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Night in a Central London hospital

10th September 2012

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“Why the hell didn’t you go to A & E last night?” These were the first words said to me when I puffed out my situation at the doctors’.

Not an ideal greeting, I’m sure you’d agree. I should have probably realised something was wrong when I found I had to pause for breath every ten metres or so down the street. The usually guarded, semi-hostile glances of strangers had turned to wide-eyed stares of pity and worry. I liked them better before.

But this is not an article about me or my lungs: it is an article about drama - a seething, dizzying drama writhing beneath our feet at every step. It takes the most remarkable, exceptional circumstances to make the majority of us just reach down, lift the rock, and see this ongoing, awe-inspiring and not just life-affirming, but actually life-saving display. We should be watching and applauding this dizzying spectacle every day if we are not already.

Well the drama watches us, even if we do not watch it: its actors stare down at us every day, from thousands of windows in hospitals not just around London, but all over the UK. The NHS watches us day and night, its mouth clamped tight shut as we rail at its inefficiencies, even as we cut its staff, its pay, and its funding overall.

“Fuck off! Don’t patronise me!” the man with a shaved head in the bed opposite me is bawling at the placating nurse who is holding his clipboard. She is the head nurse on this ward, and it is not long since she began the night shift. She will be tending to the ward, including this man, until mid-morning the next day. She will continue trying to calm him, even as he continues to shout insults at her, refusing to take his medication. Around eight hours later, having had to deal with numerous such situations throughout the night, this nurse will have to restrain the man who, having refused to take his medication on time, has gone into epileptic shock. She will grit her teeth, forget the bawled curses, and soothe the man back into consciousness, even as she and the other nurses bodily press his writhing, spasming form down so a doctor can administer emergency treatment.

The Accident and Emergency ward is full. The overnight wards in the rest of the hospital are full. Some nurses in the emergency ward are having to work overtime until their patients can be got to overnight wards. A & E nurses are having to wheel patients to overnight beds at the same time as they are supposed to be tending to patients back in the emergency ward, because the moving teams are already too busy or in other parts of the hospital.

The nurse tending me is exhausted and rarely smiles. She is into overtime. She has to measure my my lung performance at regular intervals, as well  as starting and stopping my respirator at exact times; this while performing entirely different, similarly precise tasks for several other patients in the packed ward, at similarly exact times. On top of this, the hospital administration have told her to give and explain a ‘patient feedback form’ to all patients, then collect it from them before they are moved to another part of the hospital. There are bags under her eyes and her voice is hollow. She cannot leave until she has fully explained all her tasks to the already busy nurse who is to take her place.

There is a commotion in the corridor. Incoherent shouts dull the buzz of the emergency ward to a low hum. “Just keep calm,” a resigned but firm voice says outside the doorway. “Keep calm. Do you know where you are, Mr Jones?” More raging, incoherent shouts answer the A & E nurse. Every head in the room turns as the resigned nurse pushes a wheelchair in, all the time trying to restrain its passenger. “Frank Jones! Frank Jones!” the man shouts, until he is red in the face. He looks puzzled, as if unsure why what is coming out his mouth isn’t making sense. It only seems to anger him more, so that he shouts the babble interspersed with his name even more loudly at the nurse. She remains calm and tries to soothe him while she pushes the chair towards a bed. “Frank Jones!” His face is near purple now, and his eyes bulge with that same strange confusion. He tears himself out of the chair and staggers forwards. His puzzled eyes reel around the room and finally settle on something: he lurches towards the bin in the corner, undoing his flies and preparing to urinate. “Frank Jones!” he bellows at the nurse as she tries to stop him. It is only as the nurse turns him back towards the chair that the rest of the staring room sees the gaping red mess that constitutes the back of his head. Much of the back of his pastel blue shirt has turned bright crimson. The back of his white hair looks like a rebellious teenager’s bad pink dye-job. The nurse settles him back into the wheelchair; all the time she does this, he is still bawling incoherently in her face. Her hand brushes his back in passing and comes away streaky red. She ignores it and keeps the man restrained on the way to his bed. He shouts evermore furious nonsense at every member of staff that comes near him.

The night wears on in the emergency ward. Several nurses are having to carry on in overtime while patients in their charge are forced to stay in the ward, waiting for overnight beds. Tensions run high and faces sink. A moment of relief for the A & E staff. Mrs O’Neil, a regular frequenter of the ward, complains to one of the movers that she has lost one of her many shoes. She has developed memory loss in her old age and cannot recall what the shoe looks like, only complaining again and again that she has lost it. She essentially does this every week, and the staff laugh knowingly as they join in the regular hunt for the shoe. Mrs O’Neil cheers up as she starts to recognize the faces of the ward. She smiles amiably and waves at the staff, who do the seem: the mood of the entire ward rises and weary, overworked faces stretch into grins.

It is not long after. I am still in the emergency ward waiting on the brimming overnight wards. Care of me has finally been handed over to another nurse, and the day nurse on overtime has gone home. It is almost ten fifteen. There are only two duty nurses in the still-packed emergency ward and they dart from bed to bed like agitated flies. They are gearing up for the rest of the night shift, which, they tell me, is bound to get worse. 

The overworked, understaffed A & E team tend to myself and a score of other patients still further into the night. Several of my fellow emergency ward patients start complaining - harassing the nurses to be shifted to overnight beds they know are already full.

Finally, my turn comes, and an exhausted nurse who, like the other, was supposed to go off duty some time ago, wheels  me through a maze of corridors and into a lift. Her authorization card can’t be read: she doesn’t rank highly enough to use this lift. She sighs, sets herself back against the handlebars, and pushes me to another set of doors. They are pull doors and she struggles over the chair, trying to pull the doors and reverse the wheelchair at the same time. She tries to laugh it off as she explains to me that this should be the moving teams’ job and that this really should not be a one person task. We combine efforts - me pulling the handle and she reversing the wheelchair - and finally  get through. We reach one of the lifts she is actually allowed to use and I am dropped off at my overnight bed.

“Fuck off! Don’t patronise me!” The shaved-headed man is just beginning his tirade of abuse against the head of the night shift in the ward.

Every night, healthy people; every night, public at large; every night, government ministers; every night, Mr Cameron - every night this dizzying drama replays itself for the people of this country, most of whom disdain to watch.

Every day, however, the government robs more NHS staff of their jobs, leaving those still clinging onto theirs with even heavier workloads. Some hospital trusts are in the process of cutting a planned 300 jobs, meaning that one in twenty nurses expect to be made redundant this year. Every day, the Coalition Government strips NHS staff of ever-greater portions of their pensions and paycheques, even as they pile ever-longer hours on them. Cameron’s government has pledged to cut £20 billion from the NHS by 2015. Every day the government privatises and sells off another section, trying to rip apart at the seams one of the world’s most elementally civilized, human organizations.

Boyle’s plea for the NHS in his opening ceremony has not curbed them, and now it is up to us - every one of us - to experience the drama and spectacle of this organization - to understand its impact on human life and its miracle, and to save it, that we might save ourselves. 

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