From Brenda in Hove: Goodbye Persona

9 August

I had occasion to check myself into an Accident and Emergency department recently. It was a sobering eight hour experience.

Once one gets through the Covid screening – and you haven’t got an axe in your head (so to speak) – there is a quick triage exercise: blood pressure, blood sample, urine sample and a list of questions.  A male nurse asks me how much pain I was suffering, on a 10 point scale with 10 being child birth. Naturally I answered “one or two” and thus sealed my fate.     

The department was really busy. Part of their problem is that doctors are only giving telephone appointments and if they can’t fix a problem are recommending the patient to Accident and Emergency, a department already over-burdened without the now standard Covid arrangements being added to its load.

The waiting area was adjacent to the area where paramedics bring in those needing attention. Even though I wouldn’t have been there if I hadn’t been rather desperate, I felt my problem diminishing with every arrival.  

The first thing one notices is how calm and focused the staff are – and how kind. It was truly impressive. And they have to demonstrate such perseverance. One man was being questioned right next to me. “Do you know where you are?” (Not really) “Do you know what day of the week it is?” (Not really). “Are you married?” (Yes) “Do you know the date you got married?” “C’mon, mate, your missus will be really cross if you don’t remember that one!” It turned out he had had a fall at work and been brought in by someone he works with. He was carted off somewhere.

The system is also impressive in the way it orders you through the various possibilities. It would normally take you weeks to get examined by three different specialists, get a scan, and a lab test – and there it takes hours (somewhat spread out, but nevertheless).

The second thing one noticed is how stoic the patients seemed to be. I wouldn’t know if this is generally true but the ones around me were. One elderly woman with a face covered in blood after a fall insisted that she really didn’t need to be there and had been brought in under protest. She found herself on a trolley fairly smartly. Stoic they may be, but they are also so vulnerable – probably a lasting condition for some of them.     

Behind a curtain somewhere a woman with a posh accent was saying “Stop that. Don’t do that. Leave me alone.” I was told later she has dementia. A significant proportion of Accident and Emergency patients have dementia, I am told. Imagine their disorientation magnified by all these people in masks. Jesus wept.  

You have to suspend any sense of normality in these situations and you have to also abandon your persona and identity at the door. I was lucky in that I didn’t have to strip and don a robe with an opening at the back! You might be the CEO of your company, mate, but lying on a trolley clinging to the back of your robe and flat on your back, you are nobody in particular! You are in no position whatsoever to call the shots. You are definitely not in charge here. Nobody (apart from the immediate staff) even ‘see’ you. We naturally avert our eyes from people at their most vulnerable lest we invade their privacy but perhaps that also makes them feel invisible and even more disoriented than they already are?  A lonely business.

Eight hours might seem a very long time but I was not complaining and I went home much chastened.        

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