I am not unwell; I am off to Hospital

I am not unwell; I am off to Hospital

I am spending increasing amounts of time having bits of me checked out. I don’t know whether it’s my age, or a policy adopted by my GP surgery, but I keep getting referred to specialists. This is not because of illness. They say that this or that should be “investigated”, just in case: cholesterol, moles, eye, blood pressure – that sort of thing. Specialists require other specialist input to do their work – scans, blood tests, dieticians.

So I have found myself trudging endless corridors of many hospitals and clinics, wondering if I am a deserving object of beleaguered NHS resources (I have so far balked at accepting the suggestion that I have a very expensive DNA test for hereditary high cholesterol).

In the past year I have been to: the Whittington (my local), St Thomas’ (oh, that missing ‘s), UCH and Guy’s – the first two several times each. I have been to outreach clinics of the Whittington, held in various north London medical centres.

Those trips have been on my own, out patient, account. I have also visited an elderly relative in the Chelsea & Westminster, and escorted another relative on a couple of occasions to the Addenbrookes in Cambridge.

One thing has been in common with all these episodes. I haven’t entered any medical building with anything obviously wrong with me. Pushing through the (usually) automatic doors, with their shifty guard of smokers outside, my uppermost thought is: “what am I doing in a hospital, even as an out patient?” This thought can easily reach an exaggerated form: “what am I, a perfectly well person, doing among these crowds of the obviously sick?” (a lot of whom are presumably having the same thought).

NHS hospitals are great social levellers. Most classes find their way to them (I say most, because there are those among the wealthy who have arranged for all their healthcare to be delivered privately. They do not go to the NHS public side, except possibly to A&E in the back of an ambulance). The only other institution that is comparable in this respect is the bus service (which has the same social exception as well). You can take the parallel further: the somewhat bewildered first-timer in a clinic’s waiting room, nervously alert to the vagaries of the often arcane queuing systems, is like the passenger unsure of the when and where of their stop.

Another feature of hospitals is the contrast between “front” and “back”. “Front” is all shops and cafes and bustle; “back” is minimally decorated stairs and corridors, becoming more decidedly medical as you penetrate them.  Hospitals, in this “front” aspect, increasingly resemble stations and airports (with the same retail chains and including the crowds). The ground floor of the Chelsea & Westminster, which is one huge cube of a building, is precisely like a small version of Gatwick or Stansted.

The “back” of every hospital has no such counterpart. If you use the stairs rather than lifts, you enter a neutral space – no or very few fellow patients, and just one or two medical people, either scurrying purposefully or carefully balancing coffees.

My strangest experience of hospital geography has been at Guy’s, where the cholesterol man at St Thomas’ sent me for a scan. I was directed to third floor of an obscure block. 

Up the empty stairs I went, to find the third floor apparently entirely deserted apart from a scattering of medical students, whose seminar area this seemed to be, and who appeared briefly only to vanish into out of bounds (to me) regions. I followed corridor after ill-signed corridor, the last ones empty even of students. I fetched up against a closed door, to which was stuck an invitation to ring the bell. When I rung, a nose appeared and told me to wait in the adjacent, empty, waiting room. It remained empty, apart from me, for the next 25 minutes. (Another notice counselled that, if no one had summoned you after half an hour, you should ring again at the anonymous door.)

It was as though I was in an isolation area, just for me (who, of course, am not unwell..).

The visit to Guy’s was not the strangest experience overall. That honour belongs to the weird referral to the Hornsey Medical Centre for an eye examination. My GP arranged it online during an appointment. The time which came back was 8.20 am on a Sunday. We both thought this was a bit strange – but, hey ho, the 24/7 NHS and all that.

At home, I studied the printout carefully. It read something along the lines of “Please note that this is a virtual appointment. Your referral will be assessed for urgency and a later examination scheduled”. What did this mean? That the Sunday appointment would be a very brief first assessment? That it would be a Skype-like interview with a clinician having a weekend lie-in?

I couldn’t fathom it. I didn’t work out that the NHS computer system demands that an online booking immediately yields up a time and place, even if the clinical process by contrast demands a prior assessment of the urgency of the referral before a definitive appointment is made. My “Sunday appointment” was no more than computer field-filling gibberish.

This realisation still in the future, I did indeed turn up on the Sunday, to gaze at the decidedly empty and locked Medical Centre. (Eventually I received a real appointment at a centre in Tottenham, on the way to which I got lost.)

Finally, and in harmony with every politician’s cliché, the NHS medical staff I’ve encountered have been, without exception, patient and cheerful (sometimes a little too much of the latter, especially in the blood test centres).

Their competence I cannot judge (so far), although I wish that they, or some of them, would break the cycle of referrals. I feel that, once you are in certain systems of medical monitoring, there is never going to be a time when you are released from the maze.

But maybe we should be grateful while we can get such attention.

October 2015