Letter from London: The Sharp Compassion of the Healer’s Art

Photograph Source: Djm-leighpark – CC BY-SA 4.0

Last week, a Bahamian friend living in Nassau was telling me he was getting cracked conch on Kemp Street, a Bahamian version of UK fish and chips. I was sorry not to be there. Instead, I was a guest of the NHS, our precious National Health Service. Our publicly funded healthcare system accessible to those living in the UK, no matter their citizenship, and begun after WWII when healthcare even more important than ever.

In the Accident & Emergency (A&E) department of my local South East London hospital, 64 people were presently lined up on plastic chairs. They were like characters in a Beatles song. We were all together watching a plain wide screen declaring 9 hours and 21 minutes of waiting time.

There was faltering public confidence naturally in the NHS in the wake of these types of delay, unaided by fresh difficulties in accessing GP surgeries. The latest rating from CQC (Care Quality Commission) was that this hospital ‘requires improvement’, though for some in the room the process had already begun, and they were sat back down again. As the day progressed, however, the room would almost burst with patients — free healthcare does not a sick-free nation make — and most of the medical staff would be exhausted.

I shifted in my chair. ‘Wherever the art of medicine is loved,’ said Ancient Greek physician Hippocrates, ‘there is also a love of humanity.’ The man next to me sat slumped in a wheelchair while his daughter dabbed the corner of his mouth. An elderly woman with a bloody lip in the row in front was perched next to an over-anxious husband in a wheelchair, while their two sons told everyone they dropped everything to get there.

Coughs. Sputum. A lot of that. Groans. Jugs of water and paper cups sitting on a nearby table.

At which point, a male in his late teens, barking loudly at a similarly aged female, limped into the building, loosely accusing his friend with whatever wreckage fell from his mouth. The female about-turned, both voices trailing behind them as they happened again in the big bad world.

Still feeling gratitude for the care being given, I was forgetting that NHS staff need more than our gratitude. Proper pay, as one would tell me later, and better resources — these were the orders of the day. It was all very well thinking we all need each other. The NHS was a never-ending funding crisis. There were staff shortages, impossibly high demand, weakening testing and preventative care. Not to mention well-documented profiteers still running amok down the hospital corridors.

Even Conservative Party donor Frank Hester — who said Labour MP Diane Abbott made him ‘want to hate all black women’ and that she ‘should be shot’ — has received more than £400m in swift and hugely profitable private contracts from the NHS and other government bodies.

Which is not to say hospitals don’t offer insight into the human condition. Hippocrates also said healing was a matter of time but also a matter of opportunity.

A man to my left slumped forward like a broken doll. At first sight, he looked like Laurence Olivier’s Archie Rice in Tony Richardson’s The Entertainer. He wore a loud checked suit, incongruous tie, and tiger-patterned shoes, which curled up at the end. He was trembling hard. Not a tall man, his legs while seated didn’t reach the ground. Popping one eye open when his name — a Slavic name — was called, he placed both on the ground, and marched towards the awaiting nurse, herself doing an impromptu head-count — like Nurse Ratched in the movie One Flew Over the Cuckoo’s Nest. All that was missing was the music of Jack Nitzsche.

I was still suffering from acute renal failure due to a suspected kidney stone. No big deal if I avoided organ failure, and it did allow me privileged access to the state-of-play in the NHS today as I awaited results from blood tests and a CT scan.

My assigned doctor beckoned me forward. I had noticed his gloomy disposition earlier, ascribable to a heavy workload, but he seemed lighter now and confirmed that I had a very large stone requiring a temporary stent in the kidney.

I was moved to an area with six large padded blue chairs, confusingly numbered ‘Red Chair 1’, ‘Red Chair 2’, etc. The man opposite, who was grimacing heavily, betrayed a natural friendliness. ‘I am 86,’ he chipped in, though he looked impressively younger. ‘Just been diagnosed with terminal cancer,’ he added, like a man describing a simple walk.

I said I was terribly sorry. He didn’t seem to hear, shouting instead that his wife had SAD: ‘Seasonally Affective Disorder,’ he strained. ‘Just starting to get better, too.’ He nodded and smiled. Insisting upon standing the whole time, he swayed about momentarily on his hips, just like a character in a Patrick O’Brian sea novel. To me, this man was heroic.

Next to him sat the man in the loud checked suit, still trembling. We had been placed on intravenous drips. Out of nowhere, a third man announced he had leukaemia. ‘He must be cold,’ he said, interrupting himself and pointing to the man in the suit. ‘Can’t we help?’ he asked. I placed my great coat across him and called for a nurse.

Just then, the SAD wife’s husband declared he could no longer hear because the battery in his hearing aid had run out. At which point, leukaemia man said he took something to help relieve himself, which was why in no time he was grabbing a paper cup and stuffing it down his trousers, the expression on his face one of imperious relief.

Next, a Rastafarian with a soundbox and walking stick wandered through, playing soft reggae and wishing everyone well. ‘Hopin’ y’all iris,’ he kept saying. ‘’Iris’?’ asked leukaemia man. ‘Feelin’ good,’ explained the Rasta, grinning at his bright red operating socks.

Then a youngish couple arrived, the woman in obvious pain. The man was being aggressive to one of the doctors, a young Muslim woman with a headscarf, accusing her of being rude, an accusation she politely declined.

His partner gasped and rolled. I wondered if she had a kidney stone. This was when more medical colleagues arrived, the man by now accusing them ALL of rudeness — who cares for beauty if your manners are ugly, I was thinking.

‘I would rather be kept alive in the efficient if cold altruism of a large hospital than expire in a gush of warm sympathy in a small one,’ said NHS founder Aneurin ‘Nye’ Bevin — presently played by Michael Sheen in ‘Nye’ at London’s Olivier Theatre — but this one antagonistic man seemed more in need of an ashram in Poona than even warm altruism.

Half an hour later, a needle was stabbed into my stomach, appropriately enough while looking at photographs of whale intestines taken by Jeffrey St Clair with his niece on a faraway beach in Oregon.

A call to prayer emitted from the hospital tannoy — Ramadan was due any moment — and I was wheeled to the ward as if on a camera dolly. Behind my bed’s drawn curtains, I could hear a nearby couple whispering.

I was introduced to the anaesthetist, an elegant woman with a worldly vibe, then to my surgeon, a warm and confident Bahamian with political aspirations. He was soon outlining the specifics of the insertion of the stent. This would be done under general anaesthetic via what I once remembered Italians calling the pepperoncino.

Sure enough, I soon lay beneath bright white lights in an anaesthetic room as Calumn, Ola and Sammy — I read their name-tags — put me to sleep. ‘Here’s what we like to call a nice little gin and tonic for you,’ said Calumn, administering the drugs.

I fell down a giant manhole, lights flashing as I dropped and dropped, arms gently flailing, music playing, sound effects, the surface by now so far away.

All life had become illusion. Jorge Luis Borges sat in a giant armchair stroking a tiny bird. The subconscious had left long ago. Welcome to the sub-subconscious.

Then I heard what sounded like wind chimes, animal sounds, an imagined bluebottle on a summer’s day.

At last, I was coming round. I was in a strange place. I was in the recovery room.

After being returned to my ward, I lay beneath my sheets as an unseen man in a neighbouring bed spoke in Urdu. I peered down at my catheter from where blood was flowing heavily into a bag. I called out for the nurse who took one look at it and ran for help, before returning more calmly to say I should drink more water, which I did. I began to feel better, the blood in the catheter clearing.

The catheter was removed the next day, after which the surgeon discharged me, saying he would remove the stent and work out what to do with the stone a few weeks later. ‘You can sail and play golf,’ he smiled.

I have long admired American poet Gary Snyder: ‘Doom scenarios, even though they might be true, are not politically or psychologically effective. The first step… is to make us love the world rather than to make us fear for the end of the world,’ he wrote. Placing the very real problems of the NHS aside for one moment, acknowledging the seriously injured patients trapped inside Gaza’s hospitals, remembering dying victims of war in Sudan’s growing refugee camps, acknowledging brutish casualties on Ukraine’s frontlines, I have to say I was already looking forward to hearing more from my surgeon about Bahamian politics. Perhaps we can all be getting cracked conch on Kemp Street.

Peter Bach lives in London.