Eight Medics, an Injection in the Backside and a Strangelove Moment

Yesterday afternoon I had a Doctor Strangelove moment.

Those of you who read my posts on movies and books will know that Stanley Kubrick’s masterly black comedy about World War Three is one of my all-time favourites. At the climax of the movie, an insane commander of a US nuclear bomber base in England appears to have succeeded in triggering nuclear war between the US and the Soviet Union by sending his squadron on an unauthorised mission. Deep in a bunker in Washington, the president meets with his advisers to decide what to do.

The eponymous Strangelove, played by Peter Sellers, is a former Nazi scientist who is crippled and wheelchair-bound. As he speculates on the chances of survival in a nuclear bunker, and becomes increasingly excited as he describes a scenario in which there are ten women for every man, he loses control of his right arm, which snaps into an involuntary Hitler salute. At the climax of the scene, in a sublime moment of comic acting, he rises from his wheelchair and stumbles towards the President, uttering a triumphant “Mein Fuhrer, I can walk!!!”. You can see the clip here.

My Strangelove moment was not quite as dramatic, but from my perspective just as joyous.

After months of pain around the lower back and left leg, during which I spent three weeks in a wheelchair (as described in my post Crippled in Bali) and the subsequent months dosed up with every pain killer known to man, I checked into a private hospital near my home for what’s known in the trade as a caudal epidural injection.

Basically what happens is that you get injected in the base of the spine with a combination of steroid and analgesic. This little cocktail is supposed to seep up your spinal cord and anaesthetise the inflamed nerve (caused in my case by a couple of wonky discs). The steroid then gradually reduces the inflammation.

My only previous experience of an epidural anaesthetic was as a spectator. Both our children were born with the assistance of an epidural that blocked all feeling below the lower back. Hence when our second child was about to arrive, my wife was chatting away as the surgeon got busy cutting her open. I wasn’t supposed to see that bit, but I caught a glimpse and nearly fainted. Very gruesome.

Anyway, my epidural wasn’t supposed to be so drastic. Just a needle into a little space between the bottom of the spine and the coccyx. Not serious, really, except that if the doctor screws it up you can end up permanently paralysed.

So having survived a week in Riyadh and Jeddah, with frequent sit-downs on the nearest available seat every hundred yards or so, I was due to arrive at 5.30 in the morning on the red-eye flight from Saudi and show up at the clinic for registration at 7am. Not necessarily the best preparation for a life-changing procedure, especially as I was seated next to a bear of an Ulsterman whose upper body rippled over the niggardly 17 inches that British Airways allocates to economy passengers. I don’t ripple – I tend to overhang – so we sort of collided in the middle. Fellow sufferers probably recognise the experience of eating your meal as politely as you can with your arms descending on the food from a vertical position.

A quick pick-up from Heathrow, and my loving wife duly ferried me to the hospital. There all kind of wonders awaited. The usual baggy gown that you don’t know how to wear – a choice between your backside sticking out or your other even less pleasant bits. I guessed that since an injection just above the bottom might be difficult to accomplish through a layer of hospital linen, it was the gluteus maximus that should be on display. Apparently I was supposed to don a pair of paper underpants, but none were provided. So I used my own. Charming ladies came and went. One to take my blood pressure and another to take my order for a post-procedure meal – assuming that the medics didn’t have to deal with the sudden onset of paralysis.

The consultant, equally charming and one of the best communicators I have encountered in a doctor, came in to brief me on the procedure and get me to sign the consent form. He went over the side-effects once again, but in such a way as to suggest they would never happen under his watch. Duly encouraged, I signed my life away.

Now you might expect that I would be gripped by a touch of pre-op nerves. But lulled into a questionable sense of security, I nodded off for an hour while waiting for the execution party. Though perhaps the fading imprint of the Ulsterman’s arms in my ribs had something to do with it. It wasn’t the best night’s sleep in BA’s cattle pen.

In due course they came to take me down to my fate. For the umpteenth time I was asked for my name and date of birth. Perhaps they were afraid that someone else might slip into my place for a dose of steroids.

Down in the torture chamber another team was waiting. Including the consultant, I counted at least four people who were there to tend to my needs. They included a nurse whose main purpose seemed to be to hold my hand while the needle went in. If only one received such attention in the dentist’s chair!

So I was asked to lie on my front with my backside protruding from the gown. As they prepared for the jab, they peeled down my underpants in stages. Strange feeling. When you’re under general anaesthetic all kinds of indignities can be inflicted upon you and you wouldn’t be any the wiser. But lying fully conscious on a table while a pair of female hands is progressively exposing your bum to the elements is definitely different.

These days they use some kind of ultrasound to make sure that the needle goes through a little hole in the bone structure. Looking up at the screen, I could see everything in real time. Not much pain, and five minutes later it was over.

It was back in the room where I started that I had the Strangelove moment. For the first time in three months I was completely without pain moving around. I resisted the temptation to exclaim “Mein Fuhrer, I can walk!” out of respect for my Polish nurse, whose national experience might not have helped her to share my sense of humour.

Since yesterday, I’ve almost forgotten that I had a problem. True, I’m not cured, but there seems a good prospect that things will start to settle down. And thus far, none of the symptoms of steroid abuse – no sudden facial hair, acne or irrational outbursts.

Why have I bothered to bore you with this lengthy description of a routine procedure?

Well it makes a change from talking about tetchy politicians. But it’s also because every encounter with British medicine seems to give give me fresh cause for thought. In this case it does seem extraordinary that I should attract the attention of at least eight people for an injection. My stay lasted for about three hours. It was not always thus. Two hundred years ago, in the aftermath of the Battle of Waterloo, soldiers had their limbs amputated in 15 minutes with only a slug of brandy to lighten the pain.

The complete deal cost my insurers about two thousand pounds. That’s private medicine for you. Yet if you’re prepared to wait, you can get exactly the same treatment in the same hospital under the National Health Service. So actually you’re paying for fast treatment. But is that all?

While I was in the treatment room I heard that NHS staff now have to pay for car parking. Also that they have to pay for the milk in their coffee. I couldn’t help thinking what effect such petty cost-cutting measures must have on the morale of the staff. One of the consequences of giving accountants too much say over the running of an organisation is that the cost savings they so diligently achieve can be outweighed tenfold by the lost productivity that stems from demotivated staff asking themselves why they could be bothered. I’ve seen this over and over again in my business career. Saving a few pounds by cutting out inexpensive benefits can cost many times the value of the cost reduction, as staff no longer go the extra mile, people more frequently call in sick and employee attrition rates rise. As they blather away during the current UK general election campaign about reducing deficits, politicians should note that too often austerity is the bringer of false economy.

Before checking out I was presented with the inevitable “how did we do?” feedback form. I was asked whether I would recommend the hospital to others. I checked the Highly Likely box. Thinking about the smiling, highly competent people who looked after me, I wrote in the box that asked for the reason for my response: “The staff. Keep them happy.”

You can have the best facilities and equipment in the world, but without the staff, you might as well make do with a few couches in a cow shed. As for the eight charming medics, in the nicest possible way I hope I don’t get to see them again.