I looked up the word “health” and interestingly enough it evolved from middle English hāl, meaning whole. Looking closer, we can conclude that the words inhale/exhale are connected to hāl – so here is a direct linguistic link between: living in health as living in breath.
Last Thursday night when I was in total agony, breathing is all I could do…breathe, breathe, breathe. I squirmed and rocked backwards and forwards, I inhaled and exhaled, my whole body cramped up and was arranged in survival postures on the floor at first, and then on my bed. The hours seemed to last an eternity, the excruciating pain I was experiencing was possibly the strongest pain I have ever felt, it certainly paled that of meningitis. There were several instances where I was convinced I was going to let go of this body and die. I was thinking of leaving a note in case I did die and someone did find this body dead. I could not think of much else, neither could I walk, nor make a phone call. After all, who would I have called? I do not have access to a health care system that would take my condition into serious consideration. To get an ambulance you would have to engage in a lengthy investigative questioning session on the phone to establish that you are worth it.
Let me give you a story of a journey into the health care system.
After a sleepless night, I plugged myself into the health care system the regular way. This meant, hunting for an appointment in the morning because getting an appointment is not something that is equally available to all patients. You are expected to phone your General Practitioner (GP) at 8:30 am to see a doctor that day. No, what you need to do is be the first person in the phone line. As in my case, an emergency situation, where you definitely need to see someone and cannot chance a delayed appointment, you start to hang out on the phone at 8:15 am and dial, redial, dial, redial… However, completely exhausted from the pain and a sleepless night, I fell asleep just about 8:00 am and woke up at 9:00 am. Damn. I scrambled to phone on my mobile and received a peculiar answer that I this number was not accessible. Next, get back on the internet and check the number, number is fine, dial again, still the same, hurry, hurry – ok, try with skype. I skype phone the surgery’s landline and finally get through. The voice on the other end is telling me that all appointments for the day are taken. I plead with the person, I am in severe pain, please believe me I am not kidding, why would I call you otherwise, and so forth. Eventually, he shows mercy and lets me come in and wait for an opening, because also I have been going to this surgery for the last five years so the person I was talking to knows who I am, they can match the name to my face. The surgery is near by, perhaps a 10 minutes walk, which is now the next obstacle, the smallest of them all, because I can ‘breathe myself there’.
I arrived at the surgery and my GP is on sabbatical. There are other GPs in the building and I just have to wait for one of them to become available. Positioned in front of the receptionist counter, I sit on a chair. Patients and admin personnel all share the same big room. I breathe and contain my pain while other patients go in and out the surgery. They have an appointment. They might only be there for a renewal of a prescription but they have an appointment. I am there because I thought I was going to die last night. After one hour, I drag myself to the front desk and I gently ask how much longer it will be. His answer is when the GP is available. This is after several instances when there was no other patient waiting with me. After another hour of waiting, the pain becomes completely unbearable again, and tears are starting to roll from my eyes. I have no control over my face, I suppose it is the body’s relief system that kicks in at some stage when on top of the physical pain there is a physical holding back because of the ‘social containment’ we are so trained to adhere to when in social settings. One patient, who is sitting across from me, gets up and gets me some tissues from the counter. Apparently this overt sign of severe pain then made it possible that I was going to be seen in just a few minutes.
The GP as general practitioner, their work is to guess what you might be going on with your body. This GP’s guess was that I had a virus and therefore I need to take a muscle relaxant for my intestines and that it would go way “surely”. I drag myself to the pharmacy which is also nearby and I get the drugs, go home, take the drugs, lie in bed and breathe.
At about 4:00 pm, nothing had changed. It was Friday. If I did not get to see anyone today who would give me a better deal in what they guess is going on in my body – I am as the English say “stuffed” because the weekend bears many hours for potential pain. I get on the phone again and call the surgery, after a few minutes of pleading with a different member of the staff, I am allowed to come in if I get there before 5:00 pm. I scramble to get out of my bed, dressed and dragged to the surgery. It is beginning to be evening and by now the pain has worsened. This time I see a different GP, I tell my story again, and after a brief examination she tells me that it could be a kidney colic. I am surprised. Let’s say I am no stranger to my body and I know some of its strengths and weaknesses. What I know about my kidneys is that they are some of my strongest parts. Never mind, I go with it. She gives me a letter and off I go to A&E at the local hospital.
I have now at arrived at stage two of this journey into the health care system. I arrive at the A&E which is the emergency unit in English hospitals that everyone has to pass through whether you are a walk-in or referred with a letter by your GP. In the A&E it is very busy. I sit in a chair clutching my letter and my overnight bag. Knowing how slowly things evolve and arriving at 7:30 pm only leaves a slim chance for me to get seen before tomorrow morning. After about one hour of waiting I drag myself to the counter and gently asked when I will be seen, the answer is in just a few minutes. I go back to my chair and after 20 minutes someone indeed calls my name. I walk into another room and wait. A nurse comes in and performs “observations” on me which is measuring blood pressure, temperature, pulse, collect urine samples and so forth. As we are done, another nurse walks by and acknowledges that I am in severe pain – this gets me a trolley bed instead of having to go back to my chair.
I lie there in midst of an assortment of patients, who come in with all kinds of different bodily afflictions, including men and women drunk out of their minds. One drunk woman causes a scene, and the police is called. It stops the operation in its tracks. Two hours have gone by since I have been squirming on the trolley bed. I breathe. Three hours, four hours go by. I breathe. I flag down one of the nurses rushing around me and mention that I have not seen a doctor. She refers me to the coordinator, who is a nurse orchestrating when a person is seen by whom. I speak to the coordinator and he tells me “we had an incident” – no kidding I was there, I was not blind to the fact that a drunk woman caused a scene, but “don’t you have many drunk people come in on the weekends?” The answer is yes, and he apologises for the wait. In passing he tells me that I have to be seen by a consultant because of where my pain is located and that I need to be brought to the clinical assessment ward. After an additional hour, the porter with a wheelchair arrives to pick me up, and I am stirred through a myriad of corridors and elevators. I have no idea where I am going nor did I care, I had to breathe to cope with the pain. At this time, the strength of the pain had gone back to the same level as it was initially on Thursday night.
I arrive in the ward and I get in my dedicated bed. A nurse comes to greet me and listens to my story, while expressing to me how sorry she feels for my pain. She also informs me that she will now call a consultant to come and see me because there is no doctor in this ward at night. After about one hour, a young doctor comes to listen to my story. I squirm while I am talking with her, I’m in great pain.
She examines me and tells me that she guesses that I have kidney colic and that we need to perform a CT scan to see what is going on. Before moving on with the scan procedure, we need to know if I am pregnant. I am not pregnant, I tell her. She asks me again, if I am sure if I am not pregnant. I tell her: no, there is no physical way that I could be pregnant. Trust me. She leaves me and 10 minutes later the nurse returns to tell me that I need to collect a urine sample for a pregnancy test because we cannot perform a CT scan if I am pregnant. I tell her that I just told the doctor that I am not pregnant, her response is that she has orders from the doctor for a pregnancy test.
After my urine sample and a pregnancy test, I am wheeled into the scanning unit where a CT scan is performed. I come back to my hospital bed, it’s 4 o’clock in the morning. The consultant is gone, and I have to wait until the next day to have an expert look at the CT scan and tell me what is going on. As I arrive from the outing to the scanning unit, the nurse comes back with a big smile holding a small container of four different pills. She tells me that these are my pain killers. I ask her if she means all of the them, yes, all of them – you want me to take four different pain killers? Yes, they are stepped up in strength, starting from Paracetamol as the one ranking lowest for pain relief. I tell her that I will only take one. I take one because I do need a break from this pain and I want to sleep.
The next morning I meet the other women in my room. Two older women is all I remember at this stage. One was there because she had complications with a pancreas problem, and the other was there because in a previous gall bladder removal, the surgeon had accidentally cut into her liver which caused complications in the healing process of the operation. I am greeted by the nurse who is bringing me the pain killers. I tell her that I do not take them. None of them. I just wanted one for the night. Already when I was in the A&E, nurses would come up to me and ask me if I wanted Paracetamol, I said no, I breathe. One nurse was quite insistent, so I said that I wanted to be able to tell the doctor where the pain is located precisely for an accurate diagnosis. In the environment I found myself in, pain killers are handled like candy. Paracetamol is the basic of them all and nurses are constantly encouraging their patients to take it. One conversation I listened to shortly before I left the ward was between an older woman and a nurse. The older woman was chatting with me as I introduced her to equal money. The nurse brings her pain killers and she asks: “Nurse I don’t have any pain right now. Should I be taking pain killers?” The nurse answers: “Yes of course, because you might have pain in 20 minutes and we don’t want you in pain.”
At lunch time the next day I see the expert, an urologist, he tells me that although my physical pain points towards kidney stones, my kidneys are in great shape and he has to pass on my case, because he is unable to make any further assessments. I ask the nurse what that means, she explains that we are back to square one, and my case is passed back to the general team of this ward.
After having seen two different doctors until this point, I saw an additional two doctors which took a day and a half. In each meeting I had to recount my story. These doctors mostly looked at the notes that had been taken by the previous doctor, rather than listen to my oral report and the symptoms that I was describing to them, which increasingly distorted the facts because so much was lost in translation. In the end I became a case of severe constipation, so they told me, because none of the doctors that came after the urologist had looked at the CT scan. How do I know this? Simply because these specialists each asked me if I had my appendix removed. I reckon anyone who would have assessed my CT scan would have noted that my appendix was missing from the picture in front of them. In addition, with all the note taking that was going on, someone would have noted down that they observed “vermiform appendix absentis”.
On Sunday my allocated resources by the health care system had run out, I received no further investigation into the matter, no ultra sound, nothing. On my way out, the nurse insisted that I need to take the prescribed drugs with me, which consisted of pain killers, and two types of laxatives. I told her that I will not take them, and I would prefer not to have to take them with me as there has been no proper diagnosis. It came to the point where she was getting angry, all this time in the ward I had taken one little pill, and refused everything else. Now, this last stage she was going to get me to take this bag of medication with me. Eventually, I just took the boxes and bottles of chemicals, I will drop them off at my surgery where I saw a sign for collection of in-date medication to be shipped to Africa.
Clearly my story is one of many demonstrating that the system is not working. The GP puts each patient on a track when he or she hands over a letter with a working assumption what the problem might be. If the GP is good in guessing what is going on with you, you might be lucky to be treated by appropriate doctors and procedures. If not, as in my case you are left where you were when you got in. The whole ordeal was about getting into the hospital, than trying to get seen by the right doctor, and receiving information that is meaningful. It is as difficult to get out of the hospital as it is to get in, I waited for 5 hours to get a letter that would officially dismiss me.
When I walked away from my room, I left a group of women behind that were pumped up on pain killers every hour of the day, unable to listen to their bodies or even take responsibility for what is going on in their lives. Some had missing body parts because in their own understanding these were ‘rotten’. The physical body, often hailed as our highest wealth, becomes a worthless entity. As in my case, I have an inkling what is brewing in me and I will pursue this further not relying on the system because the system has no interest in my healthy existence – to the system my health is currency. The sicker I get the more money can be made of me. The situation I described here proves this in minute detail, nurses are drug pushers, and doctors who could investigate what maybe a looming disease are not using common sense.
The root of the problem with such a health care system is the cost, the investment of time and resources, in every respect it comes down to money. Here is a perfect example why we need an equal money system, where all are receiving the best possible care in a timely fashion – where the body is respected and treated as what it is – the only ‘thing’ that is here.
Investigate equal money!