A DEATH TO DIE FOR (13 page)

I had visions of having to go back to Hereford hospital or maybe spend the night in one of the many Portakabins around the site until I was found a bed or be trolley parked in a corridor somewhere but he continued that he had managed to convince the admissions co-ordinator that it must have been a communication glitch between hospital computers and that eventually they had located a bed for me.

Relieved at this news I was assisted to disembark and sit in the wheelchair, the blanket was adjusted around me, my feet placed into the foot plates and my belongings collected together, I looked around before we set off and noted in the bright light that there were other parked ambulances and people moving about outside the hospital and I could see through the glass façade a typically modern interior design.

As we moved off I felt the coldness of the winter wind blowing across the open car park onto my face, hands and exposed ankles so I was quite pleased when the big glass entrance doors hissed open and the warm hospital air enveloped me.

We arrived at the admissions desk and my now rather large medical file was handed over for checking and then returned, I thought at this stage a hospital porter would come to collect me but the ambulance crew were given directions and we set off through the hospital towards our destination.

At first I was encouraged by the modern facilities but the further we moved away from the entrance area the more we passed through partially refurbished parts of the old building until eventually we entered an enclosed timber walkway which I imagined connected the old to the new.

Once on the other side we came to a set of double doors but instead of heading through them we took a downwards ramp to the right hand side and descended into a very old part of the original building.

We turned a corner and faced into a high ceilinged corridor which on one side had windows with high sills and on the other had a small nurses station with a disabled toilet door adjacent and then there were two possibly three large openings and a part glazed door across the corridor beyond that.

The whole area was brightly illuminated with high level florescent lighting giving it a shadowless hard look, the overall impression was that it was unloved and tatty …..and it smelled of toilets.

We stopped at the nurses station and again my file was handed over, the nurse asked me if I was able to walk which I affirmed and so I along with my belongings were offloaded from the wheelchair, the ambulance crew offered their best wishes and after agreeing to return the wheelchair to the entrance area walked quickly away no doubt with the thought of mince pies and several libations uppermost in their minds.

With them gone I felt that I had lost my last contact with the warm, friendly Hereford hospital atmosphere and was having to face this new alien environment on my own.

Having travelled for more than two hours my most urgent need was to use the loo, the nurse directed me towards the disabled toilet and said that I should use it, on entry it was a typically oversized cubicle with a WC pan fitted centrally along the back wall that had appropriate adjacent grab rails and with the sink, mirror and hand dryer set low on the walls for the benefit of anyone who had to use a wheelchair.

It was in relatively good nick and so I felt that my first impressions of where I was to spend the next couple of weeks may have been misplaced.

I returned to the nurses station and was escorted to my bed, as we rounded the corner of the first opening I was immediately aware of the level of noise as it was still visiting time and those patients with visitors were chatting while those who were without all seemed to be on their mobile phones.

I could see four beds on either side of the room, each had a rail and a curtain which finished about two feet off of the floor, I was led to the furthest bed on the right hand side.

The nurse placed my holdall on the over bed table and said that I should pull the curtain and get changed into my nightwear while she would go and fetch me a jug of water, I croaked that I couldn’t drink water but I don’t think that she heard me.

At this end of the room there were three windows again with high sills, I realised that this was because we were now below ground level, each one had a roller blind, the one on the furthest window was pulled to the sill, the one in the middle was faulty and hung at a jaunty angle and the one adjacent to my bed had no stop and the bottom hung well below the sill.

Also on this end wall between the two beds was a large cast iron radiator with a few bits and pieces set on the top, it looked like some things were being dried out.

Each bed had an angle poise type lamp and a similarly operated TV screen to the one that I had used previously.

I nodded hello to the two occupants of the closets beds and with my right hand gave a cross throat sign while opening my mouth and they quickly caught on that I could not speak properly.

I unpacked the contents of my holdall into the bedside cabinet and placed my nightwear on the over bed table, I pulled the curtain closed, sat on the bed and wept, this was how I had imagined things might be and the very last place I wanted to spend the rest of my life.

The curtain fluttered and the nurse came in with the jug of water, I was right, she hadn’t heard me say that I couldn’t drink anything, on seeing that I was upset she asked if there was anything she could do. Without lifting my head I shook it slowly and so she said that she would give me a few minutes.

I regained some composure and one handedly managed to take off my trainers and disrobe, I then put on a clean ‘T’ shirt and PJ trouser bottoms and got onto the bed.

The nurse returned but before entering the curtained enclosure asked it I was respectable, I tried to make my voice heard but it was inaudible above the general clamour so next a seemingly disembodied becapped face appeared at the join in the curtains, it curiously reminded me of a Punch and Judy show and the humour of it lifted my mood slightly.

Having seen that I had got changed the nurse pulled back the curtain, she came to the bedside with a clipboard in hand and said that she needed to ask me a few questions for the hospital admissions procedure.

However she said that the most important thing was that I had to have a hospital wrist band, she pulled a length of white plastic from her apron pocket and wrote my details on it along with my date of birth and then sealed over the writing with a clear adhesive cover.

The nurse took hold of my left wrist to secure the new band and for the first time noted the other two I was already sporting, a pale green one and the red one signifying my newly acquired allergy to penicillin.

She said that she would make a note of that on my admission form and then she proceeded to ask me a long list of questions about my age, address, nest of kin’s phone number, had I been tested for AIDS etc. I let her know that my voice was poor and that she would have to listen closely for my answers, she checked to see if she had forgotten anything and then went to leave.

I made a stifled noise to attract her attention which she must have heard because  she turned and on coming back to the bedside I asked her about my NG food and medication, she said that due to my unexpected late arrival nothing had been written up for me and things would not get sorted until the morning.

Helen and Jim arrived during this conversation and they was just as disconcerted as me that I would not have any medication to help control the mucus and assist my sleep, the nurse apologised but said that her hands were tied until the doctor had visited the next day.

Realising that there was nothing else that could be done tonight Helen proceeded to unpack and stow some clean clothes and toiletries into the bedside locker and Jim sat on the bed and asked me what the hospital was like, I said that I had not had time to explore it as yet and that I would let him know more tomorrow.

Helen said that although they had driven the long distance to see me the nurses at the desk had only allowed them an extra quarter of an hour past the usual finishing time for their visit so we would only have about half an hour before they would have to leave.

This was all proving very stressful because at Hereford there had been virtually no restriction on the visiting times owing to mine being a terminal condition but this seemed to hold little sway here.

Too soon the visiting bell sounded and although we stretched it out as far as we could in the end we had to say our goodbyes, Helen said she would text me to let me know that she had got home safely and again in the morning to see what the consultant had to say, we waved to each other as they went from view.

By now the other patients were in various stages of settling down for the night, some were reading others had their earphones on watching the TV so I thought I would do the same for a while to see what was happening about the Buncefield oil fire.

I rifled around in my holdall to retrieve my TV card only to find this hospital’s pay as you go system had been installed by a different provider and that my half used card which I had brought with me did not work, it was going to be a long night.

The nurse came and pulled back the curtain as they do at night and once the ward was settled someone turned off the main high level lighting so I dimmed the over bed light and waited for Helen’s text which was a long time coming because it took over two hours for her and Jim to get home.

I came to with my mobile phone pinging on the pillow next to me.

At Hereford I had got used to a gentle start to the day with the ‘early’ nurse coming in to open the curtains, check my blood pressure take my temperature and disconnect my NG tube but it was a starkly different start to this day.

The ward was quiet one moment and then seemed to erupt as the lights were switched on, people started getting out of bed nurses came to check that we had survived the night, patients were calling saying good morning to each other and one or two dropped items on the floor as they collected their toiletries and headed to the washroom.

During the night I had the need to go to the loo on a couple of times so I had used the disabled toilet on both occasions, it was clean and it was free each time so I thought that maybe things would not be so bad after all, but this optimism was sadly misplaced.

I rolled my shaving kit, soap and flannel into my towel and headed in the general direction that the other patients had gone, I detoured past the disabled toilet and through a door in the opposite wall that had a male pictogram on it.

It was quite a small room with a much lower ceiling than the main ward, each of the WC and shower cubicles was in use and as I stood there taking in my surroundings I noted that the coolness of the room was causing it to fill with steam from the hot showers which the one ventilation fan that had it’s internal cover missing and fan blade clacking against the casing was not coping with it at all and all surfaces were covered with a sheen of condensation.

Being a winters morning there was little light coming through the high level slit windows on the outside wall and only one of the light fittings was working making the room very gloomy.

Through the big burn hole in the cover of the broken light fitting you could see that they were the typical commercial circular type with a black base and translucent plastic cover and an upturned foil pie case above the lamp as a reflector.

The ceiling was painted white and the walls a mid blue, well what colour that was visible where the walls and ceiling were not covered with mildew and it had a quarry tile floor.

It was immediately obvious that during the regeneration programme that the general maintenance of these old Victorian buildings had been put on a back burner.

The steamy atmosphere was starting to make me cough so I left and on finding that the disabled loo was also engaged I shuffled out into the main corridor and found the first public loo that I came across and decided that, much like when Helen and I went camping, that in future I would use the showers in the afternoons.

As I made my way back to my bed I could see from the corridor that the blinds in the room had been opened but that I could not see any daylight, as I got closer I realised how far below ground level were because I had to be nearly at my own bed and look up at an angle through the window before I could see any sky. 

I was rearranging my locker contents following the rushed stowage of the previous evening when the consultant arrived, it was till relatively early so I was surprised to see him.

He said that he would be back to do his normal rounds later but that this afternoon he had to go to a meeting to discuss my having a PET scan and he needed a bargaining chip to make a case for my having one.

He suggested that it might go in my favour if I would agree to having a live biopsy taken of the cancerous growth, this would possibly be to my own advantage and would also be better for research than a post mortem sample and therefore it could be argued that I would be helping others in the future.

I wanted to know what a live biopsy would entail, he explained that under anaesthetic an incision would be made in my neck just behind my left ear and a small amount of tissue would be gathered from the growth, I asked if there would be any side effects, he paused for a minute and then said that damage to the nerves in my neck could not be ruled out but that he thought this would not be a major issue and that from the point of the view of arguing my case the benefits should outweigh the risks.

Having made the decision to come to Birmingham to try to have a PET scan in the first place it seemed to me from his description that this additional intervention would not amount to much and so I agreed.

He smiled as though he thought that he could now achieve something and said he would see me later.

About 11.00am the consultant accompanied by a retinue of about eight junior doctors re-entered the ward, I must have been his only patient becasue they came straight to my bedside and as they clustered around the foot of the bed the last in the line pulled the curtain closed behind them.

The consultant asked did I have any objection to his team being there, I shook my head, he then introduced me to his mini mes who in reply chorused an almost jolly hello as though unlike me they were quite exited to be there, the consultant reached for my file in the rack at the end of the bed, checked my recorded obs which had been taken earlier and then proceeded to explain the unusual nature of my condition.

As he read the notes and gesticulated it was difficult to avoid the eight pairs of eyes staring at me which seemed to open wider or become more intense the longer the oration continued, he concluded rather matter-of-factly by saying intervention was not an option but that I was here for a confirmation PET scan and that I had agreed to having a live biopsy to assist with research.

I thought for a minute that the mini mes were going to break into spontaneous applause.

I asked the consultant what was to happen about my NG food, he seemed a bit thrown to be asked the question, I explained that I had not had any bags of food since before leaving Hereford hospital and somewhat nonplussed he said that he would arrange for the dietician to come to see me as soon as possible to sort out my requirements.

He then said that while he was here he would write up my medication so that I could be given some straight away, I asked about atropine patches, he said that he didn’t think that the hospital used them anymore, he then turned to his team and put it to them that if atropine itself was not available what else could be used.

There was a brief huddle and then one of the young women doctors suggested that eye drops contained atropine, she was congratulated and the consultant said that he would arrange for a bottle of eye drops to be sent from the pharmacy which I could self administer by placing a couple of drops under my tongue as required although I should use it sparingly.

With their business concluded the consultant said that he would keep me informed of the outcome of the meeting and then bade me goodbye and wheeled his team out of the ward.

My mobile phone went ping!, it was Helen letting me know that she was ‘about to leave home and was there anything that I needed’, I texted back nothing I could think of, a reply came back ‘see you soon’.

Helen arrived with Jim around 3.00pm, I explained what had happened so far today and both raised their eyebrows when I told them about having to use the eye drops, then much to my delight Helen produced the now customary small vacuum flask of broken flavoured ice cubes which I took pleasure in consuming.

Jim asked had I seen the latest about the oil fire I said no because my TV card wouldn’t work so Helen gave him some cash and asked if he would go and see if he could find a dispensing machine.

While Helen and I were talking a middle aged woman carrying a clip board in both hands like a tray with a yoghurt pot balanced on top came and introduced herself as the dietician and said that she had been asked to assess me for eating solids and thickened liquids, I explained  in a whisper that I had only been having NG food for the past two weeks and although I had managed to swallow some flavoured ice I could not drink water at all.

I managed to answer some questions which she ticked off on her clip board and then she said that she would like see me try some flavoured mousse.

She removed the foil top, put the spoon into the contents and handed me the pot, I removed a spoonful of mousse and because my tongue was not working properly had to put it well into my mouth so that I could close my lips.

As my mouth shut the mousse squidged off of the spoon and into my throat causing a massive reflux cough reaction which because my lips refused to release the spoon, forced the mousse out of my nostrils.

I saw the dietician physically jump backwards and Helen squirm with embarrassment at the site, I grabbed the box of tissues from the over bed table and just managed with one hand to remove the spoon in time and catch the remainder of the mousse as a sneeze burst out of my mouth.

With Helen’s assistance we cleaned the offending residue from my face and hands, I smiled at the dietician and said hadn’t that gone well, Helen after her initial distaste could now hardly stop herself from laughing out loud.

The dietician conceded that it would probably be best for me to continue with the NG food for the time being however she thought that if I could swallow some ice then I might be able to swallow thickened liquids and set off to make me a cup of tea.

Jim arrived back and having found a TV card dispenser proceeded to make sure that the new card operated the television.

I thanked him and then we told him of the preceding kafuffle over swallowing the mousse which he found totally amusing so much so that when the dietician arrived back with the cup of tea he made sure that he took up a position that would give him and unobstructed view.

I could see from the colour of the tea in the cup that it was very milky, she assured me that it was not hot and proceeded to stir in something that looked a bit like granulated sugar, as she stirred the liquid noticeably thickened towards a consistency that resembled runny custard.

She handed me the cup and this time with tissues at the ready I tipped the cup towards my lips and took the smallest of sips, the taste was absolutely disgusting, I didn’t know how I managed keep myself from wretching unless it was just so Jim would have nothing to laugh at.

I took another small sip and did actually manage a swallow but afterwards I waved away the cup as I just could not face the contents.

The dietician said that she would leave some thickener for me to use if I wanted to and would arrange for a pump and NG food supply to be provided, luckily there were still some pieces of ice left in the flask which I swallowed to take away the flavour of the thickened tea.

The afternoon morphed into early evening and it was getting close to the time that Helen and Jim needed to make tracks.

One of the major differences between Hereford hospital and Birmingham was that no doubt simply because of the size of the place nothing happened quickly, so Helen and Jim were well on their way home before the pump and NG food arrived almost at the same time as a box containing a small bottle of eye drops, the nurse said that because of the delay I had better get onto the food straight away.

I was in my ‘T’ shirt and joggers and had my dressing gown on and as I didn’t intent to settle down just yet I laid on the bed while the nurse set up the equipment and then finally connecting the NG tube she switched on the pump and after checking all was working left to continue with her duties elsewhere.

I pulled the TV round and flicked through the channels, there was no news channel running at the time so I chose a history channel and watched someone build and test a trebuchet.

After watching for a while I started to feel dampness around my neck and left shoulder I reached over with my right hand only to discover that the NG tube had become disconnected and oozed it’s contents onto my pillow and down into the bed.

I managed to pull my self up and swing my legs over the edge of the bed, I pulled the stand towards me and switched the pump off, I surveyed the mess and soon realized that it was more of a problem than a few tissues could cope with so I pushed the emergency button on the bed console.

A nurse stood at the end of the ward and looked towards my bed as if to say do you really need me?, I signalled the problem to her by waving the loose end of the NG tube and pointing to the large brown stain on the shoulder of my otherwise white towelling robe.

On arriving at the bed side she said not to worry and that it would soon be cleared up I let her know that I had not had a shower yet today and suggested that I should go and have one now and get cleaned up while the bed was changed.

I took my towel my toilet bag and a clean shirt with me and went to the washroom, happily all facilities were available as no-one else was there however my initial impression from my earlier visit was not improved by a lack of steam.