Britain’s National Health Service – a tale from the heart

What’s to be said about a heart attack? If you’ve never had one, not a lot, most likely, unless you’ve seen it happen to others. But if, as in my case, the Grim Reaper decides get a little non-lethal practice, several things come to mind.

First, and most obviously, I lived to tell the tale. So far. Which was far from assured when I got to the top of the stairs at London’s Leicester Square tube station en route to an evening at the theatre.

Second, it helps to be married to a medic. She knew straight away. So did I, but she had the presence of mind to find some aspirin in a nearby pub and cajole the ambulance service into sending a first responder. Before he arrived, I had two policemen hovering over me ready to shock me back to life. One of them told me he’d done resuscitation on eighteen people, which was a comfort, until he told me that fifteen of them subsequently died. His mate had a better record – three out of three. Fortunately, their assistance was not needed.

Third, if you’re going to have a heart attack, have it within a mile and a half of a major London cardiac centre. In my case St Bartholomew’s hospital was that unit. It’s the biggest in Europe. Lucky me.

On the less positive side, having a heart attack is a pain, literally and metaphorically. You feel your fitness being ripped away with every day in hospital. It turned out that one artery was completely blocked and two more were seriously narrowed. So they installed stents in two of them when I arrived, after which I felt quite normal. Four days later, I had the third one done. For some reason the after-effect of that one was far more debilitating. Perhaps it was the heart telling me enough already.

After the first procedure I ended up in a ward that had three other people. Two of them spoke no English whatsoever. The hospital had to use an interpreter to talk with them. The odd thing was that each new member of staff with a function to perform for that person had to find this out for themselves. I kept wanting to shout over “he’s from Barcelona”. (If you don’t get the reference, you’re not old enough.)

The nights were not pleasant. One guy moaning constantly, punctuating his high-pitched eruptions with invocations to his Maker. Another complained about gas and ending up deafening filling the room with a series of farts that sounded like a chainsaw in high gear. And a third guy spent much of his time belching like a bullfrog.

You’re hooked up to all these monitor wires. Every time you turn over, one of them pops out, so you have to call the nurse to rewire you. If you don’t, the monitor beeps incessantly until you do, waking everyone in the ward. Since there’s no sound separation between beds, you not only wake up to your beeps but everyone else’s as well. What I fail to understand is why, with all the whizzy technology they have, they can’t transmit this stuff from chest to monitor without the wires in-between.

And then there’s the commode run. It’s a bit disconcerting to be a yard away, separated by a thin plastic dividing sheet, from someone emptying his bowels with noisy aplomb. OK for Henry VIII’s Groom of the Stool perhaps, but not so much fun as the perfume wafts over.

But hey, I’m the one who paid the penalty for my lifetime of excesses, so who am I to complain about my presence in the middle of this physical and emotional mayhem?

I remain amazed by the number of people in so many roles involved in my care – taking your blood pressure, your blood sugar, shoving a bewildering array of drugs down you. Then there’s the dinner lady, the physio, the bed changer, not to mention the paramedics, nurses, registrars, consultants, the people wanting you to be part of their research, the cleaners, the porters and finally the sweet volunteer who wants to know what you thought of the hospital. I reckon that forty or fifty people were involved in my care over my eight-day stay.

Nationalities of all these people included Nigerian, Irish, Slovak, Hungarian, Ivorian, Zimbabwean, German, Lithuanian, Italian, Filipino, Mauritian, Caribbean and yes, a small smattering of Brits.

Of course everyone’s doing their best to keep you positive and as cheerful as possible under the circumstances. But I would advise that if you are unlucky enough to have a heart attack, try and make sure it doesn’t coincide with a war in the Middle East. Heartbreaking and depressing. As if Ukraine wasn’t disturbing enough. The older I get, the more I start thinking that one war at a time is just about as much as I can deal with.

If you do happen to fall ill during two wars, either of which could metastasise into some weird version of World War 3 (without the nukes hopefully), I suggest that for your light reading choice during your recovery you might avoid one of the greatest novels of the 20^th Century, which is set in World War 2, and Stalingrad in particular. Life and Fate, by Vasily Grossman – all 950 pages of it – is one of the most profound, intense, moving and thought-provoking novels to come out of the Soviet Union. And, depending on your physical and mental health at the time of reading, the most depressing. I shall write more about it some other time, possibly while I’m off games during cardio rehab. Next time I end up in hospital for an indeterminate period, I think I’ll bring War and Peace. More cheerful.

What of the little community of (hopefully temporary) cardio cripples among whom I found myself? To a man, the Brits were grumpy old men, including me. A moan a minute. Then there was a Brazilian, who seemed cheerful enough, boosted no doubt by a succession of noisy phone calls seemingly from all parts of the world. He was right to be cheerful, since he escaped after three days.

The person I will never forget was the little guy in the bed opposite me. He spoke no English. Despite coming from somewhere in the region of Bengal, he also spoke no Bengali. Therefore to communicate with him the hospital had find someone with his dialect, which they do through a subscription app on the net. His wife also spoke no English. From what I was able to gather from overhearing various conversations through the interpreter, he lives in a council flat somewhere in East London, which suggests he’s either a UK citizen or has permanent residence, most likely the latter because to get a shiny blue passport he would probably need a language test, which he would unquestionably fail.

Though I hate to say it, because generally I’m a bit of an immigration softie (which definition probably includes anyone to the left of the odious Suella Braverman), I’m wondering how he manages to function in this country without a word of English. Only if everyone in his immediate environment speaks a language he understands, assisted perhaps by younger members of the family who do speak English.

This is the point at which Nigel Farage jumps in with “there, I told you so, you right-on liberal elitist. This what the rest of us have to deal with”. Though I doubt if our posh champion of Little England has ever been near a Bengali home in the East End of London, whereas I have. Well, not in the East End, but in deepest West Midlands. This was in the course of a summer job fifty years ago. My role was to knock on doors and hand out forms related to an upcoming national census. My beat took me though an area largely populated by ethnic south Asians – in other words, exactly the kind of family that gathered in front of me during visiting time over the past week. The scenario was just the same, except that Enoch Powell was the harbinger of doom then, and now it’s Farage. Hardly surprising, yet depressing, that we still have people living in ethnic and cultural silos. Only a surprise in that so little seems to have changed since Enoch banged on about rivers of blood, which fortunately didn’t happen then and isn’t happening now.

So what can I add to the cascade of opinion from all sides that our National Health System is failing? The quality of staff was excellent, or so it seemed to me. The kindness, the individual care and the responsiveness, from paramedics through to cleaning staff, was undiminished. That the NHS is in the shape it’s in after the battering it received during COVID is a miracle. The institution is a huge machine with many working parts. Sometimes bits fall off. It certainly has inefficiencies, some of which were evident during my stay – for various reasons I ended up in a bed for four days more than necessary.

Given the excellence of the front line staff, it does seem that most of the issues are likely to be about process and management, as is often claimed. Can they be resolved by fine tuning or extra funds? I don’t know. But when I watch generations of government ministers, administrators and consultants having their turn at “sorting the NHS”, often with unintended and adverse consequences, I’m reminded of the comment someone once made about Google, that their algorithms have become so huge and tentacular that nobody really knows how they work anymore. Likewise, I suspect, the NHS.

I certainly wouldn’t want any more contributions from the kind of government that likes to put talentless cronies into key positions for political reasons (such as Nadine Dorries in Culture and, most recently, Grant Shapps in Defence). Perhaps we should wait for a new bunch to have a crack at it.

Meanwhile, ten days on from my little episode and safely installed back home, I’m in pretty good shape and looking forward to regaining my usual stellar level of fitness.

And finally, my little episode demolished a cherished idea I’ve always clung to. I always thought that the experience of having been at a boarding school between the ages of 8 and 17 would prepare me perfectly for life in an institution – such as prison. I was wrong. Eight days in a London hospital, excellent though it is, convinced me that if I was confined in any place on a long-term basis I’d soon become a gibbering idiot, or lose most of what brain capacity remains.

So certain lifestyle adjustments are called for to avoid a repeat of the Great Collapse of Leicester Square. Those of you who know me well will probably know what I’m talking about.

Many thanks to my beloved, to the NHS, and to all the relatives, friends, neighbours and bystanders who were so supportive during and after my little brush with eternity. I’ll try not to trouble you again.