What I love about the NHS is its heart. What I hate about the NHS is its indifference. I could write a whole Edwin Morgan-style poem about the NHS.
It’s got to be a love-hate relationship. I think it is too for many of the people who work in it devotedly, and the ones who don’t.
“Nobody will look at the whole of me,” my mum said on her third stay in hospital this year. “It’s like a department store. You go to a bit of it and they say, ‘Sorry we don’t do that here. We just look at this.’ Nobody is interested in my legs.” Her legs were massively swollen, dry and cracked and purple-black by this time.
The trouble with the NHS is that there doesn’t appear to be much joined-up thinking – hospitals are not holistic. When something goes wrong, somebody is sure to say: that’s not my department. Like your body was a department store, separate floors for separate stores – heart over there, lungs on the half landing, eyes in the lift, blood sugar on the escalator, renal function in the basement. Your renal is retail. Your patient is a consumer. A customer.
It’s all like a changed weird world, partly surreal.
Past a certain age, you won’t really get people who are happy to criticise the NHS. It’s like some kind of sacrilege. Elderly people know how hard it was fought for, and what a privilege it is to have a free health service, what an extraordinary achievement it is, what an amazing thing to build after the war: to not have to depend on health insurance, to not be like selfish America, to not be stuck in a poor country with no state-of-the-art equipment, to have free and easy access to medication, to have dedicated nurses and doctors. To criticise the NHS is a bit like criticising somebody in your family. It hurts.
My parents have both been in hospital this year, my mum spending six months in four separate stays. She’s 85, bright and feisty, her wits still intact. When going through her address book this Christmas, she said on the phone to me: “He’s dead, she’s dead, she’s dead, he’s dead, God, she’s dead, they died last year, dead, dead. Jackie, I was afraid to turn the page. Everybody’s dead. Everyone’s got a line through them.”
It must be so strange, I thought, to survive all your friends. Yet nobody really talks about what that must be like for older people. Like during the Aids epidemic when people lost friend after friend, but at least some people understood how traumatic that was.
And in Glasgow’s Gartnavel hospital, where my mum ended up for four months after falling down the stairs and breaking her hip and arm and thumb, the nurses were amazing, and the doctors too. And though the hospital is creaking under the weight of all the elderly people, and the people living with dementia shouting on repeat “Help me, help me”, or wandering into the wrong ward and trying to get into the wrong bed – like lost people from fairytales, trying to catch a bus or find the keys for home – the auxiliaries still try and keep the spirits of the place going with the banter of the tea trolley.
A gay male nurse sings jazz songs and changes my mum. He brings her a rose quartz to protect her. Another nurse says in her Nigerian Glaswegian accent, “Helen, we must wash your rose” – and my mum kills herself laughing, repeating the story back to me. Wash my rose!
But you also can’t escape the hopelessness that has crept into old hospitals. They creak and can’t take their own weight. The wards are over-full and everyone is overworked. The doctors and nurses, the porters and cleaners – all on 12- or even 13-hour shifts – they look like zombies. Like they are operating on the hysterical energy of the overwrought.
Exhausted from the relentlessness of visiting, you walk down the corridor with a clean nightie for your mum, grapes, Robinsons no-added-sugar orange, magazines – and you see on the faces of the weary, worried workers the same surreal exhaustion that’s on your own. Your 90-year-old dad wheels your mum to the cafe, tired but still trying to be cheerful. It breaks your heart. You find yourself stuck in lifts with porters and other visitors, and even in the small, confined space of a lift everyone looks existentially alone, stressed. NHS: the nation’s heart on a sleeve. But you are lucky: you live in a country that has the NHS!
There has to be a better way of ageing than this. There has to be a better kind of hospital. My mum’s hospital, old and never meant to still be in existence, promised state-of-the-art physiotherapy. It was nothing like what we had been led to expect. It used to be, the sister told me disappointedly, but it’s not any more.
There’s one physio for two whole floors. The plumbing was also broken. They couldn’t mend it because the whole system was old and connected and every time they tried to fix it a ward would flood. The roof of the ward above my mum’s ward fell in. Everyone had to be moved. My mum didn’t have a shower for three weeks because they had no hot water. The nurse said, “Thankfully this is an old people’s ward, the old don’t mind not having a shower. The old don’t mind a bed bath.”
In the middle of the night one night, my mum got herself out of bed and, on her Zimmer frame, found the disabled bathroom in the dim light and then crashed to the floor, fracturing her pubic bone and banging her head. They sent her for scans in the dead of night and in the morning she had no memory of what had happened: “Apparently I sleepwalked on my Zimmer,” she said. “The whole system is going,” she said. “My body’s a broken-down car.”
Nobody told us she’d fractured a bone in the fall. We read it after in the report.
I thought they should change places, the old plumbing system and the treatment of the body. The body could use the hospital’s connected plumbing system and the plumbing system could do with the body’s departmental isolation.
“Nobody looks at the whole of me.” You go with your swollen legs to the next department, and they say, sorry your feet are not my problem, we only upholster the heart here. And you’re wheeled down another corridor and another and another, the names for things appearing and disappearing, blood, heart, lungs, bones.
Nobody looks at the whole of me, she says. Then sings: the knee bone is connected to the thigh bone, the thigh bone connected to …