It was this day last week when I woke up with the pain. Around 4am. I had a packed day ahead – record Planet Normal podcast, travel North straight after to do an interview – and the multiple tasks were whirring in the Rolodex of my brain but, my God, The Pain. Like an iron corset squeezing my chest. Must be indigestion.
I went to the bathroom and glugged down some Gaviscon, went back to bed and waited for the feeling to subside. It didn’t seem to have any effect. The corset tightened another inch. I took some Anadin and tried to get back to sleep, already fretting that I was going to be too tired to do my work.
Around 6.30am, the pain was so intense that I decided to have a bath, something that had helped when I was in the throes of labour. I got in the bath and immediately decided it was an idiotic decision; if I passed out, a possibility that felt imminent, I could drown. Get out of bath, collapse face down on bed, hold tight to sides of bed like person clinging onto raft on a storm-tossed sea and try to think what to do.
I was alone. Himself was away, reporting on the Republican Convention in Milwaukee. If he was here he’d say, “Don’t worry, darling, everything will be OK.” I mouthed those consoling words to myself.
It was surprising how long I kept acting as if all this was completely normal. I emailed my editor at The Telegraph to say, so sorry I have chest pains and won’t be able to do the interview. The email was garbled but I was too weak to correct it (I always thought pedantry would be the last part of me to die; disappointingly not).
That pain was so all-consuming it blotted out reason. Shards of the Anadin had just come back up with great force. Even sipping water made me feel sick. I texted a doctor friend and asked what should I do?
“Call an ambulance,” he said when he rang a couple of minutes later.
“That seems a bit extreme.”
“Call an ambulance. You can’t be too careful with chest pain.”
The 999 operator said the ambulance would take up to 40 minutes. My friend Kate turned up to wait with me. When I opened the door and saw her I burst into tears. I’m scared, I realised. I’m scared. After an hour, I called back and asked the operator if she could tell me where my ambulance was.
No. That isn’t possible, the woman said curtly, like an old-school nanny telling off a child for being greedy. “That’s ridiculous,” Kate said, “they can tell you exactly where a Post Office delivery is. Why can’t they locate your ambulance?”
“Please don’t call us again unless your condition deteriorates,” said the operator, reciting her robotic script.
“Would it be more convenient for you if I died?” I don’t think I spoke that aloud, but I thought it.
When the ambulance finally came, the three paramedics were wonderful. They must see so much s—, actual as well as the dregs of human conduct, but they managed to be gentle, reassuring and jokey, as well as incredibly professional. The young one, Hannah, was fascinated that I was a writer and kept asking about it while I was retching unstoppably into one of those cardboard bowler hats.
“Are you famous?”
“No. But it doesn’t matter. What you do is what matters.”
And it didn’t matter. Nothing about my life mattered in those moments except the ravishingly green trees and hedgerows flashing past the open window of the ambulance on that hot day and the young paramedic longingly asking her boss when they could go and get McDonald’s.
I didn’t know it then, and I’m glad I didn’t, but theirs was the first and almost the last human sympathy I would encounter during my day at the mercy of the NHS. An ECG was not showing signs of a heart attack, the driver said, but that didn’t prove I hadn’t had one. At the hospital, they would do a blood test which would confirm it one way or the other.
The Pain, my ghastly companion for six hours, still squatted on my chest like a hod of bricks. They wouldn’t give me any painkillers now, she said, because it might prevent the doctors giving me the drugs that I actually needed. “You can hang on till then, Allison? Can’t you? They’ll see you within 10 minutes.” I nodded. I could bear it for that long.
Anyone unfortunate enough to have had recent experience of “our NHS” and Accident and Emergency will know what came next. I went from being looked after in the ambulance by three people who, by their every action, showed they were in a caring profession, to a place staffed by people who had lost any sense of vocation, if they ever had one.
My wheelchair was parked up against a wall of an L-shaped waiting room rammed with patients. It was a scene from the Third World. Naively, I expected a nurse to come up and take me for that crucial blood test and offer me pain relief. After a quarter of an hour, a man pushing a monitor on a trolley came up and took my blood pressure. “Sorry, I’m in a lot of pain,” I said. “Can I please have some painkillers?” The man looked blank, not meeting my eye. “I will ask my colleg,” he mumbled and walked away.
Maybe an hour passed before I saw the same man and stopped him, asking for pain relief once again with what must have been mounting distress. “I will ask my colleg.”
By now, I thought I was about to faint and, remembering some far-off instruction from school days, put my head between my knees. The kind guy sitting opposite stopped a nurse and pointed at me, “That lady is in a lot of pain. Can you get someone to help her?” The nurse moved on. Any compassion in that place was from patient to patient. I’d like to report that a Blitz spirit kept us going, but there was only a sense of exhausted fatalism. This is what we must endure because this is all they offer us.
Every so often, a nurse or doctor would emerge from behind the swing-doors and call out a patient’s name. (How you long to hear your name!) “Sharon Marshall? Is there a Sharon Marshall?” I was amazed how few people came forward to answer to their names.
“They must have given up and gone home to die,” I said at one point, finding that an increasingly attractive option myself. My neighbour, an elderly chap, his check shirt splodged with blood, nodded and said, “How long?’
“Four hours so far,” I said.
“Six hours,” he said.
“Eight hours!” The silvery-haired man opposite raised us. He had come to the hospital a couple of days ago, he said, and they’d sent him home. He was from Eastern Europe. “My country is poor, but this…” he gestured around us, “my country won’t treat the people like this. Never.”
Back in April, I wrote about a study which said long waits in A&E were leading to 250 needless deaths a week. Here I was witnessing that lethal calamity for myself. I had a lot of time to observe what was happening – or, mainly, not happening. Despite the crisis, a sullen, Soviet-era socialist listlessness prevailed. We were not treated as sick people desperately in need of help and comfort as I believe we would have been in any other healthcare system in the developed world. We may as well have been in a bread queue for no bread.
I got up from my wheelchair and managed to get to the Ladies where I was sick everywhere, including, disgustingly, on my hair. I dabbed at it with a wet paper towel, trying to restore some semblance of dignity. I just wanted someone to help me. “Don’t worry, darling, everything will be OK.”
Back in Purgatory, someone was telling the silver fox from Eastern Europe that the NHS didn’t have enough funds. And that, dear reader, was when I finally lost it. “One hundred and eighty-two billion pounds a year we give the NHS,” I said, “and this is what we get in return. It’s shocking.” The poor patients around me sat numbly, dead-eyed in defeated silence. No one loves the NHS any more; we just pray it doesn’t kill us.
In a booth in the far corner there was a nurse who seemed to be overseeing things. She was gossiping with a colleague. “I can’t keep water down and I’m in great pain,” I interrupted them. “In the ambulance, they said I’d be seen in 10 minutes because of chest pain.” She glanced at her screen. “You’ll be treated in order of acuity,” she said.
Acuity? Which tier of useless NHS management came up with that buzzword to fob off the folk they are paid to care for?
“Fine. Could I at least have something for the pain, please?”
The nurse said she would ask a doctor to prescribe an antiemetic and paracetemol.
Of course, she didn’t. Forty minutes later I returned to the booth and I said with as much force as I had left: “This is not humane treatment. I may well faint from the pain. If I hit my head on a chair or the floor, that is going to be on you and the hospital.”
Ten minutes later, a miracle of sorts. A cheerful, bustling young woman who could have stepped out of a 40s film, called my name and said we were going for an ECG. “Come on lovely,” she said, taking my arm. Her kindness felt like the first merciful drops of rain after a drought. “That’s rubbish,” the old-fashioned angel said when I told her some nurses insisted I couldn’t have pain relief until I’d seen a doctor. “I’ll go and get it signed off right now.” And she did.
After more than 10 hours of agony, I finally lay back in a big padded chair and felt the iron corset loosen as intravenous paracetamol entered my veins. In a place called, without apparent irony, the Rapid Treatment Room.
The blood test eventually ruled out a heart attack, thank goodness, and a chest X-ray was clear. “Stomach virus,” felt more like a weary guess by an overwhelmed junior doctor than a diagnosis. “Come back in a few days if you’re no better,” she said.
COME BACK? What, to that terrible, unfeeling place? I’d rather be flayed alive with nettles.
And that was it. No referrals for the cardiac tests, upper endoscopy and colonoscopy which I’m told any good healthcare system would have recommended immediately, and which I will now have done on the private health insurance I am so lucky to have.
Back at home, I texted my friend, a senior doctor at the hospital I had just left. “A vision of hell,” I wrote, “Hard to believe we live in a First World country.”
“I share your assessment of A&E,” my friend replied, “and it is the same on the wards. Lack of empathy and concern for a fellow human being. Partly cultural. For some people it is just a job, a means to come to the UK and get more money than they can make at home. Language and cultural barriers don’t help.”
No, they certainly don’t. Not when you’re ill and want reassurance in your own language. My doctor friend, a first-generation immigrant who has built a brilliant medical career here over 30 years, points out that the UK has failed to train enough of our own high-calibre doctors and nurses and so the NHS is hugely dependent on healthcare migrants from 214 countries, some of whom barely scrape the English language requirement (“I will ask my colleg”) and don’t relate to the patients. Even though we are now, at long last, training more British medics, immigration rules prevent the NHS prioritising students from our own universities over those from abroad. Can you believe it?
It’s a week now since what I think of as The Ordeal. I still feel sore and fragile, I cry at the drop of a hat, I move through the world with rather more caution, and I may have hugged the kids that bit tighter when they came for my birthday on Monday. I am so grateful when I think of the handful of individuals who did their best to take care of me under appalling pressure.
But the lingering symptom, the thing I don’t think I will ever get over is the awful sense that we live in a country with a health service so broken, so badly managed, so very far from providing a safe service (“Please don’t call us again unless your condition deteriorates’’), so indifferent to pain and suffering, so conscious of its own rights yet so deficient in basic kindness and consideration that it has forgotten its first duty, which is to humanity.
The NHS is now the biggest reason to leave Britain; it’s scary. You would find better treatment almost anywhere else. How can we call ourselves a civilised country while people are left in pain? We can’t go on like this. We just can’t.