forget everything you ever learnt about a balanced diet

Shortly before she died, in a hospital similar to the one I recently  myself in, my mother asked for her Christmas present a Ralph Lauren watch. I’d bought her a watch a only a couple of years earlier yet despite this she declared most emphatically that she wanted another, and an Ivy League icon to boot.

Looking at the silver Oris I’d given her, strapped to my left wrist, next to the cannula into which an antibiotic intravenous drip was attached, I tried to imagine what I would request should my present situation turn south. Dismissing any pie-in-the-sky fantasies of Hoyo de Monterreys, Jack Daniels and Jaguar XK8s I decided I’d settle for not having to stumble out of my hospital bed in the early hours of the morning clinging to my intravenous pole begging for something to take the pain away. Believe me, it had been easier getting pain relief at home.

handiwork

My consultant, a solid looking man in his 40s, with an honest old fashioned face and a firm handshake, insisted my condition was “life threatening”, revealing to Kim that the choice of my bed in the middle of the ward was so that the nurses could keep an eye on me 24/7. Nevertheless, when other patients were wheeled in, usually in the dead of  night when the ward was illuminated in a shadowy off-world amber glow, they seemed in far worse condition than I. Their intense pain etched across their faces and their voices muffled by oxygen masks. I may have been restricted to a diet of custard and soup but at least I could get myself to the bathroom and field hysterical SMS text messages from Spike in London who seemed annoyed that my sickness appeared to be more troublesome than his? 

It had all happened quite suddenly. Kim had been away and I at home with  Asta. One minute I’m knocking back pints of Proper Job with brandy chasers and the next I’m face down on the bathroom floor comparing the pain in my belly to that of John Hurt’s in Alien. It felt taught and inflated and at any moment it would explode and the relief would be palpable. Kim returned the next day insisting I contact the local health centre where, after a few prods and pokes. I was instructed to head for hospital where a bed would be set aside for me. The diagnosis? Suspected appendicitis, swiftly dismissed by the consultant and recognised as advanced diverticulitis, with a perforated colon (a hole) and a blood crp inflammation count of 380. The following day the crp (aka c-reactive protein) rose to 435. A young doctor said it should be five but that they’d be happy to see it below 100 without operating. An operation would doubtless mean a colostomy bag and naturally, to quote Leonardo diCaprio in Catch Me If You Can, I concurred  with the consultant; let’s beat this thing and keep the scalpel in the drawer. 

In hospital pain is scored on a chart of one to ten. I took a stab at 15 my first night, not wanting to overplay my hand, and was assured by a young doctor with a ginger beard and a glint in his eye wearing blue surgical fatigues that the plastic single use enteral syringe in his hand contained, “the real deal”. Except, like the curry house waiters who insist their vindaloos will blow your socks off the grinning doc’s idea of the last word in pain relief had as much oomph as a chicken korma. By 1am I was on my knees begging for something stronger. When it arrived it had to be inserted into my bottom by a young nurse who must wonder why she entered the profession?

“We’ve hardly met,” I offered as a way of breaking the ice. She left, and the pain with her. 

A CTR scan on my second day revealed a good deal to the consultant with the firm handshake and seemed surprised when I asked to see the results for myself. Looking at his laptop he tried to explain which bits of the swirling intergalactic mass of grey, black, and white was which. It didn’t look good. He pointed out the perforation and the infection in clear adult terms, completely at odds with almost everyone else I came across who for the first four night days insisted upon addressing me as though talking to a small puppy. Was this another facet of getting old or merely bedside protocol? 

I was surprised at how quickly I adapted to hospital life: The nursing shifts and rapid turnover of medical staff; the blood pressure and temperature readings day and night; the lack of sleep;  the speed with which the consultants make their whistle stop morning and afternoon tours (usually less than 90 seconds per patient); the farting; the pitiful moaning of other patients; and the nauseous way in which men decrepit enough to be the nurses’ grandfathers were shameless in their relentless flirting and double entendres. It was the chief farter’s birthday the second morning and a group of nurses presented him with a card and a tuneful rendering of ‘happy birthday’. What about a little dance came a voice from another bed? “Yeah, a striptease,” intoned the farting Methuselah. 

By the middle of the week, drifting in and out of reality thanks to my ‘real deal’ morphine cocktail, it still remained unclear how often I should receive painkillers and what, if anything, I should have to eat? The doctors said one thing and the advice on the meal trolley chart read something else.

“Basically you’ve got to forget everything you know about a balanced diet,” said the meal trolley girl placing another bowl of custard in front of me. “Jelly, ice-cream, custard. Imagine you’re at a seven year old’s birthday party – permanently.” She laughed and I asked her if she had any paper hats?

The hospital was a 50 mile round trip from home and the daily commute, in addition to the worry and the organisation required to have Asta cared for, was taking its toll on Kim. Each day she’d arrive with a smile and concern and a bag with clean pyjamas underwear and mushy things to eat. A couple of times we rode the lift to the ground floor and drank Americanos at the coffee shop. Another time we stepped outside for some air. I wanted to get well for her sake as much as my own. 

Thursday morning a sister with an irrepressible smile helped me redesign my painkiller combination.  The fruit flavoured morphine shots were proving effective hallucinogens but slow to kick in when I needed relief most. It was making me see things: Big headed monsters in a sea of darkness every time I closed my eyes. Some of the nurses looked at me as if I was mad but one said she’d experienced similar horrors when she’d been on the morphine cocktail herself. A codeine paracetamol blend was deemed an effective alternative. It could cause constipation but would avoid the hallucinations and besides there were powders that could help with the other problem. The new system worked well until the middle of the next night when I left the ward and asked, and asked, and asked a third time for pain relief. When the nurse arrived at my bedside, sometime around one in the morning, with the paracetamol in one hand and the fruity morphine in the other, I explained that during the day the sister had prescribed codeine instead. The nurse was livid. She repeated “you asked for painkillers and this is a painkiller.” I explained again the change we’d come up with, and why. She wasn’t listening. “This is a painkiller. You asked for painkillers.” We were going round in circles, so often infact I recall saying “we’re going nowhere with this, just round in circles.” She walked off and as a parting shot called me a difficult man. I couldn’t disagree with that but nevertheless  grabbed my dressing gown and intravenous pole and loped after her finding her talking to some doctors in a small office off the main lobby. In the absence of any alternative relief, and with a strong desire to keep the peace, I agreed to have the morphine, to which she replied it was too late, “it’s been destroyed.” Sometimes you just feel like screaming.

In response I did the only thing I could. I grabbed my overcoat, and slipped on my boots. Turning around I discovered someone had slipped a morphine syringe on a cardboard cup on my bedside table.  After swallowing the contents I walked past a group of nurses oblivious to the fact that one of their patients was leaving the ward at 1.30 in the morning. The coffee shop and WH Smiths were closed and the information desk deserted. The only people milling about appeared to be night shift employees taking turns to step outside for a quick fag in the bus shelter. The storms that had shaken the ward during the day had subsided and the empty car park was shrouded in a comforting stillness. In the chilly blackness, with the smell of tobacco drifting along from the shelter, away from the intransigence and the moans, I felt more comfortable than I’d been all week. The morphine was kicking in and I could have stayed there, leaning on a metal barrier, indefinitely. In fact, I nearly did. The hospital’s automatic doors are switched off at night and to get back inside I needed a swipe card. I waited until one of the smokers, hunched malodorous and evidently uneasy at the sight of a man in his pyjamas outside  in the early hours, let me in. I returned to the car park after my 6.30 am blood pressure test and antibiotic drip. By then the path to the entrance was busy with day shift employees. Dozens of young workers some of whom smiled kindly at the old man with an intravenous drip and a Dries Van Noten overcoat slung over his shoulders. I walked across to the other side of the car park and sat at one of the picnic tables. I wondered how many people picnic in the hospital car park. I was joined by a woman who had been at the hospital all night with a heart condition. She was waiting for a minicab to return her to the back of beyond. We talked about Brexit, and the NHS, and the anger of people, and both cursed the Conservative party.

The incineration of food and medical supplies is a feature of the NHS. On my fourth day, clearer headed, and with the news that my CRP numbers were falling, not dramatically but in the right direction, I agreed with the food trolley girl that I’d try some sloppy solids. Scrambled eggs? “Can’t do that. How about an omelette, with cheese?” she suggested. When it arrived I was reminded of a pair Clarkes shoes I’d wore in the 1970s stitched around the top on one side. I seem to recall they were known as omelette shoes. It had the texture of linoleum and didn’t appear to have been anywhere near an egg. I considered  not eating it at all and taking it home for use in the rockery. 

Ever the pompous arse I resolved to subtly suggest to the food trolley girl, who I was taking a shine to due to her quick repartee wit,  how to cook the perfect omelette (something I was taught by a French chef on a cross Channel ferry); two and a half minutes in hot pan, flip it over and give it another thirty or forty seconds.

an omelette

“I didn’t cook it,” she said looking at me as though I was mad. “It comes in a box. We just heat it up.”

The reason for this? Simple, there isn’t a hospital kitchen, or a cook. Nothing is prepared fresh. All the meals arriving pre-prepared in boxes from a supplier in Redruth. Disheartened I asked her to return my tub of ice cream to the freezer so that I could have it that evening or the next day.

“Can’t do that.” It would have to be destroyed like everything else that’s been ordered but isn’t consumed. I put this to one of the nurses later in the day who explained that if the doctors deem that their patients refrain from solids, despite having misguidedly ordered something from the meal trolley after breakfast, those meals, despite never having neither been near the ward nor a sick patient, must be destroyed. She didn’t say how much food was wasted in this manner, but it’s a lot. I wondered why the lunchtime meal orders couldn’t be placed after the doctors’ round? She shrugged and said that’s the way it is.

You overhear a lot of conversations in a ward where the patients are cheek by jowl, separated only by a thin curtain. 

Derek was sobbing when he was wheeled in the dead of night. He explained to the young doctor he’d parts of his bowel and lung removed due to cancer. His left hip and knee had been replaced. On the plus side his angina and blood pressure issues were improving, while Colin, also sobbing when he arrived, perked up after his bed bath insisting the nurse is “a lovely girl. Aren’t you a lovely girl.” A man, whose name I never learnt, filled the vacancy in the bed next to mine and was so ill he was hooked up to a machine that sounded like a dishwasher. He barely said a word before being taken to surgery. 

Eddie arrived sometime on Friday. Through a gap in the curtain I could see he was a big man with a shock of white hair, stooped forward in a chair with his eyes closed. A popular man too judging by the number of visitors he received, but alone when the reality of his condition was explained to him the next morning. The young doctor said they could operate but that there was little chance he would survive surgery. His condition was terminal and all the staff could do was ensure he was as pain free and comfortable as possible. After a pause he said, quite perkily, “I’ve had a good life. A wonderful life.” And after another pause. “I was working two days ago. I’ve always worked. I never missed a day at school. I didn’t learn much though.”

I liked Eddie, more so when he confessed to having eaten a pasty three days that he’d been uneasy with. Some hours later an end-of-life carer suggested three options to him: going home; a small hospital close to his home; or a hospice.“I don’t think I’ll be going to a hospice,” replied Eddie candidly. “I’m not a very good mixer.” I heard about Eddie’s funeral a fortnight after I was discharged.

By the fifth day my consultant, a different one from the one I had seen originally, taller and more athletic but with an equally firm handshake, suggested that with my CRP numbers dropping I could be out in a couple of days. “Just sit tight. This is the boring bit,” he said straight faced.

I was over the moon and having been moved to an airier blue ward next door I celebrated my imminent departure with toast and marmalade for breakfast and a £6.00 card for the bedside television multi media device. I’d wasted my money. The television didn’t work. One of the nurses said the company that runs the devices has switched several of them off because the hospital can’t afford the maintenance charges. I tried reading except the angle poise beside lamp was busted and wouldn’t shine down on the bed.  I still had my smart phone so I called Vodafone and bought some extra gigabytes so that I could cheer myself up listening to Fulham losing. By early evening the wind had picked up again and was howling through the frame of the panel window making the strips of sun blind flap about. My attempts to staunch the wind with my overcoat and a towel failed so as a last resort I took a roll of sticky tape from one of the duty nurses and spent the next half hour taping the edges of the window. 

The consultant had said I could go home on Monday (maybe) so I needed to work harder on my recovery. Learning about my Clarkes omelette Kim brought in scrambled eggs. After five days in hospital you cannot imagine how delicious cold scrambled eggs taste. Indeed, all that interfered with my first genuine meal of the week was the sight of patient’s gonads across the way. You see a lot of gonads in a mens’ ward. For my evening meaI was offered a tuna sandwich in one of those cardboard triangular wrappers you find in supermarkets. There were bananas in my bedside cupboard and a pot of tomato and basil soup Kim had left. I quit the codeine, drank the cold soup like it was beer and downed two packs of laxative powders. Nothing happened and when the nurse attempted to fit my fourth cannula she expressed concern that there could be ‘track line’ in my left arm, indicative of an infection. My heart sank. 

It was on my last night that I came to understand why my mother had been so set upon a replacement watch. The Oris is automatic relying upon body movement to maintain functionality: the more you move the more wound up it is. My mother, not being a very technical, had placed the Oris in a drawer unaware that the lack of any chronometrical  movement would bring the watch to a standstill. The penny dropped when I mistakenly thought it seven o’clock when in fact it was way past 11 and the lights were going out. I can’t explain the Ralph Lauren part.

After six days and 15 hours a third consultant took less than 30 seconds to say I could go. The nurse deemed there was no infection and my crp numbers were dropping. I was handed a goody bag with laxatives, antibiotic tablets and a suggestion to stick to children’s party food for the foreseeable future.

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