A Day on a Hospital Trolley

Even though he’s a fictional character, GP Geoff is not so very different from most other medics. If he needs to see a doctor, all he does is look in the mirror.

hospital entrance

But the swelling and dragging sensation in his left groin have become hard to ignore, and today he’s going into the Day Surgery Unit of his local hospital. Hernia repair used to mean a sizeable incision and several days in hospital, but, with keyhole surgery, Geoff will be home the same day.

About 90% of operations are now done as day case surgery. Beds are as rare as unicorns, thinks Geoff as he meets Cecil, the day care nurse who’s looking after him today.

Today Geoff doesn’t get a bed, just a trolley on a six-bedded ward. If a patient turns out not to be fit to go home the same day after all, then he gets to stay overnight. On that same trolley.

Geoff has been qualified just 15 years and already things have changed beyond measure. Or have they always been like this for patients?

surgical dressings

A junior surgeon pops round with a consent form, then the anaesthetist visits. Geoff is distracted by her dazzling smile, her shock of red curls, but mostly by her multiple nasal piercings. What happens when she has a cold?

“With modern anaesthetic drugs,” she tells him, “you wake up so clear-headed that you can do The Times crossword.”

Which is wonderful because Geoff’s never been able to do The Times crossword.

He won’t get a pre-med, which is a shame. It used to be the best thing about having surgery, but there’s no scope for such things on the day surgery conveyor belt. Besides, Geoff needs to be in charge of his feet, because, when he’s changed into a flimsy gown and paper underpants, a nurse takes him for a long trek to the operating theatre. He hopes he doesn’t run into any of his patients.

Geoff meets the consultant surgeon for the first time in the anaesthetic room. He’s more Doogie Howser than Dr Finlay. Geoff resists asking if his mother knows where he is.

scalpel

When it’s all over, he can hardly feel he’s had anything done, but he’s lying in a large well-lit room where a nurse is telling him to drink. He had not realised he was clutching a small Styrofoam cup.

Back on the Day Surgery Unit, Nurse Cecil checks his pulse, blood pressure, and oxygen saturations every half hour, and reminds him to eat and drink. There’s an obligatory six hours before he can go home. There’s also the requirement to consume the tea and roast beef sandwich placed next to him.

The man on the neighbouring trolley is smiling at a film on his iPhone. Geoff can’t see the man opposite, as his girlfriend is busy delivering a prolonged post-op snog.

Geoff decides against powering up his phone. The pre-op instructions were clear: do not do anything important in the next 24 hours. The last thing he needs is a spirited twitter exchange with one of those anti-vaccine types.

Geoff doesn’t have a newspaper so he can’t test the anaesthetist’s promise. He brought the latest British Medical Journal, but he doesn’t much feel like it now. Or the sandwich. 

British Medical Journal

The patient by the window has already regained his appetite, judging by the takeaway his family brought in. The red and white packaging is already open, filling the ward with the heady aroma of grease, along with 17 different herbs and spices.

Eventually Geoff does what’s required of him: drink, eat, and pass urine. Post-op pain is breaking through by the time he gets to the tiny WC, where someone has already hosed down the floor.

In the corridor, one of the female patients is asking Cecil where she can find a nurse, oblivious of the fact that she is speaking to a nurse. “I’m a nurse,” says the nurse. The patient’s face is blank.

Finally Geoff goes home with a paper bag. It has spare dressings, a packet of painkillers, and instruction leaflets on not picking your scabs.

There’s supposed to be a responsible adult with him for the first 24 hours at home. Geoff, who’s single, fibbed about that bit. Luckily nobody checks, and he absconds in an Uber.

Nothing will go wrong, Geoff tells himself. Aside from the little lie he told the hospital, he plans to be a good patient and take careful note of all the instructions. At first, he is a little confused by the stated telephone times.

Then he realises it’s exactly like Sainsbury’s, trolleys and all.

 

Geoff lives in North London where he looks after patients, longs for a meaningful relationship, and rants about the NHS. You can find out more about him and his life in the pages of Hampstead Fever.

You may also like these posts:

How Are You Today, Grandma?

Germs and Geriatrics

 

Six Things my Camera Taught me about Hampstead

Hampstead is part of London that inspires much of my writing. So I set off to take a few photos of this beautiful area, armed only with an iPhone and the belief that I’d discover more through a plastic lens than I usually see just with my own eyes.

One of the ponds on Hampstead Heath

Oh, and a pair of comfortable shoes. Parking is scarce. Besides, there are some places only legs can reach.

The Mount

1 The street signs are rather special.

Like this one, many road signs in NW3 are made of individual ceramic tiles in shiny white on black, often chased into the wall. They’ve been there since Victorian times, and owe a lot to the Arts and Crafts movement. The tiles aren’t just letters and numbers. Some are nifty symbols like a pointing finger leading to places of interest.

2 If in doubt, zoom in. You may catch detail that’s often missed.

Ornamental gate

3 People tend to get in the way. Hampstead is crowded, especially outside certain shops and eateries.

Hampstead Butcher & Providore, Rosslyn Hill

Queuing at the Creperie

4 You may spot celebs such as Emma Thompson, Imelda Staunton, Tom Conti and Liam Gallagher.

5 Some of the celebrities are canine.

Two local residents

6 Even the prettiest parts of Hampstead can turn ugly with overspilling bins, fly-tipping, and uncollected rubbish. Sadly this is set to get worse with Camden Council’s new bin collection schedules.

#CleanUpCamden

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Other posts you may like:

If you want to know more about Hampstead, see my novel Hampstead Fever.

A plea for reviewers – can we open up a dialogue about self-published books?

Thanks to Roz Morris and Nail Your Novel. Much of this strikes a chord, so I’m sharing her post with you here. It’s long, but well worth a read whether you’re a reader, blogger, reviewer, or author.

Nail Your Novel

So I find a lovely-looking review blog. The posts are thoughtful, fair and seriously considered. I look up the review policy and … it says ‘no self-published books’.

Today I want to open a dialogue with reviewers. If you have that policy, might you be persuaded to change it? Or to approach the problem in a different way?

I used the word ‘problem’. Because I appreciate – very well – that in making this policy you are trying to tackle a major problem. Your time as a reviewer is precious – and let me say your efforts are enormously appreciated by readers and authors alike. You get pitches for many more books than you can read and you need a way to fillet out the ones that are seriously worth your reading hours. A blanket ban is a way to fend off a lot of substandard material and save you…

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When Beer is an Aid to Diagnosis

With the FA Cup semi-final, pubs attract their fair share of crowds. Today I spotted a Spurs supporter with deposits of cholesterol around his eyes, along with a physique one can only get from eating all the pies.

This spot diagnosis took me back decades to my days as a medical student at the Middlesex Hospital, when we’d try to convince ourselves that time spent in a local hostelry was equivalent to the same amount of time spent poring over textbooks.  

Three essential texts

I say ‘we’ but the pub pathology sessions were a guy thing. There were just four women in my year. Swots that we were, however, we often tagged along to make sure we didn’t miss out on anything educational.

We didn’t just think of the pub as a causal factor in disease, though it must have been in some cases. One of doctors would regularly claim that the King & Queen had given him spider naevi (small blood vessel swellings typical of liver disease).

In the interests of presenting both sides of the story, I’d like to add that Steve from my year was convinced that impurities in the beer were to blame for all the complications of excess alcohol.

“Pints of Beer” by Simon Cocks is licensed under CC BY 2.0

Anyway, someone would go, “That’s a basal cell cancer over there.”

“Where?”

“Guy at the bar. Left cheek. Don’t stare.”

“So it is.”

“Also known as rodent ulcer,” another student might offer.

“Doesn’t spread to distant organs,” said someone else at the table. “Not ever.”

“Unlike squamous cell carcinoma,” added a show-off.

“You’d never know I had PSORIASIS – SIROIL 1959” by Nesster is licensed under CC BY 2.0

A pint or two later, one of us claimed to have spotted psoriasis. All nodded sagely, even though at that stage we barely knew the difference between psoriasis, cirrhosis, and sclerosis.

It was like winning the jackpot when a man with a stomping gait entered the pub one winter evening. This type of gait occurs in late syphilis, when foot position sense is lost, so the person bangs the foot down hard at each step. Although it’s possible that the man was just been getting the snow off his boots.

I like to think that the fictional GP Geoff from my novels will have once given pub pathology a whirl. On the whole, however, education has moved on. Sitting in the pub is not a learning method I’d recommend to my current medical students. For one thing, misdiagnosis is common. For another, it’s rude to stare.

Though sometimes it’s impossible not to. In one saloon bar, there was a man with a massive swelling down there.  So ginormous did it grow that he needed a wheeled trolley to help him (and it) get around. He finally did seek expert advice, but, it was said, only when one of the wheels fell off the trolley and needed to be replaced.

One keen student was desperate for the chance to shout, “Let me through – I’m a medical student,” but we never witnessed a medical emergency. Lucky, really, as our life support skills at the time would have done nobody any favours.

We never saw anything as dramatic as the stripper and the snake, though we all heard about it, naturally. This particular lady had a snake as part of her act, until the night her sidekick decided to hug her neck a tad too tightly. She was rushed to A & E wearing little more than a sizeable reptile, where an anaesthetist injected the snake with muscle relaxant and saved her life.

Photo FreeImages.com/Marcel Herber

As I say, we all heard about it. But we missed it. We were in the pub instead.

***

GP Geoff and other characters can be found in my novel Hampstead Fever.

You may also enjoy these posts:

What They Don’t Teach at Medical School

What Happens When You Become a Doctor

Hampstead Fever

How to Tell if You’re Old

Every time I go away, it takes me longer to recover. If you too find that jet lag lasts longer than the holiday, or that hangovers are more vicious these days, there may be a simple explanation: no matter how young you look, you could be deep in the clutches of anno domini.

Here are six more signs of age.

1 You enjoy sex. But a cup of tea and a nice sit-down are far more appealing, especially with a slice of Battenberg cake.

Royal Doulton teacup

2 Your kitchen cupboards are full of empty jars, take-away containers, and margarine tubs. Then you graduate to saving bits of aluminium foil, smoothing the creases out carefully to make it easier to reuse.

storing empty jars

3 You have to sit down to put your socks on. And you can’t put underpants on without holding onto something for balance.

pair of men's socks

4 You understand the meaning of “How are you?”, and know perfectly well that people don’t want to hear all about your gall stones or your hip replacement. But you tell them anyway.

5 Your mobile phone is powered up only when you’re expecting a call. After which you may turn it off. Or else forget all about it, until it plays Sgt. Pepper in the middle of a funeral.

Nokia mobile phone

6 It’s a mystery why people offer you a seat on the bus. After all, you still feel as young as ever. You even look it, as your mirror will tell you.

That’ll be the cataracts, then.

Apologies for not posting last week. I had some jottings for this post, somewhere. Spent days looking for the piece of paper, only to discover it right where I had left it. It was so unfair that I then had the worst gall bladder attack ever. A shocker, it was, I don’t mind telling you.

Ooh, before it slips my mind, you can now get my novel Hampstead Fever in many WH Smith travel bookstores, where it’s on a buy-one, get-one-half-price offer. Which is handy if you’re heading for a dose of jet lag.

Hampstead Fever, as seen in WH Smith

No Mother is Perfect

This week, a friend of mine happened across a book while tidying her daughter’s bedroom.

“Did your mother write this, by any chance?” she asked me.

 

Now Le Crazy Cat Saloon, with a cast of cats and a sprinkling of French words, may be amusing, but it’s hardly literature.

Nor is it politically correct. For one thing, it features a cat who’s a stripper. As my sons pointed out, stories about strippers aren’t exactly suitable for readers of all ages, no matter what the cover blurb says.

All the same, whenever people talk about my mother’s many books, or her cat paintings, Le Crazy Cat Saloon always features in the conversation.

On Mother’s Day, I have a vested interest in thinking that mothers should be remembered in the best possible light.

If I were to choose one book to remember my mother, it would be Cocktails and Camels. Although she wrote it just after Suez, and her divorce, it’s upbeat and funny.  Here’s how it starts.

I used to live in Alexandria—Egypt, that is, and not, as some Americans think, the one in Virginia. I liked Alexandria. There was no place like it on Earth, I used to think, and now, on looking back, I am quite sure there wasn’t. It was a nice, friendly little town basking in the sunshine and cool Mediterranean breeze, and in summer its streets smelled of jasmine which little Arab boys sold threaded into necklaces. Alexandria had plenty of character—characters, rather—Italian, French, Maltese, Turkish, even White Russians, to say nothing of Copts, Pashas, Effendis, and bird-brained but devoted Sudanese servants. The grocers were Greek, the jewellers were Jews, the shoemakers were Armenians, and the Lebanese were everywhere. The British Army used to play polo and complain about the heat. How they came to be there at all when they had a most roomy Empire in which to exercise is a long, sad story. For the British, though they like to look like good-natured and paternal fools, are, as every Arab knows to his sorrow, very cunning indeed, especially when it comes to taking advantage of trusting Arabs.

Happy Mother’s Day.

Note: Mother’s Day may be on the second Sunday in May in most of the world, but in the UK ‘Mothering Sunday’ aka Mother’s Day is today.

***

You may also like to read an earlier post: Dating, 1940s Style.

My London Book Fair 2017 #LBF17

Three days of trudging around Olympia with an increasingly weighty bag of goodies is too long, according to my feet, even when they’re well prepared.

well-worn Converse trainers

But two days, as I found out this year, isn’t nearly enough. While the London Book Fair is industry orientated, there’s plenty for authors to do. Here are some of my highlights.

1 Catching up with friends and colleagues, many of them from ALLi, the Alliance of Independent Authors.

With fellow author Helena Halme

with fellow author Helena Halme

 

me with cover designer Jessica Bell

with ace cover designer Jessica Bell

Making new friends is part of the fun too. Book people come from far and wide for LBF, like Aussie writer Rebecca Lang from Sydney.

ALLi authors

from L to R: Jessica Bell, me, Rebecca Lang, Glynis Smy

2 Talks at Author HQ.

Author HQ at LBF

The varied fare is excellent, and this year the seats even had proper backs for weary spines. Too bad Author HQ is once again tucked away at the far end of the first floor. You may need GPS and Kendal Mint Cake for the trek.

3 Author of the Day sessions.

They’re at the PEN Literary Salon, which is where I met the inspiring Alaa al Aswany a few years ago. Sadly, this year Roddy Doyle had to cancel his appearance, so, instead of a capacity crowd, there were half-empty benches where people collapsed to eat their sandwiches. As ever, there’s a dire shortage of seating, which is why visitors have to perch on the displays.

following the Yellow Brick Road

4 Learning more about organisations like the Society of Authors, Gardners the wholesalers and distributors, or the Booksellers’ Association. There’s a whole world outside sitting at a desk writing.

the Grand Hall, Olympia

With a bit of planning, you can also arrange one-to-ones with agents or publishers. There are other ways of publishing too. I should have spent longer talking audiobooks.

5 Admiring awesome new books. There are 20 new books published every hour in the UK. Some of them might even be yours.

General Practice Cases at a Glance

at the Wiley stand

6 Haggling over a bagel.

The sticker said £2.75 but it was £4.60 on the price list. In the end, I got it for £2.60. Nothing is quite what you expect at LBF.

salmon bagel

7 The bottle of Veuve Cliquot I won. This was thanks to Byte the Book‘s legendary networking session on the Tuesday evening. I also collected a dozen useful email addresses and a temporary tattoo.

With many friends and colleagues, I only managed snatched conversations between one meeting and the next. Others, like writers from the Romantic Novelists’ Association, I hardly saw. Next year, I tell myself as I get on the train home, it’s back to a three-day marathon.

On the subject of travel, I can’t resist a digression to add that my novel Hampstead Fever will be on special offer in selected WH Smith travel shops throughout the UK from March 30. That’s buy one, get one half price.

Did you go to the London Book Fair? What did you think of it?