHS in the last three years or so, and I can report nothing but first class service.
    And from a light skirmish to full-blown artillery fire, a dear friend, had a pulmonary endarterectomy (google it - there's even a video for the non squeamish) at Papworth Hospital in Cambridge in August this year. Crikey, what an astonishing operation which requires opening the chest cavity, by-passing the blood supply and rummaging around in the arteries. The patient is chilled and the brain effectively switched off. Prior to the development of this complex procedure the only option was a heart/lung transplant. Not easy to find the right donors, not easy to undertake and not a very good success rate.
    The surgical and nursing staff were outstanding and I am pleased to report the patient is flourishing.

  7. I agree Riley the NHS can be wonderful.
    My story is a bit scary, at least it scared me and is no criticism of the NHS.
    I was in theatre and the anesthetist had done his work on me and had turned back towards the surgeon who was busy in the corner alongside another person masked up sharpening their scalpels or whatever they do. I know all this because I was watching it all completely paralyzed.
    The anesthetist turned round exclaimed "OMG he's still awake." Panicking a bit he thrust a tube down my throat and more gently this time extended his thumb and forefinger to close my eyelids - finally oblivion.
    Afterwards with a throat absolutely red raw after the violent insertion of the pipe, I informed the hospital staff what happened.
    The op was on a Monday to fix a badly broken nose after a Saturday game of rugby which we won, the consensus being the celebratory booze still sloshing around one's system was wot done it.
    Did the late Oliver Reed ever visit
    the NHS for a minor operation?

  8. Just remembered, 'Ollie' was once a hospital porter for the NHS, as was I.

  9. I too was a hospital porter. I spent a very happy year at the Wimbledon Cottage Hospital, off Copse Hill and opposite Atkinson Morley.
    None of my colleagues wanted to do theatre duty so I volunteered for every session - fascinating. I was also in charge of the mortuary - ever seen an embalming ?
    All this aged about 20.....

  10. Years ago one of my pupils told me Oliver Reed was a regular at her parents' pub. She said he was "very prankful" (sic).

  11. Oliver Reed was a regular boozer in most of the Wimbledon boozers and known to many of us King's boys. There is a very amusing video called something like the Wimbledon Seven which is worth watching, it charts the route of O Reed from pub to pub.