Monday, May 23, 2005

Ashamed

Another reason why I was up at 5.30am writing my last entry, and the reason why I haven’t written again for a few days since, is that we were waiting to hear some news about a close friend of Tracy’s who was sick in hospital.

We heard the news a few hours later. She had died.

She was 36.

All sorts of thoughts race through your head when someone close to you dies, particularly when that person is young.

Tracy took the news badly at first but that subsided after a couple of days. To be honest, I’m not quite sure she’s accepted what has happened. Tracy was chatting with her friend at her bedside on Sunday. A couple of days later she was gone. But Tracy hasn’t yet had to confront the reality of that passing.

If the process of assimilating bad news really can be broken down into a five stage, denial, anger, bargaining, depression and acceptance process, Tracy’s still stuck on first base. For many reasons, I’m not looking forward to the cremation service later this week.

Grief is a deceptive emotion. On the face of it you are feeling and expressing sorrow on behalf of the person who has died. But, on reflection, that just doesn’t stack up. That person is gone. Either way, whether you believe or disbelieve in survival of consciousness after Death, it simply doesn’t make sense feeling bad on their behalf. They really do not care any more.

Grief, and I don’t mean this in a judgmental way, is a selfish process. It’s about that which is lost to the living, not to the dead. Most of the time, if young enough or strong enough, we eventually learn to live with our new reality without the person we have lost and invest in that new reality. Some people, usually the old, never adjust and live the rest of their lives faced with a permanent vacuum. Having said that, there are some holes that can never be filled, however young and adaptable you might be. How do you fill the gap left by a parent or the love of your life? How do you deal with the second half of your life, when there are more people leaving than joining you?

Growing old can really be a pisser but, as I like to say, it’s usually better than the alternative.

Death, particularly untimely death, stirs up other emotions as well as a sense of loss. If you’re older than the person who died there’s a sense of guilt as well. Why is it you have enjoyed five, ten or however many more years of life? Are you using that time well? Was there something you could have done to help that person in some way? Were you a good enough friend, partner or son when they were still alive?

And then, of course, there’s you own sense of mortality. Over a meal with a couple of friends last week we drifted onto the subject of passing forty, as I have just done. We all agreed that little within ourselves had changed as a result of reaching that milestone save one very significant thing. We no longer felt immortal. When you turn 40 you hope that this is just the halfway point in life and that you have many productive and enjoyable years ahead of you. However, unless you’re pretty stupid or highly accomplished at self-deception, you also realise that after 40 you’re fair game for the Reaper. A terminal lump or a telltale twinge could appear for the first time on any given morning and no one, least of all yourself, would have the right to be the least bit surprised. If you die younger than 40 it’s a tragedy, after 40 it’s a shame.

There are also a couple of other, less usual, emotions I’m feeling after hearing the bad news last week.

Anger and shame.

You see, it doesn’t look like our friend died from what she went into hospital with in the first place.

She died from an infection. Whether it was contracted in the hospital or not is unclear. Maybe we’ll never know. Hospital staff have learned to be quite coy in discussing such matters.

My own father spent the better part of seven months in hospital last year. He underwent major surgery to remove his cancerous bladder and, to our surprise and gratitude, pulled through surprisingly well. Then the infections started. He was in and out of hospital, mostly in, for six months. He came close to death at least a half dozen times. And throughout that time I kept thinking ‘Why can’t they keep him free from infection long enough to get better and get out of this place. What the f*ck is going on here.’ It was like torture, and it went on and on. My father is a tough and stubborn man who had the full-time support of a very dutiful, extended family. Other, less fortunate, people would have just died.

Our hospitals are death traps.

Even according to triple-spun government figures, something like 5,000 – 20,000 people die in the UK from hospital contracted infections ever year. Something like 100,000 people contract infections without dying. I’m not sure anyone knows what the true figures are. I have no doubt that there is a problem. My own experiences and those of nurses I know and have met over this last couple of years leave me in no doubt of that.

So, when a friend of ours dies in a UK hospital from an infection, I can’t fight back the nagging thought that, if she was in a hospital back home in New Zealand, she might have made it this time. I shouldn’t even be saying such things and I would never dream of airing such thoughts to her family but the suspicion is there in the back of my mind.

That’s reason to feel angry and shameful isn’t it?

The fourth richest country in the World and we can’t keep our hospitals clean. We spend countless billions on machines, drugs and surgery yet people are dying from lack of basic hygiene.

It’s fucking medieval.

I’m certainly not blaming the nurses. Almost without exception they are fantastically dedicated people. Nor do they consume much of the colossal amount of money spent on our health service. Most are paid less than, say, London Underground ticket collectors who are considerably less well-trained and much less pre-occupied with the welfare of their fellow creatures.

But someone is to blame. Someone is wasting all that money. Someone is pursuing a twisted set of priorities.

Underlying all that anger and shame is the thought of my government and its behaviour. I think of all the billions of pounds and other resources expended on the domestic ‘War on Terror’. And I wonder how even more deranged and expensive all that nonsense would be if terrorists were killing 5,000-20,000 people in Britain every year, rather than the current rate of none per year. And then I wonder if Tony Blair or any of those people who rule us would ever die, or expect to die, as a result of piss poor hospital hygiene…

Somehow I doubt it.

7 comments:

Anonymous said...

Hi Stef, reading your thoughts on Phil has sent me once again into deep thought, tell Tracy I am thinking of her, and all of us, and most of all Phil. It still seems unreal somehow, how could she not get better when she was in the 'right place', this will be one of the hardest things a lot of us have had to go through to date.

Ness xx

Stef said...

What can I say? It just doesn't seem right. It isn't right.

And, yes, it doesn't seem real either. How can it? Tracy visited one evening, Phil looked tired but OK. A few days later and she was gone.

Thursday is going to be very hard.

Juno said...

Your latest post has me thinking about the people I've lost in my own life, and how you never really ever fill that hole.

Sending warm thoughts to you and Tracy.

zenyenta said...

I'm sorry to hear about what happened.

I'm spending more time on a new blog than on my regular one, mostly because the new one seems to accomodate the personal stuff better and at the moment life is dominated by the personal. And that's because of my mother's dementia, and that all started with endocarditis. And guess how she got that? Having a test she really didn't need in our best, state of the art hospital.

It's not like your loss. My mother is 84. But the fact remains, she got sicker and has been permanently damaged because of an infection picked up during a procedure in a hospital.

Stef said...

J.

Thanks.

When thinking about people you've lost it's important to think about what they meant to you when still alive. None of us are here forever. If we're lucky our life overlaps, at least for a while, with good people we care for. We should be grateful for that even in the face of loss.

Z.

Dementia is a terrible, distressing thing. In some ways it's as if the person afflicted is already lost to you. Seeing the impact this has had on friends who have had to cope with its effects, I'd say it's often worse that losing a loved one outright.

And the infection thing. As I mentioned in the post, there is something incredibly frustrating about seeing loved ones damaged by preventable infections. We both live in countries with developed infrastructures. Countries that seem to have limitless resources to spend on bullshit and war, yet we can't keep our hospitals safe.

And sure, most, but not all, the people affected are older. We are reminded of this whenever the issue is reported in our press. But so what? Does this make the situation less disgraceful in any way? 84 or 36, it shouldn't make any difference at all.

Zenyenta said...

I'm not even sure if most people affected are older. Maybe most who don't recover are older is more like it.

My husband was in the hospital several times in the last five years. Twice he came out with an infection. His were treated after his release and he got over them, but infection seems to be more of a given than it used to be. I'm wondering why? Maybe some of it is short-staffing?

I don't know how it works in the UK, but here in the US there's a kind of heirarchy of nursing that's developed since nurses started insisting on pay comensurate with their skills and education. Registered nurses are at the top. They're degreed. Often multi-degreed. They tend to run things and there aren't so many of them.

Next are LPNs - licensed practical nurses - also very well trained in what they do, but they're doing what RNs used to do.

Much of the day to day care is done by aides. A generation or so ago, the aides only did non-medical care. Now they're doing what LPNs used to do in terms of routine medical things. Everything's been pushed down a notch, seems like.

That's not the whole explanation. My mother's infection probably came during an invasive procedure performed by a doctor and attended by real nurses. But I still think that the fact that we're having less well trained people to more patient care can't be a good thing.

Stef said...

There are lots of reasons. Most of them are preventable.

The vast majority of our nurses are poorly paid, however senior. That's why many of them give up on the profession or migrate. The US is a popular destination.

To compensate for this we have actively recruited overseas for nurses from the 3rd World on a large scale. The majority of them are very dedicated, capable people. Though I wonder who is filling the gaps they leave back home.

But, yes, you're have a point. The UK is suffering from the same syndrome of employing under-qualified, under-trained staff in key public roles; nursing, the police and education. We're told this is an act of empowerment but it strikes me, and others, as a straightforward reduction in standards

Even the cleaning staff in hospitals fall short of the standards of the past. Instead of being directly employed by the hospital they are employed by lowest bid contractors. We are told that the cleaners know what they're doing but the nurses I've spoken to are frequently appalled by their standards. And the nurses have no say over the cleaners or their contracts.

Why is this happening? Why are such vital jobs being done by people unqualified to do them? Poor pay and poor working environments are probably the main reasons and, as I said, it disgusts me that my government permits the death of so many thousands of people and chooses, instead, to squander resources on wars and nonsense domestic security measures. I, for one, am more worried about those around me dying needlessly in hospital rather than from a terrorist attack.

We lived in London for 25 years with the constant, and real, threat of IRA violence but we weren't afraid of of health care system the way many people are today.

The comparison with the War on Terror is a fair one to make. 9/11 supposedly changed the world because of the numbers of people killed. Nonsense. We lose that many people in the UK every few months from poor hygene. The US loses that many people every few months from gun violence. I don't see our governments doing anything to stop those needless deaths, certainly nothing comparable with the War on Terror. Our leaders are wicked and they lie.