IT HAPPENED TO ME
Gerald H Thornhill
An experience with Cancer and the NHS
"A cancer is the abnormal growth of
cells that have the ability to invade or
spread to other parts of the body."
Monday 30th April
I had a blood test a couple of weeks ago, something I have every six months and drive down to the surgery in Lingfield for the results.
Usually, Doctor Richardson stares at the computer screen and says, "Mmm… yes, everything is fine – kidneys, liver… yes, you look fine, you are fine. Come and see me in another six months."
But today I detect a difference. She looks at the screen and frowns, fiddles with the mouse, scrolls up, looks at the screen again. There is a silence. Then: "Mmm…" More silence. From the waiting room I hear a mans voice, one of the other doctors, shout, "Mr Brownlow, please."
"It's telling me you are a little anaemic, Gerald." Doctor Richardson says.
"Anaemic? What does that mean?" I ask.
"It means your haemoglobin is low – you're lacking red blood cells." She swings away from the computer screen and looks at me, "We must find out why."
"But I feel fine."
"Yes, you do look fine, but we must find the cause of this anaemia. I'll arrange for you to have an ultrasound up at Queen Vic's and…" She pulled a plastic tube out of a cupboard and putting it into an envelope she gives it to me.
"…I'll need a stool sample, okay?"
"Okay," I say, "But I'm going away – to America – in a couple of weeks."
"I'll tell the hospital it's urgent and with a bit of luck, they will arrange for you to have the scan before you go. Okay?"
I am dismissed.
Four days later I receive a call from Queen Victoria Hospital, could I come in for a scan on Friday? That was quick. I'm impressed.
Friday 4th May
Heather comes with me and we go via Lingfield and drop off the stool sample at the surgery on the way. Queen Victoria Hospital, in East Grinstead, is famous for its care of Second World War pilots who suffered horrific burns in their battle for Britain and it still does wonderful work for burn victims. It has the atmosphere of the late nineteen forties early fifties, I don't know why. Maybe it's the temporary look of the buildings; maybe it's the general feel of the place. It reminds me of cottage hospitals as they used to be. It's a ‘pay and display' car park. (Not like cottage hospitals as they used to be.) £2 an hour, but it's full. We sit in the car waiting for a space to appear and eventually it does. How long are we going to be here? We shell out £4. We are not late and soon a nurse invites me into an examination room.
"The toilet is just down the corridor to your left," she informs me.
"Oh, okay." There is a short silence. "Why are you telling me that?" I ask.
"I need you to empty your bladder," she says.
"Oh… right." I act as instructed and I'm soon lying on a bunk-like bed half undressed being ultra-sounded. It is much like pregnant women have to check the baby. The nurse stares at the screen and moves the device over my stomach and chest asks me to move on to my side, studies the screen. It doesn't take much more than five or six minutes. "Can't see anything wrong," she says eventually, "I'll send a report to your doctor."
Heather and I walk back to the car park. "I hope that's the end of me visiting hospitals," I say.
“Yes, let's hope so, but if not, well, it will be for your own good, won't it?"
"Yeah, I suppose so."
Wednesday 9th May
Back in the surgery to see Dr Richardson to get the results of the tests. I ask Heather to come with me again so she can ask any questions I don't think of.
After a short period of sitting in the waiting room reading a three-month-old Sussex Life (Heather) and a two month old People's Friend (me) we are watching Doctor Richardson peer at her computer screen. The analysis of the stool sample has not been received from the lab and we discuss whether I should submit another one but decide the delay is probably due to the early May Bank Holiday on the seventh and the result will come through in a day or two.
Wednesday 16th May
I've heard nothing from the surgery and so, as arranged, I fly out to join my brother Cyril in Florida. He left the UK two or three weeks ago and we plan to spend another six weeks here. He meets me at Fort Lauderdale Airport. A neighbour and friend, Dennis, has brought him down in his car and we drive north to Stuart where we have a two-bed-two-bath flat on a marina community called Circle Bay, which sits at the side of the wide St Lucie River.
It's a warm evening and in spite of it being such a long day – getting up at 7 AM, a ten hour flight a one-and-a-half-hour road journey and a five hour time change, I am not too tired to sit on the lanai and have a beer and chat with my little brother before going to bed. "How did your blood test go?" Cyril asks me.
"Fine," I say without thinking and then realise it wasn't ‘fine'. "No, not fine," I say, apparently, it's shown I'm a little anaemic."
"What? You don't look anaemic."
"How do you look when you're anaemic?"
"Pale, you know, ill-looking."
"I think it's just mild, though I don't really know. The doctor arranged a couple of tests. I'll see her when I get home. Get the results."
"But that's not until the middle of June."
"Well, the surgery will ring Heather if the doctor wants to see me before then." I took a sip of beer and shrugged my shoulders, "As I said, it's mild, I don't think it's too much to worry about. I'll probably have to take iron tablets or something."
We watch a large yacht on the river sail past. They are having a party aboard; laughter and music float toward us through the warm evening air and into Circle Bay.
Saturday 19th May
The temperature has been up in the eighties, blue skies and cotton wool clouds in the mornings but thunderstorms in the afternoons, though we have been able to get out on the Brompton's and – most importantly – cycle to ‘The Sailor's Return,' our favourite bar, several times. We have also been to the weekly Circle Bay Friday night party on the deck and have met neighbours and friends; chatted, swopped stories, told jokes, translated – "No, no, a fag is a cigarette!"
As usual, I was greeted with great enthusiasm: "Hey Gerry, good to see you again" and "Welcome back – you're looking younger than ever, how do you do it?" and, "Waddya doin' here? The wedding's tomorrow!"
It's weird how Royalist many Americans are. They all seem to be excited about the wedding yet they fought a revolutionary war and got rid of all things ‘Royal' in the mid-1770s. I suppose the fact the new Princess – the Duchess of Sussex (has she ever been to Sussex, I wonder?) is American has a lot to do with the present royal hysteria. We are both up early this morning CBS, NBC, ABC, Fox – all the main TV channels are full of The Wedding. They are all encamped at Windsor. The weather there looks beautifully royal, sunny and warm. I make tea while Cyril slots bread into the toaster. We sit and watch the wedding. The pomp, the circumstance. There is a ‘happy-clappy' choir, an evangelist, Bishop Michael Curry, who delivers a fiery sermon for fifteen minutes or so, waving his arms about – not the type of thing St Georges Chapel would be used to hearing. A two second shot of the Queen and Prince Philip showed them both looking stony. Clearly not impressed.
"How long do you give it?" Cyril asks me as we watch the happy couple come down the aisle and wave to the cheering crowds as they horse-and-carriage it through the streets of Windsor.
"Five years," I say.
"I doubt it will last that long," Cyril says, "she'll get fed up, she'll want to visit her friends and family in America, and take any kids with her, that is not going to go down well with the controllers in the Palace. A section of the Royal Family running free in the United States? They'll not like that!"
Cynics both we are, I think.
I Skype Heather. We chat for a while, "Everything okay?" "What's the weather like?" " Did you watch the wedding?" Then, after a few minutes, Heather says, "The surgery rang."
I say, "Oh?" There is an unusual fluttering in my stomach.
"The doctor wants to see you. I told them you were abroad and won't be back until June 20th. The girl said you should make an appointment as soon as you are back."
"Did she say why the Doctor wants to see me?"
"I didn't ask, she wouldn't have told me."
"Should I get a flight back now do you think?"
"I think you should ring the surgery on Monday and see if you can talk to Doctor Richardson."
"Okay, I'll do that."
When I put the phone down Cyril says, "What's up, you look worried."
"The doctor wants to see me, I'll bet something's come up with those tests I had."
"Maybe nothing, you worry too much. Let's get on the bikes and go down to Flannigan's and have something to eat."
"Yeah, okay. And something to drink."
Tuesday 22nd May
I Skyped the surgery yesterday, "Doctor Richardson is with a patient, I can't interrupt her," the receptionist said.
"She wants to see me apparently, but I'm in Florida if I could just have a quick word to see if it's something urgent. If it is I'll come back but if not, well, I don't plan to come back to the UK until June the 20th ."
"I can arrange a time for you to call her. Can you call me back tomorrow?"
I got up early this morning and called the surgery again. A different receptionist to the one I spoke to yesterday answers so I have to explain it all again. "Doctor Richardson wants to see me but I'm in Florida for six or seven weeks, one of your colleagues was going to arrange a time for me to telephone her." She puts me on hold.
It's another sunny morning, a clear blue sky; I look through the sliding glass doors and watch a yacht on the river sail slowly past, there can't be much wind judging by the flapping sails and the slow progress it's making, but the weatherman on TV tell us there will be more rain this afternoon, so no going out on the bikes again.
"Hello, Mr Thornhill?"
"Doctor Richardson will speak to you now."
There is a clunk, a silence, another clunk, "Mr Thornhill, I believe you are in Florida, lucky you!"
"Hello, Doctor Richardson. You want to see me, I believe, but I planned to be out here until June 20th. Should I come back?"
"That's for you to decide, I would like you to see a specialist, it's possible you may have to have a colonoscopy to help find what the problem is. Perhaps you could have one out there?"
What the hell's a colonoscopy?
I think quickly. The medical insurance I have is fairly limited. Knowing insurance companies I'll bet somewhere in the small print it will exclude ‘investigative medical problems.' I could perhaps arrange to have a colonoscopy here and pay for it but knowing the way the American health system works I'll bet it would cost a small fortune.
"I think I should come back," I say
"Well, Mr Thornhill, you can go on holiday at any time, but if you return I can get you an appointment with a specialist within a fortnight," Dr Richardson answers.
‘Okay, I'll come back."
I tell Cyril, "I've got to go back, sorry; you'll be on your own again."
"Don't worry. You are doing the right thing. We'll have to get on to Norwegian Air and see about changing the return date. When were you thinking of going?"
"As soon as I can get a flight."
It turns out the only flight I can get that will suit me is on May 31st (arriving home on the 1st June) from Orlando, nothing from Fort Lauderdale, and – of course – because I have changed the return date there is a cost - £400. The fact I have already paid for a return flight cuts no ice with them, I've changed the date and that's enough for them to screw more money out of me.
There has been an awful lot of rain during my stay at Circle Bay this time, much more than I have experienced before, I haven't even had the chance to laze around the pool like I usually do, but we have been able to get out on the bikes a few times and, of course, it is very warm, the temperature in the high eighties.
We usually go out for a meal with our neighbours, Chuck and Laurie – though I shouldn't describe them as neighbours, they have grown to be good friends over the years. We always spend at least one evening with them when we are here but Laurie hasn't been so well, hospital visits etc., and it's not been possible.
"You're going home, Gerry? You've only just got here!" Not out of choice, I tell them and explain as best I can. "You are doing the right thing," they both assure me and I'm sure I am.
This evening we have been able to meet up with Steve Campbell – another good American friend – he is – or I should say was – a realtor, or estate agent, and is the man who found us our place at Circle Bay in 2002. We meet at Ruby Tuesday's in Palm City. Mary, Denise – more friends – are also here. I explain again why I am going home so soon. "Don't you have long waiting lists over there," Denise asks, "You know if it's something serious – I hope it's not – but if it is you could die waiting, isn't that true?"
"That's what Trump tells you," I say and all of a sudden I'm defensive about the NHS, "No, it's not true, if it's something life-threatening you are dealt with very quickly. Our National Health Service has its faults, of course it has, but if it was choice between your system, based on profits for the insurance, medical and pharmaceutical companies, and our system – I'll take ours any day."
"Huh, Trump," says Steve disparagingly, that man should be taken out and shot. He's a disgrace." The conversation moves on to Trump and his presidency and it soon becomes clear he is not particularly popular amongst those present.
Thursday 31st May/Friday 1st June
Our friend Adele, another next-door neighbour whom we have known now for a number of years, has given us a set of her car keys and as she always does when we are here and told us to use it whenever we want. How generous some Americans can be. Adele is up in New York visiting her son so we are now speeding down I-95 toward Fort Lauderdale in her Toyota Varris, light coloured leather seats, radio playing, "You're listening to one-oh-three-point-seven the only golden oldies station on the Treasure Coast."Fats Domino comes on – Blueberry Hill.
Always liked that track.
Cyril drops me outside No 2 Terminal, "I'll get parked and join you in a minute to make sure you get away." With my bag, I get into Norwegian Air's upper-class queue. A few minutes go by. The check-in starts to get busy, "Next please!"
Then I see Cs head of white hair pushing through the crowds, he looks panicky.
"What's up?" I say.
"Have you got the car keys? It's one of these key-less cars, you only need the key in your pocket or nearby. I'm still where I dropped you, and they're threatening to tow it away. He's given me three minutes." He taps his pocket, "I haven't got them so I can't start it."
I remember I moved the car at Circle Bay before we loaded it. I feel in my pockets, find them, hand them over.
"Thank Christ for that." He dashes off and is back ten minutes later looking much more relaxed. The short queue moves forward and I'm soon checked in, "Let us know how it goes," he says.
" ‘Course I will. Don't go off with any strange woman, behave yourself, remember, I won't be here to look after you."
He gives me a hug, something we don't normally do, "I'll ignore that. Love to Heather."
It's a night flight. I am able to sleep for a couple of hours or so. Heather picks me up at Gatwick and as we drive along tells me a letter was delivered a few days ago informing me an appointment has been made to see a Specialist, Mr Smith, at East Surrey Hospital next Wednesday morning. Things are moving along.
I look out of the window. Everything is so green and it's sunny and warm. A good-to-be- alive-day. It can't be anything serious, can it? I feel fine, I get a little tired these days but, as I keep reminding myself, I am getting on a bit and old people do get tired, don't they? It's natural. Okay, so I'm a little anaemic, Mr Smith will probably put me on a course of iron tablets – something like that – and that will fix it. No more problems.
"…you're not are you?" Heather has been talking, I've not been listening.
"Sorry love, what did you say?"
"I said you're not worrying, are you? Because you shouldn't, they are looking into it. They'll sort it out, whatever it is. Doctor Richardson is being thorough and arranging all this for you, that's good, isn't it?"
"Yes, ‘course it is."
Wednesday 6th June
Heather and I drive down to East Surrey Hospital in Redhill. It is sunny and warm and we get parked without too much difficulty. £2.00 an hour.
After reporting to the appropriate out-patients desk we are directed to a waiting room and sit for half an hour during which time I am called forward to be weighed. After the weigh-in, a few minutes go by and then we are invited in to see The Specialist.
He sits at a desk but stands as Heather and I enter the room and holds his hand out grasping mine and shaking it and then Heather's with equal enthusiasm. A nurse stands in the background smiling, "Mr and Mrs Thornhill, do sit down. I'm Neil Smith, call me Neil." Sitting in the corner a younger, junior doctor, whom Neil Smith introduces and he nods at us both smiling.
We sit. He studies the computer screen in front of him. "Now," he says, looking up and smiling, "tell me why you think you are here."
I'm a little taken aback thinking he would know exactly why we are here. I go through it: A Routine six monthly blood test…doctor informing me I am a little anaemic…telling me we must find out why …having an ultra-sound…stool sample…her arranging this appointment today…
Mr Smith – Neil – listens intently as my description of events finally comes to a halt.
"Right." he says, "The trouble is the Lingfield surgery don't always seem to get things right. They've sent your records over but they are not complete." He turns to the nurse who is still standing close by and nods at her, "Maria here will get on to them now and have what we want sent over, so…if you don't mind waiting a little longer? As soon as we get them we'll get you back in here and have another chat. Okay?"
We don't have to wait too long before we are sitting down at Neil's desk again. More smiles. He has a way of relaxing me, Heather too, I think.
"Well, I'm sorry," he says looking like he means it, "but we still haven't got all we want from Lingfield so this is what I propose – we send you along for a blood test now, Maria will take you, and we need a stool sample which can be taken to Crawley Hospital if that is easier for you and then we'll decide the way forward, so we'll be in touch again in about a week, is that okay with you?"
"Yes, of course, fine." We stand, shake hands and follow Maria out and along to where I am to have the blood test.
A week goes by. I have carried out Neil Smith's instructions and now wait to hear from East Surrey regarding another appointment.
Copy of part of a letter from Mr Neil Smith, Surrey and Sussex Healthcare NHS Trust to Dr Richardson, Lingfield Surgery, 6th June 2018:
Thank you for asking me to see this very nice 81-year-old gentleman who you referred under the two-week rule citing a ‘change in his bowels to loose stools…On examination, he looks well and his abdomen was soft and non-tender. There were no palpable masses. On rectal examination, he has got an enlarged prostate gland and a little bit of soft stool but no blood. I have explained to Mr Thornhill that at the moment I do not have a good indication for him to have a colonoscopy. His anaemia is mild/borderline and there is no evidence of iron deficiency on your tests, but I accept that we may not have the full picture as we have not yet been able to get all the information from your practice. With this in mind, I would be grateful if you could send me all relevant test results and perhaps a slightly more detailed referral letter. I have requested some repeat blood test including a full range of haematinics as well as a faecal calprotectin. Once I have got your results and my results, I will then write to let you and the patient know what we are going to do next.
Mr Neil Smith
Consultant General Colorectal Surgeon
Tuesday 12th June
So Mr Smith seems to be saying I may not need a colonscopy. I'm pleased about that. Perhaps this whole thing is something and nothing after all. The anaemia of little consequence, a few tablets… back to normal. I certainly hope so.
To a funeral today. Janice Friend, an ex-colleague; an up-front, straightforward kind of person. Didn't suffer fools gladly, had no time for boss's who didn't know what they were doing as she believed many didn't.
As arranged I pick up Merete and we carry on to Chris and Andy's place and we and all travel together in Andy's car to Worthing Crematorium at Findon. People mill about outside the chapel and we all spend time saying ‘hello' to faces from the past, some instantly recognisable, others I struggle to put names to, most I haven't seen for over ten years.
The service is just about the right length; none of us fidgets, we all smile at the right moments during Glen Adams' eulogy which struck exactly the right note for Janice. She will have enjoyed listening to his words. Afterwards, we retire to a venue a couple of miles away, by the side of the Downs where Bob, Janice's ex has arranged drinks and snacks for us all. The faces from the past say ‘hello' and we chat and for a few spaces of time it's like being back at the airport for one of the meetings to discuss roster changes or some such.
This is the third or fourth funeral I have been to this year. They are becoming a little too regular.
Copy of part of a letter from Mr Neil Smith to Dr Richardson, Lingfield Surgery, dated 6th June 2018,
"… I can tell you that at our end we have identified that his haemoglobin is 129 just below the lower limit of normal of 130. He has a normocyclosis with an MCV of 90 (82-98), his iron level is low(5.8-34.5) while his teratin and B12 were normal. Interestingly his folate is also low at 3.1 His faecal calprotectin has come back mildly raised at 73.0. I think this is just enough to justify a colonscopy in this gentlemen and I am making the necessary arrangements now. In the meantime, if you could send me whatever information you have from the Surgery as I think would be helpful in us a more complete picture as to why this gentleman was referred to us in the first place. With best wishes and kind regards.
Mr Neil Smith Consultant
General and Colorectal Surgeon
So I have got to have a colonoscopy. Not a pleasant prospect. Never mind, worse things happen at sea, so they say.
Surrey and Sussex Healthcare
East Surrey Hospital
Dear Mr Gerald Thornhill.
We are pleased to offer you a date for your Day Case admission for surgery at Surrey and Sussex NHS Trust, as follows:
Consultant Mr N Smith or a member of the team Speciality Colorectal Surgery Date/Time Saturday 30 June 2018 at 15.15
Location Endoscopy Unit
East Entrance Ground Floor
East Surrey Hospital
REDHILL RH1 5RH
Please read the enclosed information, which contains important instructions and further information relating to your hospital stay.
If you are no longer available on this date, please contact us on the number above. Please be aware that as you have previously agreed this date cancellation will result in your waiting time restarting. In this situation, we will endeavour to agree a new date for your admission as soon as possible but other longer waiting or urgent patients will take priority.
Waiting list Co-ordinator Colorectal Surgery.
"The procedure you will be having is called a coloscopy. This is the examination of the lining of your large bowel. (colon). It will be performed by, or under the supervision of, a specialist doctor, and we will make the investigation as comfortable as possible for you by using a combination of sedation and pain relief.
This test is a very accurate way of looking at the lining of the whole of your colon and rectum to establish whether there is any disease present. A thin flexible tube called a colonoscopy is passed into your rectum (back passage) and guided all the way around the colon.
If there is any abnormality in the bowel, then it should be possible to see it during the procedure, which is relatively quick (about 30-45 minutes. It allows the doctor to take samples (biopsies) of tissue so they can be examined under a microscope. The lining of the bowel is insensitive to pain so you should not feel anything when the samples are removed."
The letter of invitation included reams of instructions regarding the diet I must adopt on the days leading up to the procedure, laxatives I should take, including detailed instructions of when to take them – "One day before your procedure: From 11.00am to 11.30am take 10 tablets of senna with a glass of water…"
"…at 2pm dissolve the contents of one sachet of Citramag in 200 ml (8fluid ozs of hot water in a wide-mouthed measuring jug. Allow to cool for at least 30 minutes in a suitable glass and drink. During the day drink at least one and a half litres of water. At 6,00pm dissolve half of the second sachet of Citramag in 100mls (4 fluid ozs) of water and drink this solution once cooled…"
Cyril returns from Florida and we pick him up at Gatwick. He is looking annoyingly healthy.
"You look well," we tell him.
"What about you?" he asks, "what's happened about the anaemia?"
"He's having a colonoscopy on Saturday," Heather tells him.
"A what?" We explain. "They insert a camera?" he asks, "They don't use a tripod, do they?"
"I've already heard that joke," I tell him.
Saturday 23rd June
As instructed we are at the Endoscopy Unit, East Surrey Hospital at 15.15. on the 30th June. I've already drunk a couple of pints of water this morning but a smiling nurse urges me to drink more. My temperature is taken, my blood pressure is taken, I am questioned about my bowel movements. Cyril wanders off, Heather sits with me. Eventually, I am ushered into the procedure room where the deed is to be done. I sign a consent form. The nurse asks me to remove my trousers and lie on a trolley. Mr Aslam, the consultant, introduces himself; the nurse inserts a cannula into the back of my hand through which a sedative will flow that should make me feel drowsy and, according to the paperwork, cause me not to remember too much about the whole thing.
Mr Aslam directs me to lie on my side with my knees slightly bent. The nurse positions a pulse monitoring probe on my index finger and a small tube supplying oxygen is inserted into my nostril. I am tense, I try to think of anything but what is actually happening – I try to imagine a sun-kissed Caribbean island, the shore curving away, the sun warm on my face, in the bay two or three sailboats anchored in the crystal clear water, a few yards along the shoreline there is a bar, a crowd of people sitting by it drinking, enjoying…
It doesn't work. As Mr Aslam manoeuvres his instrument I jump a couple of times, much to his irritation as twice he says, "You must relax." An instruction I found impossible to comply with.
The operation takes about thirty minutes. I can't say it was painful, just uncomfortable, and, well, intrusive. Obviously. The sedative which was to relax me, make me feel drowsy and cause me to hardly remember any of it – doesn't do any of those things.
Afterwards, I lie in a room next door, my blood pressure, heart rate and oxygen level are taken and then I'm left to rest for a while, a male nurse offers me a cup of tea. After a while, Heather joins me and a few minutes later Mr Aslam comes in and sits with us.
"Okay," he says. "let me explain. "I've taken some samples of polyps which we will have the lab take a look at and I have also found – and I very nearly missed it – a small ulcer-like place in the large bowel." He leans over and presses his finger to the right side of my stomach about level with my navel, "Just here. It is small not much bigger than a pinhead, as I have said, I very nearly missed it."
"Is it that that has caused the anaemia?" I ask and it is then I notice he has been talking to Heather and practically ignoring me because I decide, he believes, wrongly, the sedative I was given has made me drowsy and I am unable to recall all that has just happened. "Yes, undoubtedly," he says.
"So what needs to be done?" Heather asks.
"Well, what will happen now is that Mr Smith and I and the rest of the team will have a meeting, discuss the results of today's procedure and come to a conclusion about it. Decide the best way forward. I believe this small spot should be cut out of the bowel, the bowel then clipped back together and…" he shrugs his shoulder "…all will be well."
"When will I know what you decide?" I ask.
"It won't be long, one or two weeks. We will write to you."
But before I am called back to see Mr Smith again arrangements are made for me to attend the CT Department, for a scan. "For CT Thorax abdomen pelvis with contrast,” the letter says.
Another visit to East Surrey Hospital.
"You should be pleased, they are being thorough," Heather says.
I can't argue with that, thorough is the word.
About ten days later I'm sitting at home on my own, Heather has gone shopping, Cyril is at Meridian FMs studio for his usual Monday morning show and I'm listening to him ranting on about the amount of rubbish in the streets of East Grinstead, one of his favourite gripes, when the phone rings. It's Maria, one of the Clinical Nurse Specialist's on Niel Smith's team, "Mr Thornhill? Mr Smith has asked me to speak to you. He would like you to have a Pet Scan, it is – "
I interrupt her, "I had a scan a week or so ago."
"Yes, this is a different type, it will give us more information about your lung."
"My lung? I'm sorry Maria, what has my lung got to do with the problem with my bowel?"
There is a short silence broken by someone laughing in the background, then Maria says, "The scan you had the other week has shown up a small spot, it needs to be checked, it's just a precaution, it's possibly nothing. You'll get a letter from Guildford, okay?"
I say ‘yes' and put the phone down and stare out of the window trying to take in what I have just heard.
Guildford? That's where you go if you've got Cancer.
Do not email@example.com
Dear Mr THORNHILL This e-mail confirms that an appointment has been made for you to attend our Scanning Unit: On: Saturday 28 July 2018 09.30
At: Guildford Diagnostic Imaging, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey GU2 7XX
Please see attached letter for full details of your appointment and any required preparation.
ALLIANCE MEDICAL LTD
"A PET/CT scan is made up of two types of scan ‘imaging'. PET (Positron Emission Tomography) uses a very small amount of a radioactive tracer – injected into your body – which can be seen on the scan and shows how parts of your body are functioning. CT (Computed Tomography) uses X-rays to produce images of the different density or thickness of organs in your body. By combining these two images, you get a very detailed and accurate internal picture which a referring specialist can use to help diagnose and if necessary, decide the most effective treatment."
Heather and Cyril took me to Guildford. We found the scanning unit easily enough tucked away at the back of the hospital and was able to park close to the reception (for free!)
It must have been pretty boring for them as the procedure took over two hours. After the ‘tracer' was injected I had to rest for an hour, then lay on a bed in the scanner room which moved me through the ring of the scanner while I was instructed, "Hold your breath! Breathe normally… Hold your breath! Breath normally…"
The results are to be sent to Mr Smith.
Saturday 28th July
Wednesday August 8th
Another lovely warm and sunny day. Back to East Surrey this morning, accompanied by Heather, to see Mr Smith. He will now have studied the results of the various investigations and tests I have had over the last few weeks and, presumably, has decided what the problem actually is and what should be done about it.
The sun is out again, this summer must be the best I can remember, it is even better than 1959. It is beautifully warm. It's one of those days when you feel good to be alive.
We are not kept waiting too long before we are ushered into Mr Neil Smith's office. Big welcoming smile, "Mr and Mrs Thornhill, good to see you again. Do sit down."
Once again we are both struck by his friendly charm. Perhaps East Surrey Hospital runs a Charm School for their doctor's.
We sit down and both smile at Maria, the specialist nurse sitting nearby. Neil studies the computer screen for a couple of minutes and then says, "Well, Mr Thornhill, we have had a report of the CAT-scan that you had on your chest," he swings the computer screen toward us, "there was a place there," he points to the scanned image of my chest, on the screen, "that we thought might be a problem but we are assured by the chest experts that it's nothing, so…" he smiles, "that's good enough for me."
"I had a chest infection earlier this year," I say, "maybe that had something to do with it?"
He picks up a booklet and turns to one of the pages and pointing to a coloured diagram of the bowel begins to explain about the surgery he says I need. I hear words like ‘right hemicolectomy' and ‘anastomotic leak' and, although Neil is carefully explaining it all to me, I'm not grasping his words at all because as he is speaking he hands me a couple of booklets and some leaflets and I glance down at them taking in the titles:
‘A Guide to Colorectal Cancer,'‘Help With The Cost Of Cancer,' ‘Supporting You Through Cancer,'‘We're Here For You – Macmillan Cancer Support.
The word is leaping off the pages at me.
Niel's voice has faded off. Heather has been asking questions, I've not been listening. She takes my hand in hers, "Are you alright, love?" I don't answer, I can't answer. It feels like something is squeezing my insides, I have a sudden empty, sick-like feeling. My throat has suddenly gone dry.
Neil says, "If you go with Maria she will take you somewhere quiet and answer any of your questions and I'll see you on the 23rd, okay?"
We all stand, I manage to say, "Yes, okay," as we shake hands. Heather and I follow Maria out of the room, along a corridor and into a small office. Maria is talking to me, I'm not sure what she is saying.
I didn't expect this. I should have, it was never going to to be just a prescription for iron tablets, of course it wasn't.
Maria says, "This kind of news is distressing, Mr Thornhill, I understand." She can see I am shocked.
She talks to us, her words are kind and sympathetic, understanding and compassionate. I'm still unable to speak; there is a big lump in my throat and I'm frightened if I attempt to say anything I will break down. And then, to my dismay, a tear rolls down my face. This is ridiculous, I need to pull myself together, I quickly wipe my eye but they have both seen it. Heather leans across and holds my hand tightly. Maria says, "We've caught it early – you will get over it. I promise."
I nod and try to smile, but the word is still bouncing around in my head.
I've got Cancer.
Heather has been talking to Maria, she turns to me, "Is that okay with you, Tott?'
"What? Sorry." My voice sounds strangled. "Is what okay?"
"Maria is going to take you to the pre-admission clinic. If you go there today it saves us a journey. Otherwise, we'll have to come back next week. I'll meet you at the coffee shop when you've finished, all right?"
I nod, stand and follow Maria out of the room and down to the pre-admission clinic. It's a long walk down a wide corridor, past the Purple Zone, through the Orange Zone, the Green Zone. Patients in wheelchairs ride by, a middle-aged woman on crutches catches my eye and smiles as she hobbles past; a porter pushing a trolley containing an unconscious elderly man glides by. We pass a garden area where patients, relatives and friends are sitting in the bright sunshine chatting. I try to make small talk with Maria but my voice still sounds quavery and we reach the pre-admission clinic in silence. I am given a form containing four or five pages of questions all to do with my mental and physical health; I am filling it out when Maria leaves me saying, "Don't hesitate to call me if you have any questions or if there is anything I can help you with." She smiles, touches my hand, “Are you alright?”
I nod, try to smile back, fail.
I am taken into another room where a blood sample is taken, then I have an electrocardiograph and MRSA screening. My blood pressure is taken and the nurse taking it notices my swollen ankles. I tell her it's a side effect of the blood pressure tablets I take. She calls in an older, more senior nurse who studies my ankles and asks, "What tablets do you take?"
"Amlodipine." I tell her.
She pulls a face, shakes her head. "Come into my office, would you, Mr Thornhill?"
She waves me into a chair, "My name is Chris, are you on your own?" I tell her ‘no' my wife is in the coffee lounge. "Well, we need her here," she says, "What's her name?" I tell her and she turns to her colleague and says, "Do you mind?"
I am now getting worried. Is there something else? "Is there something wrong?" I ask, but she has picked the phone up and is tapping out numbers.
I hear the ringtone. She says to me, "All these surgeries use Amlodipine," she shakes her head in disapproval. "Hello, Neil? I have Mr Thornhill with me… yes…he's taking Amlodipine and it's… five… yes… he's scheduled for the 23rd …"
The conversation continues for another minute or so and ends with Chris saying, "Yes, I agree, that's good, okay." She puts the phone down and turns back to me, "Right, Mr Thornhill, it will be okay. We will have to see about putting you on to something else when you are with us."
She has an air of efficiency and gives me the impression she is the type that won't put up with any nonsense. "Is there anything wrong?" I ask again, "I mean apart from what I've got wrong?"
She shakes her head, "No, no, it's just that I'm not keen on Amlodipine, there are better alternatives, but it seems to be prescribed, well, too often in my opinion."
The younger nurse returns with Heather. Introductions are made.
"I wanted you together because I need to go through this with you both so that nothing comes as a surprise," the senior nurse tells us.
The next fifteen minutes are taken up with her explaining, in some detail, what I should expect to experience during my four to six-day stay in the hospital which starts on August 23rd. I should prepare myself physically, walk, cycle; eat a well-balanced diet… I am to have Laparoscopic (Keyhole) surgery which means performing surgery with the use of a fibre optic camera and specialised surgical instruments introduced into the abdomen through 1cm incisions.
She talks about complications that could occur: Blood clots could develop due to lack of movement, I will be given white stockings to wear and injections of Heparin – a drug used to thin the blood – and I'll be encouraged to move around early in my recovery; leakage at the join (anastomosis of the bowel) is also a complication but only occurs in less than 5% of patients. So that's alright, then.
After the operation, I will go into the high dependency unit for a while and I'll have several tubes attached to me when I awake: an intravenous drip to give me the fluids I will need; a catheter and an epidural supplying painkillers.
I will be in East Surrey Hospital between four and seven days and recovery will take up to three months.
Chris asks if we have any questions and tells us if between now and my admission on the 23rd I am concerned about anything we should contact one of the specialist nurses attached to Niel Smith's team.
As we walk back down the long corridor Heather asks me if I want to get a coffee or tea before we drive home, but I say ‘no,' my head is still in a kind of whirl; a jumble of incoherent thoughts. I've got Cancer yet I feel fine, no different to how I felt this time last year, or the year before. Shouldn't I be feeling ill?
"What would happen if I didn't have this surgery? Did I ask that?" I say.
"Yes, you did. He said you would be okay for months, maybe years, but eventually it would get worse and it could spread and…Why are you asking that, Tott?"
"I couldn't remember if I asked him what would happen if I didn't have it."
Over the next few days, I read the leaflets and booklets handed to me. Much of the information doesn't seem to apply, but I read it all anyway. I go to Google and look up some statistics and read: "Bowel cancer survival is improving and has more than doubled in the last 40 years."So that's good.
I read: "7 in 10 people in England diagnosed with bowel cancer aged 15-39 survive their disease for five years or more, compared with 4 in 10 people diagnosed aged 80 and over."Not so good. I try to tell myself that after all, I am 81 so that's not a bad life. But it doesn't work. I know if I dropped dead today people would say, ‘Well he had pretty good innings.'But these sort of thoughts are no comfort whatsoever. The older I get the more enjoyable and the more precious life becomes. I want it to go on and on. Preferably without Cancer.
Thursday 23rd August
Surgery day. It's warm and sunny again, a blue sky, warm breeze, the sort of day you want to go down to the beach, walk along the Downs, take a cycle ride, have a picnic, sit outside a country pub somewhere and sip a pint. Do anything except go into hospital.
We make our way to the Surgical Admissions Lounge. Seven or eight people sit there, male and female. It's easy to work out which are there to be admitted and which are friends or relatives giving moral support. Those being admitted look the way I feel: Apprehensive, worried, nervous, a little scared. They are probably having the same thoughts as me: Will the operation be successful? Will the surgeon's knife slip? Their ages range from forty-odd to one elderly guy who looks even older than me, though as you will see in a couple of seconds I am wrong – he is younger.
After a few minutes spent people-studying a nurse invites me into a side-room and takes my blood pressure, temperature, oxygen level.
I return to the Lounge and Mr Smith comes to see us. "I normally have my oldest patient in for surgery first," he tells us, "but although you are the oldest we are seeing today, Mr Thornhill, you are also the fittest, so I'm afraid you will be the last. Sorry about that." He turns to Heather, "We have your phone number, I'll call you when I have some news, okay?"
I urge Heather to go home, as it is obvious I am going to be waiting here most of the day. She wishes me luck, tells me to try not to worry and assures me everything is going to be all right.
I am handed a piece of paper and asked to sign, I do so and it possibly seals my fate.
It is the middle of the afternoon before a nurse comes to me and asks me to confirm my name and date of birth, gives me a gown to wear and I'm wheel-chaired to an anti-room near to the Theatre and I'm told to make myself comfortable on a bed. Although the long days wait has done nothing to lessen my apprehension these last few minutes before I go under the knife become quite interesting, if not entertaining. There are three nurses in the room with me (one male, two female). They stand and sit by a desk about fifteen feet from where I Iie answering the phone and filling out forms One of them, a girl, about twenty-five or so, starts to tell her colleagues about her father whom she discovered when he died, a few months previously, that he had fathered twenty-two children besides herself.
"What? By different women?" Her male colleague asks.
"You mean you've got twenty-two half brothers and sisters you didn't know you had?"
"How did you find out?" The other nurse asks.
"Well, when he died several of them turned up at the funeral. Two were from New Guinea, three from someplace in Africa, one from Australia." She laughs, "It was quite an interesting event."
"Good God!" The other female nurse exclaims. " I bet it was. Did your Mother know?"
"Yes, apparently she did. The only one who showed any surprise or was in any way shocked was me."
"What did your Dad do? I mean apart from…Well, travel the world? "
"Well, you'll never guess - he was – "
The phone rings interrupting her, "Hello? Mr Thornhill? Yes, yes, okay."
The male nurse comes over to me, "Okay, you are on, Mr Thornhill, I'm going to wheel you through, are you okay?"
I'll never know what her dad did for a living now.
"Yes," I say and wonder if I am, and it's only now a thought flits through my mind and then stops and backs up and settles for a minute or two: Operations sometimes go wrong. I try to push the picture this creates in my head away but it stubbornly keeps creeping back and now I'm being asked by the anaesthetist's assistant my name and date of birth and now the anaesthetist is talking to me and I'm trying to concentrate on his words, "You'll get a warm feeling in your bum and after that you won't feel too much," he says.
My heart-rate, blood pressure and oxygen levels are taken and a cannula is inserted into my arm and I'm asked if I'm okay and there are other questions directed at me which I can't remember and were clearly just to waste time while the anaesthetic takes effect. I look around for Mr Smith but can't see him. Has he forgotten me?
"Keep still, Mr Thornhill. How's it going? Feel anything yet?" The anaesthetist is leaning over me.
"Not really," I say, and I'm beginning to worry that it may not be working. I remember reading a few weeks ago about a woman who woke up in the middle of an operation because her anaesthetist got it wrong. I look at his face for any sign of concern but there is none, just a smile. Before I can entertain more doubts a pleasant warm feeling starts creeping into my backside and voices, faces, the lights, and then me all fade to black.
Friday 24th August
I can hear a noise, a rhythmic sound, not far from where I lie. There is a slight pain in my chest. The noise is some sort of machine next to the bed. A nurse is looking down at me. "Do you feel sick, Mr Thornhill?" I shake my head. "What is your date of birth?" she asks.
"Seventh of April nineteen… " I stop. My voice sounds weak, my head feels a little fuzzy. For a split second my mind goes blank. For God's sake – what year was it?
Then a feeling of relief, "Thirty-seven," I say.
She gives a slight nod and then puts something in my ear. "I'm just taking your temperature, Mr Thornhill and then we need to check your blood pressure, okay?"
I nod and realise there are tubes in my nose. Oxygen. I become aware other tubes are attached to me, a drip in a vein in my left arm, a catheter in my bladder.
"Do you have any pain?" she asks me.
I shake my head well, a bit here," I touch my lower chest. I notice a porter hovering by the foot of the bed.
"We are going to take you down to the ward now," she says. "We'll give you something for the pain."
"Copthorne, right?" the porter says.
"Yes," the nurse answers.
Along a corridor, lights above my head sliding by, people walking past, the rattle of lift doors closing, the hum of machinery, lift doors opening; around a corner, around another corner. We enter a ward and slow down by the reception counter.
"Hello Gavin, Gerald Thornhill," the nurse accompanying us says.
"Four, A," a male voice answers.
We speed up again, sharp turn, some manoeuvring about. Stop. A whirring as the bed adjusts. There is a light on somewhere behind me, the rest of the bay is dark. The nurse who accompanied me and the porter leave. I fall asleep.
When I awake there is a nurse by the bed fiddling with the drip stand. A steady ‘beep… beeb…beep' emanates from the machine measuring the fluids entering my body. It has an array of different coloured buttons and a small screen with the word, ‘Infusing' displayed; below various figures in white which mean absolutely nothing to me. There is a pain in my lower chest.
"I'm just going to take your blood pressure, Gerald." The nurse who was fiddling with the drip stand is looking down at me. Small, dark, she emphasised the ‘R' in ‘Gerald' making the name I have heard used for eighty-odd years by hundreds of people sound unusually attractive and uniquely different.
"Can you tell me your date of birth?" she asks. I tell her. "Do you have any pain?" I nod, touch my lower chest where the pain seems to be getting worse. The nurse puts something in my hand, "Press this button," she says, "if it gets too bad, and the pain will go. Is there anything you want?"
"Could I have a drink of orange?"
"Still orange, you can't have fizzy orange."
"That's fine." The pain is getting worse so I press the button she has given me and now notice it is attached to one of two cannulas in my right arm. I try to pull myself up to look around but it's too much of an effort, I feel weak and sore. The nurse returns and hands me a glass of orange with a straw and I suck greedily. "You should sleep," she says, "how is the pain?"
"It's nearly gone, that button is magic," I say and she smiles and tells me to press it again if the pain returns and then points to another button hanging over the side of the bed and tells me to press it if I need help for any reason. "I can't sleep like this," I tell her and try to turn on to my side but the effort is too demanding.
"I'll help you," she says and leans down and helps me move onto my side.
“What is your name?" I ask,
"Kunju," she says.
I fall asleep again.
The pain is back, it wakes me up. I press the magic button and stare up at the ceiling for a couple of minutes. The overhead lights are on. Above and to the side is a television on a movable bracket with a telephone next to it; on the wall behind my bed a whiteboard proclaims: "Gerald Thornhill"and "Soft."With an effort, I pull myself up and look around. There are four beds. An old boy opposite me stares across in silence, in the left-hand corner a younger man, fifty maybe is sitting by his bed and looking out of the window. The man next to me is out of bed, dressed and looks as if he is getting ready to go home, packing his holdall folding pyjamas and looking pleased.
I examine my stomach. A plaster covers my navel and there are two smaller plasters on either side. I still have drips attached to me, various plastic lines delivering nutrients, and the shots of morphine via the magic button and the catheter. The pain has faded away. I wonder if Neil Smith called Heather as he said he would.
I'm given a menu and asked to tick what I want for lunch and supper and told I can only have the foods marked with an "S".
A male nurse comes in pushing a small green coloured trolley with a large and a substantial looking door. Attached to the side is a typed notice:
"PLEASE DO NOT DISTURB THE NURSE
GIVING OUT MEDICATION"
"PATIENT SAFETY IS ESSENTIAL WHEN
He stops by my bed and studies some paperwork and then says, "Good morning, Gerald," He's tall, dark, very slight accent but his English is perfect, Asian I guess. "I have some pills for you, he says." He places a small plastic container on the wheeled table by my bed and a glass of water. Inside the plastic container are two pills, different colours.
"What are they for?" I ask.
"One is anti-sickness, the other a blood thinner."
"Okay. What's your name?"
"Mathew," he tells me. His English is impeccable. He pushes the cart across to the old boy opposite, "Good morning, James," and receives a grunt in reply.
I start to doze off again but a nurse wakes me by taking my blood pressure, temperature and oxygen level, but first asked me my date of birth which this time I am able to recite without hesitation.
I fall asleep. I awake to a group of people at the foot of the bed staring down at me. Neil Smith and his team. "How do you feel?" he asks.
"Okay," I say and then pause thinking about it, "Yes, okay," I say again but more firmly this time. He tells me the surgery went well, asks if I have felt sick, I tell him no, he asks if I have any pain and I tell him I did but it has faded off. He looks pleased and he and his group move off and over to the guy in the corner next to the window.
I pick up my Kindle and start to read and after a while fall asleep again. I wake up as lunch is being served. I get myself into a sitting position and manage to eat the filled baked potato, but not the tomato soup which tasted quite repellant, but it was compensated by the jelly and ice cream for sweet which was good.
In the afternoon I doze off again. The pain has faded and I haven't needed to use the magic button at all. I wake up to Heather's smiling face peering down at me, "Hello….. how are you? Are you feeling okay?"
I try to gather my thoughts…
Yes, bowl cancer…hospital… operation… Copthorne ward – it all floods back.
My thoughts gathered I tell her I'm fine, "I keep falling asleep," I say.
She leans down, kisses me. "It's the anaesthetic. You look all right. Mr Smith called me, I didn't think he would but he did – that was good of him, wasn't it? – he said everything went well. Your brother is parking the car, he'll be here in a minute."
It's good to see her smiling face. She holds my hand, Cyril joins us, we chat. I talk about the long wait in the Admissions Lounge yesterday, the food. There's a new family restaurant opened, just up the road, Cyril tells me and they are going to try it on the way home.
"Huh, it's all right for some," I say. Heather pats my hand, "You'll soon be out of here, when do you think, Monday?"
"I don't see why not, I feel fine, though I haven't tried walking yet, and Monday is a Bank Holiday, do they release patients on a Bank Holiday?" They leave after an hour or so and then supper is served. I'm not hungry but eat lemon sponge and custard and sip at the ‘nourishing' drink they keep giving me. In the evening the chap in the corner by the window has visitors – his whole family by the look of it, there are five or six people round his bed, sitting, standing, talking, laughing, the radio is on tuned to the hospital's own station playing requests. The result, incongruously, is a noisy party atmosphere.
Saturday 25th August
Our little enclave is coming to life. A lady with a trolley dispensing tea comes in with a cheery, "Good morning! Good morning!"
“Morning Isabel!" Someone shouts.
Isabel stops by the bottom of my bed and asks me, "Tea, coffee?"
I nod, say, "Yes, tea, please". My voice is still a little weak.
"Milk, sugar?" she says. Sounds Italian, pours a cup, brings it over and puts it on the oblong table that can be wheeled and swung across the bed.
Another nurse, female, comes in and makes straight for me, "Blood pressure, Gerald, okay? What is your date of birth?"
I recite the date stumbling over the year for the second time in 24 hours. What's going on here? Maybe I am subconsciously rejecting my age, perhaps it wasn't 1937. Yeah, that's a wishful thought.
The nurse sticks a thermometer in my ear to take my temperature and takes hold of my hand and places a plastic clip on the end of my forefinger for oxygen measurement.
Blood pressure, temperature and oxygen levels taken, Helen urges me to drink some water as she leaves pointing to the jug on the table next to my cup of tea.
The morning moves on. Isabel with the catering trolley returns doling out breakfast. I'm not hungry but she offers me some milky porridge and I take it with another cup of tea. She hands me a menu for lunch and supper. I am to tick what I want but only those items marked ‘S' for soft.
Later a youngish couple comes along with a trolley full of bed linen, they both help me into the chair in the corner of the bed space carefully manoeuvring the drip stand with me. They give me a blanket and proceed to change the sheets and pillowcases chatting as they work, "How did you get on last night?" she asks the boy who shrugs his shoulders and mumbles something I don't catch and I wonder what it was he didn't get.
I stay in the chair as it seems the thing to do, James is sitting by his bed, having been helped into it by a nurse; the chap next to him, in the corner, is also sitting in a chair, staring out of the window.
I settle back and start to read my Kindle. I'm feeling fine, weak, but hardly any pain, what pain there is I can cope with easily enough. I should make the effort and try a walk. I will. Tomorrow.
The day continues. My blood pressure etcetera is taken every two hours. The nurse notices the jug of water hardly touched and urges me to drink some. A doctor, youngish, comes round, one I haven't seen before, he asks how I'm feeling. Any pain? Have I been sick? I tell him I'm feeling good, hardly any pain, no nausea.
Lunch is brought round, soup, cottage pie, lemon sponge, custard. The soup is ghastly, one spoonful is enough, the pie is good as is the lemon sponge and custard. Heather and Cyril visit in the afternoon and stay an hour and a half. They both say I am looking good and reckon I will be home by Tuesday. They could be right, though there has been no bowel movement the booklet given to me, "A Guide to Colorectal Cancer and your Treatment Plan,"tells me it will be slow to re-start, so I'm not too worried about it and I too think I could be home by Tuesday.
I notice each time James, opposite, presses his emergency button, which he does quite often, he complains, "These nurses don't come, they never come," but they do, he presses the button and one comes along and helps him to the toilet, attends to the dressing on his legs, adjusts his pillows, helps him get comfortable in his chair, assists him into bed for his afternoon nap. But he still complains, "Where's the nurse? They're ignoring me!"
Sunday 26th August
Not a bad night, apart from the blood pressure tests every few hours which I know is necessary so that's not a complaint.
A doctor came by this morning. He didn't give his name, but he isn't one of Neil Smith's team. Youngish – 30 – 35. He asked how I was feeling, any sickness? Pain? I told him I was feeling fine and no, no sickness, no pain to speak of. He asked if I wanted to go home. I told him yes, of course, if I was well enough. He said I could go home tomorrow.
After the doctor leaves, I take another walk, this time out of the ward and up to the main corridor and sit there for a while watching the passing scene: Nurses hurrying past, a couple of doctors deep in conversation, porters pushing wheelchaired patients. The sun is out again and it looks warm and still very much summertime. I make my way back to Copthorne Ward feeling good. My walk is still slow but I feel in a week or so I might be taking brisk strides up to the library again.
Heather and Cyril visit again and I tell them the good news and agree to call them tomorrow when the discharge procedures are complete.
Monday 27th August
Mathew has taken the plasters off the wounds on my stomach. "I don't think there is a need to put any more on," he says. I look down, there is hardly anything to see, my stomach is a little distended, my navel a little red, but that's all and hopefully neither will last. After a few ‘goodbye's' and ‘thank you's' we finally get away from the hospital in the late afternoon after going through what seemed like a long-winded exit process and armed with packets of various pills dispensed and some leaflets on diets for patients such as me, a porter wheelchairs me down to the east entrance where Cyril waits with the car. We head home in good spirits.
It's good to be away from East Surrey and yet again it is sunny and warm. I'm to eat little and often I was told at the hospital and Heather cooks a light meal for me. It was as we were watching TV in the evening that the pain started, in my chest. I took a couple of the paracetamol the hospital had given me but didn't say anything hoping the pills would sort it out.
I didn't sleep too well and early in the morning started to feel nauseous. By 8 am I was feeling distinctly rotten and stayed in bed. The pain had returned and I took more paracetamol. Heather came up and urged me to get up. They had told her at the hospital I should be up and about as much as possible. After half an hour the paracetamol started to kick in reducing the pain and with an effort, I got up, showered, dressed and descended the stairs. Slowly.
Things got worse. I sat in the TV room. I had no appetite and refused Heather's offer of breakfast. The very thought of eating made me feel worse. Sitting down next to me Heather said, "You don't look so good, how are you feeling?" I shook my head not wanting to speak. "Tea?" she asked, I nodded and she went through to the kitchen. The nausea was increasing. I started to get up, I needed to get to the toilet. but it was too late. I vomited all over the glass coffee table in front of me.
Heather brushed aside my apologies, as she cleared up the mess. "Don't worry, don't worry," she kept saying, "But I think we should call the hospital."
Heather rang one of the clinical nurse specialists attached to Mr Smith's team, Maria Lovatt, and after describing my condition Maria told Heather I should be brought back to the hospital, "Or should I send an ambulance?"
"No,' Heather told her, We'll bring him."
At the hospital, Cyril finds a wheelchair and wheels me into the outpatient's lounge. By now I am feeling very ill, and quite wretched. The pain has not lessened and before we left the house I was sick again. At the lounge, Heather speaks to the receptionist who appears to have been expecting our arrival and asks us to wait, "A doctor will see him shortly."
Cyril wheels me into the waiting area which is nearly full. I am slumped in the wheelchair feeling utterly miserable. Heather talks to me in her usual positive way, ‘I'm now in the right place… they will soon discover what the problem is… Mr Smith will sort me out… give it a little time and I will be back on the road to recovery…'I try to respond, I know I should respond, but can't manage it, I just don't want to know. I want to withdraw, from everybody, everything…
After a few minutes a doctor comes over, English, young, I didn't get his name. He kneels down to my level, "We're going to pop you into a bed," he points vaguely behind him, "and sort out the pain, all right, Mr Thornhill?"
I nod, manage, "Yes, okay."
Heather asks, "Are you admitting him, doctor?"
"Oh yes, we'll get him up to a ward as soon as we can."
I'm wheeled into a small enclave containing four or five beds and helped into one of them. A nurse gives me a glass of water and a couple of tablets, Heather and Cyril stand nearby, both looking worried.
"I'll be okay now," I say, trying to believe it. "You go home, it's pointless you both hanging around." They take a little more persuading but eventually they leave, promising to see me tomorrow. Heather's usually smiling face looking more worried than I have ever seen it.
The next few hours are a little vague, I dozed in and out of consciousness. I know the bed, with me in it, was wheeled along corridors and up a lift and eventually into Copthorne Ward, in the same bed-space, I left 36 hours ago. When I'm finally fully awake there are two cannulas in my left arm, one feeding me nutrients, the other I don't know what. Plastic lines lead up to the drip stand next to the bed. The machine feeding me the nutrients is beeping rhythmically.
I'm back where I started, except now I feel really ill which I didn't when I was here before.
I lie in bed while the routine of the ward goes on around me. Nurses, male and female attend me. Mathew with the green drug trolley hands me pills in a little plastic cup and tries to cheer me up by making a joke in his impeccable English, "Couldn't keep away from us, is that it Gerald?"
My blood pressure, temperature, sugar levels are measured. The pain keeps returning and I'm given paracetamol intravenously which reduces it. A glass and jug of water are placed on my table and I am urged to drink. In the evening I feel sick and ask for a bowl but I only retch, nothing comes up, I've also developed a cough.
A discussion takes place: Perhaps I should have a catheter? No, I tell them, I would rather not and they finally agree a bottle should be kept at the side of the bed. Opposite me, the old boy, James, is still here and next to him, in the corner, the fifty-odd-year-old, Chris, and once again his whole family are gathered around the bed talking loudly and over one another, telling jokes; every now and then one of the women bursts into hysterical laughter, the radio is on as an accompaniment to it all. The bed next to me has the screens pulled around it.
I try to sleep but it's impossible while the party in the corner continues and the cough doesn't help. The clock creeps toward ten o'clock and the party finally breaks up and after another blood pressure test (Could you tell me your date of birth?) I fall into a fitful sleep.
Tuesday 28h August
I wake up with intense pain, it's early in the morning – one o'clock, two o'clock? The ward is quiet, lights out. My mind is filled with the agony of the pain in my chest and I keep coughing, I can think of nothing else but the pain. I can hear someone moaning. I'm lying on my stomach and manage to push myself around and on to my back hoping this will help. The moaning continues and I then realise it is me. One of the booklets given to me mentioned something about ‘effective pain control being an essential part of the Enhanced Recovery Programme.'Okay, where is it? That's what I need, pain control. Right now. This minute.
I feel around for the emergency call button. I can't find it. It should be hanging on the side of the bed. It isn't. Should I shout the way James, opposite, often does? I'm getting desperate, feel around again. The bloody thing isn't here.
For Christ's sake!
I pull myself up and try to peer over the side of the bed and then I feel it under my leg, the cable has got itself wrapped around my waist. I get hold of it, press the button and hold it pressed for several seconds. This is urgent, please hurry. A minute passes, it seems like an hour. Another minute, another hour, and yet another. At last, she's here. She switches the light by the bed, on. I recognise her, it's Kunju, the nurse who helped me the first night.
"What is the matter, Gerald?"
"I have an awful pain," I tap my chest, I need something to take it away. Now. Please."
"I will see if I can get something for you."
"No! Don't see if you can get something – get me something! Now!" My voice is raised and there is irritation in it which I instantly regret.
"Don't raise your voice to me, Gerald, or be angry." She speaks quietly, "That will not help you. I am doing my best."
"Yes, I know you are, I'm sorry. I didn't mean to…I'm sorry, it's just that this pain is really hurting and… I want it to stop."
She moves away, "I will get something for you."
I lie back. Now I feel guilty on top of everything else. I shouldn't have spoken to her like that, she is doing her best. The moaning starts again, it somehow lessons the discomfort but I put my hand over my mouth in an effort to stop it. I try to think of something – anything – to take my mind elsewhere… Heather… our holiday in Madeira last year… the summerhouse we've built in the garden… Cyril and me driving across America… the fog enveloping the Golden Gate Bridge… the heatwave in New York… last Christmas with the family…
"Open your mouth, Gerald." Kunju is back. I open it and she squirts a liquid in.
"That will help you," she says.
"What is it?" I ask.
"Morphine," she answers. It does help, the pain lessens and I manage to fall asleep.
I wake up, I'm not sure of the time, around seven I think. Isabel offers me tea from her trolley and later she is back with breakfast but I still have no appetite and can't eat anything though I am urged to drink one of the ‘nourishing' drinks offered and to drink water from the jug on the bedside table. The pain has receded so that now it is tolerable. Isabel moves on and from behind the curtained bed next to me a voice shouts, "'Mornin', Isabel, I'll ‘ave a full English!"
A little later the bed linen trolley is wheeled in by the same couple as last week and they help me out of bed and into the armchair in the corner of my bed-space. The drugs trolley comes in wheeled by a nurse in a dark blue uniform which I have concluded means she is a staff nurse. She is young – mid-twenties – I guess though it's difficult to estimate age in their uniforms, but she is attractive, gives me a smile, studies some paperwork and then comes over and hands me some pills in a plastic cup to take and asks if I am still in pain. I tell her yes. She asks on a measurement of one to ten, ten being the worst, where would I put it? " Four," I say.
I am given paracetamol intravenously. After a while, the pain disappears. Later I am in the chair, dozing again when I become aware of Neil Smith and his team gathered in front of me.
"Not feeling so well, Mr Thornhill," he says. It's a statement, not a question and I nod in agreement. He talks to me, I will get better he assures me, I must give it time. He mentions nasogastric intubation – whatever that is – as he turns away and speaks to the ward nurse accompanying him. They all move on I don't catch what he is saying to the nurse and maybe that was the idea. The nurse nods writes, something down. They all go over to Chris, the guy in the corner.
A nurse comes up to me, "Are you drinking this water, Gerald?" she points to the jug on the table, "You must drink it. May I take your blood pressure?" I nod. "What is your date of birth?
She is adjusting the blood pressure strap on my arm when a young man (35 – 40?) in a wheelchair whizzes past the foot of the bed, "Mornin' Shivani!" he shouts cheerily and wheels himself into the toilet. "Who's that?" I ask. "Matt, he's your neighbour." She nods toward the bed next to mine which still has the curtain pulled around it. "You shouldn't talk while I'm taking your blood pressure." "Sorry." Chris, in the corner, by the window, says to Isabel, "What I want is some toast – I'd love some toast!" "You know you can't have toast," Isabel tells him. Matt, in his wheelchair, come out of the toilet and wheels past us. He catches my eye, nods and then shouts to the nurse attending me, "‘Ow yer doin Shivani?" and to Isabel, "I'll ‘ave a cup of tea, dear!" And disappears behind his still curtained-off bed area.
In the afternoon Heather and Cyril come to see me. The pain is now just a dull ache, but I am still feeling rotten, and I'm still coughing. I try, but fail to be social, I am too dispirited. I really don't want to talk but Heather is anxious to know what Neil Smith said to me this morning and I tell her he said it will take time but I'm going to be okay. She is not her usual cheerful upbeat self, she looks anxious and worried. I reach for her hand and say, "It's just a bit of a setback, I'll get over this."
"'Course you will," she says.
"'Course you will," says Cyril.
Wednesday 29th August
After my visitors left yesterday I manoeuvred myself back into bed and then endured an experience I don't want to endure again, the result of which is I now have a ‘nasal gastric tube' up my nose, down my throat and into my stomach.
The tube is draining all the nasty stuff that has, apparently, settled there unable to move further due to the surgery. It is now flowing out – no, not flowing, trickling – out of my stomach, along the tube and into a plastic bag at the side of the bed. I stare down at it, a brown coloured obnoxious looking liquid. That stuff has been gathering in my stomach since last week, no wonder I have been feeling so bad, no wonder I was sick and retching all over the place.
Inserting this gastric tube was an ordeal I do not wish to go through again. Two nurses came to my bed, one a very motherly type, Mary, talked a lot, the other younger, quieter. "We need to insert an NGA line Gerald, it's going to make you feel better," said Mary.
"Oh? What's that?" I asked and she explained. She held a thin plastic tube in her hand,
"If you do exactly what we tell you it will be in and done in a few seconds. Can we go ahead?"
I nodded. The younger one, Monique her name, handed me a glass of water, "Now," she said, "As Mary feeds it in you drink, okay?"
"What if I'm sick?"
"You won't be."
Mary started to push the tube up my nostril. I jumped, pushed her hand away. It was almost instinctive. Having something pushed up your nose is not natural, it's not right. I don't like this.
"You've got to let me do it, Gerald. We'll go again, all right?" I hesitate. They are both staring at me, waiting. I nod.
This time I'm ready. "Drink," orders Monique. I put the glass to my lips, swallow some water. The tube is up my nose; now it's in my throat, I want to gag, I pull back, the water spills, the tube comes out.
"I know this isn't pleasant," Mary says, "But we've got to get it in there, it really is necessary, I promise you. Let's try again."
They are both patient. It's obvious they have done this a thousand time before. They say the right things, words designed to calm, reassure. The tube is sliding down my throat again. My throat doesn't like it, my body doesn't like it, I don't like it. "Drink!" ordered Monique.
This is how I imagine water-boarding to be.
"More," says Monique, I drink more water. I want to retch. I want this to be over.
I want to go home.
"Nearly there, Gerald… drink." I drink.
"Okay. We're there. Well done," Mary looks down at me, full of smiles. Monique squeezes my hand. "Good, this will make you feel better."
The ward nurses change shift at ten o'clock. The night shift, six or seven nurses, are led in by Shivani, and they all stop and form a kind of half circle at the foot of my bed. Shivani clutches a clipboard and looking at it tells the group why I'm here, my condition etcetera. A lot of medical jargon is involved, I notice Kunju who catches my eye and give me a smile before they move on to Matt's bed area – which still has the screen around it.
Supper is brought round, but I still have no appetite. I manage a little jelly and some ice-cream.
Blood pressure… Temperature… Pills… and then a porter turns up with a wheelchair. One of the nurses, Joe? Jim? Can't remember – tells me I am to be taken down to have my chest x-rayed to make sure the cough is nothing serious. I'm disconnected from all the lines, helped into the wheelchair and off we go down to the X-Ray Department. Along corridors, down a lift, past members of the public – visitors - who glance at me, curiosity written in their eyes; no doubt envy is written in mine, they are going home tonight, fit and well… I will be here, not so fit, not so well. Now we go through doors, and here we are at last. I'm parked outside for a few minutes and then I'm wheeled in. This is where I came for the scan a few weeks ago.
I'm X-rayed and afterwards, a different porter takes charge of me. He says, "Copthorne, isn't it, mate?" I tell him, yes and he lets me know Copthorne is the furthest ward from t he X-Ray Department. I'm not sure if he passes this information on to me to expand my knowledge of the geography of the hospital or if it's a complaint.
Back in Copthorne, Area 4, I am helped to bed A, hooked up to the drip stand the plastic bag slowly filling with the contents of my stomach is placed at the side of the bed and I am left to sleep.
Thursday 30th August
The pain is back. Not so bad as last night but intense enough to wake me up. It 1.30 AM, it's dark, I manoeuvre myself onto my back and the steady bleep… bleep… bleep of the machine at my side changes to a high pitched urgent beep!|beep!beep!beep!beep! I stare up at the ceiling wondering if I should use the call button but I'm saved that decision as footsteps approach.
"What's the matter, Gerald? A nurse I haven't seen before. She switches the light on and Fiddles with the machine attached to the drip stand and the beep! beep! beep! returns to the steady bleep… bleep… bleep… "Try and keep your arm still or it will set off again, okay?"
"Can you give me something for the pain?" I say and tap my chest.
"When did you last have paracetamol? You can't have more now if it's less than four hours ago." "It's more than that." "I'll check. I'll come back."
She leaves me. I stare up at the ceiling again trying to concentrate on something other than the pain which is now a dull intense ache more than a sharp pain. From behind the screen next to me, I hear a groan, then an oath, a rattle of a wheelchair; Matt appears, glides past, stops at the little wash basin by the doors, cleans his teeth vigorously, and then wheels himself out of the area and disappears from view. It's nearly two in the morning. The nurse comes back, shoots some paracetamol into me. I point to the screened bed next to me, "Where's he gone?" I ask.
"Cigarette," she says. "Or something like it."
The aching pain recedes. I fall asleep.
I'm getting used to the routine. Blood pressure taken every two hours…temperature… Isabel with early morning tea… night shift handing over to the day shift…breakfast (though I still have no appetite and can only manage a few spoonfuls of porridge)…bed changing… drug trolley… (drink that water, Gerald!)… doctors' visit, a different one today, Mr Tim Piggot-Smith, "How are you feeling? This is a setback for you, I know, but it will come right… Have you opened your bowels? No? Any wind? No? It'll happen, just give it time… "
I'm hardly aware of the NGA line down my throat which surprises me but the flow through it seems slow and intermittent. The plastic bag at the side of the bed is barely a quarter full. I still feel lethargic and weak and it is an effort to be social. I haven't spoken to any of the other three patients here, just nodded ‘hello.' I still feel ill – not so ill as yesterday and the days before yesterday – but pretty rough. One of the booklets they gave me before I came in here said,"Most people feel tearful on the fourth or fifth day after surgery."I don't feel like crying but I do feel depressed, or maybe I am just feeling sorry for myself.
I've got to snap out of it.
Chris, in the corner, is going home today. "Okay to have a shower?" He asked Jo, the nurse in charge today. "'Course," she said and he goes into the bathroom and fifteen minutes later comes out looking clean and fresh and ready for home and shouting, "Quick, nurse! The place is flooding!" Water follows him out of the door, spreading across the floor. Jo is talking to James and she looks up, "Oh my god!" She exclaims and dashes into the bathroom shouting, "Get a cleaner!"
She emerges a few minutes later looking dishevelled but triumphant. "The drain was blocked," she announces. "Lucky my husband is a plumber and I know what to do."
At four o'clock Heather walks in smiling as usual though I can see she is still concerned, but, positive as ever, she says, "You're looking better than you did yesterday, Tott, I think you are on the mend."
I don't feel as if I'm on the mend. "I hope you are right," I say. "Where's Cyril?"
"We're going to take it in turns visiting if it's alright with you, me today, your brother tomorrow. Do you mind?"
"No, that's okay. Makes sense."
Friday 31st August
I'm woken up by gunfire. It's coming from the screened-off bed area next door. Someone is shouting. More gunfire, more shouting, "Give it up, Jo!"
My sleep-filled head clears, Matt has the television on, it's "Rawhide,"or "The Ponderosa" or could be Wagon Train- I think I heard Ward Bond's voice – but whatever it is why the hell is it on at this time of night? It must be two o'clock in the morning. Why doesn't he use earphones? Thoughtless, selfish, self-centred sod.
It's still a negative answer each time I am asked, ‘Have you opened your bowels, Gerald?' and I'm beginning to worry about it. In the ‘Enhanced Recovery Programme' booklet given me, it says, ‘Severe pain that lasts several hours may indicate a leak from the join in the bowel. This is an uncommon complication but can be very serious.' This only happens in 5% of cases, but could I be in that 5%?
Shift change-over. The nurse in charge last night, an older lady I haven't seen before, reels off my condition to her day shift colleagues, most of which I don't understand or can't hear. She ends with a number, apparently I was ‘One' last night. I'll have to ask what that means.
Isabel comes round with her breakfast trolley. I force myself to eat some porridge, and jelly, drink some orange and a glass of water. I still have no appetite and it takes me a long time to get it all down. I am still feeling weak and lethargic.
Chris, the chap that was in the corner has been discharged and a new man has replaced his position, Darren his name, in his forties I would guess. The screens have been pulled around his bed and the Stomer nurse is spending time with him, so, obviously, he's here for bowel problems that are more serious than mine.
I am not feeling as bad as I did yesterday but I'm still not right. The pain seems to come and go and I still feel so weak. Still, it is only eight days since the operation and I was told there would be a three-month recovery period so I suppose I am being an impatient patient.
The bed-changers came round earlier and helped me into the chair in the corner, drip stand by my side, then it was the drug trolley with well-spoken Mathew, "Good morning, Gerald. How are you feeling today? Have you any pain?" Pills in a small plastic cup. Paracetamol into my arm.
I spent some time this morning trying to work things out. The plastic bag at the side of the bed with the tube that leads into my stomach is now half full of the horrible looking brown sludgy stuff. Better in there than in me, but it means my bowel isn't working. Did they explain this to me when they shoved this tube down my throat? Maybe they did and I didn't take the information in. I think I was too concerned about what was about to happen to me at the time, but it doesn't matter, Mr Smith (‘call me Neil') and his team came round earlier and he explained what was occurring – or not occurring is a better description. "The bowel doesn't like to be touched," he informed me, "And sometimes, and it's happened with you, when it is touched it goes to sleep and it is a matter of time before it wakes up again. It may take a day or two, it's difficult to predict, but it will wake up and things will return to normal." He smiled his everything-is-going-to-be-all-right-don't-worry-smile and he and his team moved on to the new chap, Chris, in the corner.
Well, no leak from the join then. If there was any hint of that he would have mentioned it, wouldn't he? ‘Course he would. He's the expert. He's doing this every week. Operating every week, three or four times; he knows Bowel Cancer inside out, back to front, from the large bowel to the rectum, from the small bowel to the anus. I have no need to worry.
The old boy opposite me, James (perhaps I should stop calling him ‘the old boy' as I have just found out he is the same age as me) after the doctor's tour and it was all quiet, started to shout, "Nurse! Nurse!" but there was no response and after a couple of minutes he shouted again. He sounded a little distressed so grabbing hold of the drip stand I manoeuvred over to him, "What's up, James?"
"I've lost the bloody emergency button and I want to go to the toilet," he said in a querulous tone. The button was on the floor hanging from the side of the bed I picked it up and handed it to him, "There you go," I said wondering whether I should offer to help him into the toilet, quickly deciding against that idea. Over the last three or four days I had observed, too many times, nurses helping him into the toilet, holding, for modesty reasons, the hospital gown he wore across his pale, scrawny backside. No, I'm not doing that, I decide, and drip stand and I move back to my bed area with a slight feeling of guilt which evaporates when Shivani comes in and takes charge of him, all smiles, "Hello, James, are you all right? What do you want?"
Cyril came to visit in the afternoon. I'm wasn't feeling so good again and although I tried I wasn't too social. My brother tried to make conversation but I found it hard to respond until he told me our half-brothers, Richard and his wife Gabby and Derek and his wife Pam are coming down over the weekend and would like to come and see me. I responded then but not positively. I should have. (They are travelling hundreds of miles to see me? How kind, how thoughtful!) But I didn't. I didn't want them to see me like this – attached to a drip stand, an NGA line up my nose leading into a bag of sludge; urine bottle on standby at the side of the bed…
Can you put them off? I said. Can you tell them I'm not up to it? He agreed, okay, he said, I'll talk to them, I'm sure they will understand.
I hope they will understand. After Cyril leaves and feeling a little better I decide to make an effort and take a walk, so, Drip Stand by my side we move slowly out of Area 4 and into the main thoroughfare of Copthorne Ward, bed areas off to my right and left, I glance into each, one looks like all women, another, old men. I keep walking, rather slowly; past the reception counter, the two nurses there glance up at me, smile, one says, "Going for a walk? That's good. Don't get lost!"
I make my way out to the main corridor and sit down on one of the seats, thoughtfully placed, I guess, for people like me who have to sit down and rest after a couple of hundred steps. I gaze out of the window, the weather looks good, little white clouds, patches of blue. I sit and watch the passing parade: Two doctors deep in conversation walk by, a cleaner with brooms and mops and other paraphernalia attached to his cart, wheels slowly past, two junior female nurses come out of the nearby lift, one leaning close to the other and speaking quietly into her colleague's ear. As they drew level I heard, "What do you think, should I? Would you?" The words creating all sorts of possibilities in my mind and visions in my head. Two visitors come past, middle-aged ladies, one carrying a sad looking Tesco bag the other is more up-market, an M&S bag in her hand with smart looking rope handles, "She looks much better now, don't you think?" Says one. "Oh yes, they've worked wonders, did you see her last week?" Says the other, "She was at death's door, I swear it."
None of these people glances my way. They probably don't even notice us, me and Drip Stand, sitting here, me in my PJ bottoms, tee shirt, slippers and pullover. We make our way back to Copthorne Ward, Area 4, bed A and arrive in time for supper – and I force some jelly and ice cream down and a cup of tea. Then it's drugs time, then blood pressure measurement time again, not forgetting, ‘Have you opened your bowels today, Gerald?'
Saturday 1st September
I wake up, the pain is back. I peer down at the plastic bag by the side of the bed that the NGA line is supposed to be feeding, I can hardly see it in the gloom but it doesn't look as if there is any more of the brown sludgy stuff in there than there was yesterday. That means stuff is in my stomach that shouldn't be there. Is that why it's hurting? I move my hand to my chest and the steady bleep…bleep… bleep of the machine feeding me nutrients changes to the urgent, loud, beep!beep!beep! I look up at the small screen, "Infusion stopped" it says "check fluid path between pump and patient access site." I feel around for the call button, find it, press it. Wait…
At last, footsteps… The light by the bed is switched on, a figure fiddles with the machine, the urgent beeping stops and returns to the steady bleep… bleep… bleep…
"Hello, Gerald. What's the matter?" It's Kunju.
"I've got a pain," I touch my lower chest, "And this bag, it's not filling."
She picks the bag up, shakes it, "Mmm." She puts it down again but in a different position, twiddles around with the plastic line. "Okay, it's coming out now."
I look down and can see gunge flowing along the tube and dripping into the bag.
"How bad is the pain?" She asks.
"It's not so bad now, I think it's easing," I say, and I think it is.
Darren, the new chap in the corner has been told he needs an NGA line inserted. I know this because as this is a small area with just four of us in it is easy to hear conversations going on around other beds and Darren has not been quiet in his resistance. "I'm not having it," he says, loudly. "Forget it. Down my throat? No way, it's out of the question!" The nurses – several – have been trying to persuade him for most of the day but have so far failed. His wife has been here, back and forth. In her thirties, slim, dark hair, attractive. He is clearly in pain but seems determined. ("It's no good you keep asking me – the answer's no!")At one stage she came out from behind her husband's screened off bed, tears in her eyes, "I'm going, Darren. I can't stand this." And she clipped clopped out of our area in her high-heels and I thought she had left and gone home but a few minutes later she came back but stood at the door to our enclave not far from where I was sitting up in bed reading (and feeling much better now, thank you.)
She stood there for a few minutes and caught my eye a couple of times and after a minute or two she came over, "May I ask you a question?"
"Yes, of course," I said.
"That…" She hesitated and pointed toward my nose… "Tube thing you have… does it hurt… I mean when they put it in, is it difficult?"
"It doesn't hurt, no, but it isn't the most pleasant experience when it's inserted but I'm glad it's there, I mean if it wasn't all the stuff collecting in my stomach would be causing major problems. Tell your husband it is about twenty to thirty seconds of discomfort and then it's over. Once it's in he will start to feel better."
"Thank you. I hope you didn't mind me coming over and asking – "
"No, I don't mind at all."
An hour or so later the nurses had another go at persuading him and this time was successful. I could hear the procedure taking place, ("Drink, Darren, drink!)I like to think my short chat with his wife had influenced him but I don't really know if it did.
Sunday 2nd September
Rowdy Yates wakes me, "Okay Mr Favor, I'll head out."
‘Rawhide,' Clint Eastwood pretending to be an 1860s cattle drives' scout. Cow's mooing, horses galloping, music. It's the TV again, it's two o'clock in the morning. Behind his screened off bed area Matt has the volume up too high and I also get a whiff of something, a cigarette? Something else? Surely not. I start to turn over, beep!beep!beep! I look up at the machine I'm attached to, "Infusion stopped, check fluid path between pump and patient access site."
Well-spoken Mathew comes along, switches the bed light on, presses buttons, the steady bleep… bleep… bleep… returns. "It is very sensitive, Gerald. You should try to keep your arm still."
Easier said… I decide I'm going to complain about Matt's TV but then realise it's not on now so don't say anything.
"How are you feeling, Gerald? Any pain?" Mathew asks. I shake my head. No there is no pain. A metallic sound comes from behind Matt's screen, an expletive, followed by Matt in his wheelchair. He stops at the wash basin by the door, cleans his teeth vigorously and then rolls through the door and out of site.
"Why does he keep the screen around his bed all the time?" I ask Mathew.
Mathew shrugs his shoulders, "I don't know, he shouldn't really, but, well, he is a bit of a loose cannon."
Things are looking up. The cough seems to have gone. To the daily question, "Have you opened your bowels today, Gerald?' This morning I answered, "Yes, well, sort of. I mean there has been a southern wind, and a little diarrhoea."
The nurse, Annette, looked delighted, "That's good." She laughed, "Things are beginning to move. Make sure you tell us each time, we need to take samples."
In the middle of the morning Mr Piggott-Smith and a young man I hadn't seen before, a junior doctor I surmised, stopped by the bed with the usual questions: "How are you feeling now? Any nausea? Any wind? Have you opened…?"
I answered positively: Much better, no, yes, yes. He looked pleased picked up the bag at the side of the bed, stared at it, "Mmm… I think we will leave things as they are for a couple more days, okay?"
"Yes, fine, if that's what you think is best."
"Good," he said and nodded to his junior colleage who was shuffling some papers and looking puzzled. "Isn't this Mr Thompson?"
"No, this is Mr Thornhill. I suggest you make sure you are talking to the patient you should be talking to when you visit. Otherwise, it could become confusing for all concerned, wouldn't you agree, Mr Thornhill?" I laugh, "I would agree, yes."
The junior doctor looked a little sheepish as they moved over to Darren in the corner.
I feel much better and the day has been going by quite merrily; I went for another walk, a little further this time and I was much more steady on my feet. When I got back I decided to have a good and thorough wash in the bathroom. I am unable to shower yet due to the cannulas in my arm and my Drip Stand friend, who follows me everywhere, so a good wash is the best I can manage, my hair looks lank though I can't do much about that yet. But today's effort ended not quite so merrily. I had hooked my other constant companion, the plastic bag receiving the contents of my stomach, onto Drip Stand and was trying to get it into a position that would enable me to wash reasonably thoroughly when the line caught itself on something, pulled out and fell to the floor. The Elastoplast stuck to my nose and holding the line in position had worked loose. I looked down at it with dismay - I knew I would have to go through the insertion procedure again and sure enough, as I came out of the bathroom Shivani was there and said, "Where is the NGA line?" I had it in my hand and held it up, "It came out while I was trying to wash."
"We will have to put it back in."
I shrugged my shoulders and said okay and sooner the better and a half hour or so later it was: "Drink, Gerald, drink!" And the same sensation of being waterboarded for thirty seconds was with me again and then, once more, a tube was up my nose, and in my stomach and the nurses were smiling and saying ‘Well done, Gerald!' And I, for a reason I cannot fathom, was feeling immensely pleased.
Heather came in the early evening. I had fallen asleep in the chair and I woke up and there she was, smiling down at me, "You are looking a lot better, Tott, you've got your colour back. How are you feeling?"
"Yes, much better," I say.
Monday 3rd September
It looks as if next-door-behind-behind-his-screen-Matt, is leaving us. I listened (couldn't help listening) to a conversation between him and Darren this morning. Clearly, Darren is feeling much better now, he was out of bed and sitting by the window and Matt had wheeled over. "Yeah, well, I shoulda gone home a couple weeks ago, like," says Matt. "But the bloody Social Services fucked that up for me."
"You won't believe it, mate. They come round regular, I've been in this wheelchair fifteen years so they reckon they ‘ave to come. I've got a boy – he's ten – so they're checking he's alright, it's just an excuse to stick their noses in. I've told ‘em to fuck off before now. Anyway, I bought my boy a toy gun, you know, like a pistol, plastic, it's a toy. One of these stupid social service cows reports it to her supervisor, only she says it's a real gun, so they refuse to come until I get rid of it. I told them not to be so bloody stupid – it's just a fucking toy, but then the police got involved and they came round and after a lot of ridiculous arguments agreed it was a toy, but still the social services wouldn't come so the hospital wouldn't release me until it was sorted."
"Have they sorted it now?"
"Yeah, they're going to, like, discharge me tomorrow." A short silence and then Darren's voice, "What put you in the wheelchair?"
"Huh, well, I'll tell yer. I was nineteen, me and me mate, we'd been out, picked a couple of girls up, ‘ad a few drinks, like. We was coming home, me mate was driving, he'd had too many – well, we all ‘ad ‘ad too many. Comes to this roundabout, we're going too fast for it and he oversteers the bloody thing; we hit the fuck'n roundabout, shoots across it, comes off the other side and hits a fucking lorry. Been in a wheelchair ever since."
"Christ! What happened to your mate and the two girls?" "He was no mate of mine after that. Tried to blame me, tried to make out in court it was me driving, but the police prosecuted him – driving under the influence, dangerous driving, they threw everything at him. He got five years." "Were the girls hurt?" "Killed, mate."
There was a silence. Darren probably as shocked as I was. Matt again: "Anyway, I'm going for a fag, mate, See yer later."
He wheels past me nods ‘hello' and disappears out of the door.
They've taken one of the cannula's out, the one that was used to shoot paracetamol into me, so now I've just got one line attached to the drip stand and I've learnt how I can disconnect that, so this afternoon I went for another walk but this time without the companionship of Drip Stand. I even went up and down a flight of stairs, so things are definitely looking up.
I've had several visitors today. Neil Smith and his team, "You are looking better, Mr Thornhill, how are you feeling?" Have you had any bowel movement?"
"Yes, I am. Yes, I have." Everyone looked pleased. He points to the line in my nose. "Perhaps we can take that out, Mr Thornhill." It's almost a question. "I don't want you to do that if there is any possibility of it having to go back in – I don't want to go through that procedure again."
"Alright, we'll leave it another day, okay?"
The Pain Nurse came along, introduced himself. Middle-aged, smiley. I could have done with you a few days ago, I thought. Didn't say.
A man from the Hospital Radio came, "Have you any music requests?" Not today. Then a doctor, female, flawless brown skin, very white teeth, looked no older than eighteen but must have been in her mid-late twenties (she's a doctor, after all). She was slim, attractive, professional, friendly. She introduced herself but I can't now recall her name. "I'm Doctor … " And she sat down and kind-of interviewed me. How was I now? On a scale of one to ten where would I put the pain, I have had? When I go home is there someone to look after me? A dozen other questions I am unable to remember. Nor can I remember what department she was from. Part of Neil Smith's team I assumed, though I hadn't seen her before. (I would have remembered her, she was very attractive) she gave me an injection in my stomach, "To prevent blood clots," I think it was she said.
Tuesday 4th September
Matt has gone home, thank heavens. At least I won't be waking up to ‘Wagon Train,'or "Rawhide' tonight, or detect the tang of something illegal floating through the screens. His bed space is now occupied by John, about the same age as Matt, 35 – 40. He has, apparently, come up from another ward, I'not sure why. His mum and dad are here most of the time, both are elderly, well, when I say ‘elderly' I mean the mid-sixties which isn't really ‘elderly' is it?
They each have strong Scottish accents although their son sounds quite English. I don't know what's wrong with him but his parents both have worried looks and talk to him in the way you would talk to a young boy, encouraging him to take the tablets, eat, drink. When they are not here – which isn't often – he will get out of bed and walk across to the bathroom/toilet, although a couple of time he has missed it and wandered out of the door to be brought back a minute or two later by a nurse and shown where the bathroom/toilet is.
I spoke to James this afternoon, he had lost his call button again. He told me they have been trying to find a home for him to go into and thinks there is a possibility of one in Crawley and he could be moving there at the weekend. "About bloody time," he grumped.
He has some nasty sores on his legs which they are treating but he complains about them every day so I am guessing they are not getting better. If he does go into a home I bet he won't be looked after as well as he has been in Copthorne Ward. Nurses literally at his beck and call twenty-four hours a day, always patient and good-humoured with him (and he can be a bad-tempered old guy).
I mentioned the fact Matt has left us, "Good bloody riddance," he said without hesitation. "We might get a good nights sleep now."
Wednesday 5th September
As predicted by James, a good nights sleep – apart from the usual being awakened to, "Gerald, can I take your blood pressure?" followed by, "What date is your birthday?" But I don't mind, it's for my good and at least it wasn't Major Seth, or Rowdy Yates, or Gil Favor I'm eating now, jacket potato, beans, creamed potatoes, ice cream, jelly, I even tried the tomato soup again but my first impression of it was confirmed. It's awful.
After the daily bed-linen change Mr Smith plus team came round and several questions later he says, "I think you could go home by the weekend, Mr Thornhill, everything seems to be working, you look fine, what do you think?"
"Yes, good, thank you."
"Yes, good, thank you." I know I am grinning as they all moved on to Darren. After lunch Shivani takes the NGA line out – I hope never to have one of those again – and then the remaining cannula. (Free! Free at last!)
"Can I have a shower?" I ask her,
"Of course," she says. I hunted through the toiletries Heather had packed for me hoping she had included shampoo and yes, of course, she had. Then the shower. Bliss, utter bliss. The first one for well, I dare not work it out, much too long by any measure.
As I come out of the bathroom it is obvious something has happened. A nurse hurries past me, followed by a doctor, they both disappear behind the screens that have been pulled around the bed space of the new guy, John.
"Okay, we've got ten in two," a male voice says. "Can someone measure the (unintelligible) rate?"
A woman's voice. "Give him diazapan."
Someone says, "Let's get him on the bed."
A male voice, loudly, "John! John! Can you hear me? John!"
Another voice, "Get the (unintelligible) now."
I sit on my bed as a female nurse comes out from behind the screens next to me and hurries past and then I notice John's parents. Somebody has provided them with a couple of chairs and they are sitting just outside the doors. John's father is looking grim, his mother is crying. Next door a female nurse is saying, "John, John, can you hear me? Squeeze my hand if you can."
Pulling the screens around my own bed I get dressed and decide to go for a walk, sitting listening to the drama going on not four feet from me is disconcerting and I somehow feel I am being invasive.
"Clear!" A doctor's voice. An electronic sound. A thump. "Again." An electronic sound, another thump. They are using a defibrillator
I open my own screens and approach John's parents sitting by the door. I catch his mother's eye and she attempts a smile but it's clear she is very upset. I stop, take her hand and say, "They are doing their best for him."
She says, "Aye, we know, they have been so good, but I don't think he is going to make it this time." She starts to cry again. I don't know what to say. Her husband puts his arm around her and nods at me and I move past them, past the reception desk, the nurse sitting there looks up and smiles, "Going for a walk? Don't get lost!"
I am away for about a half hour and when I get back where John's bed was is now an empty space, I point to it and ask Darren, who is sitting by the window, "What's happened?" Darren gives me a thumbs down gesture and says, "They've moved him to a private ward. I don't think he's made it." This sad news is confirmed an hour or so later when John's parents come in and remove toiletries and clothes from his locker. I am sitting in the chair in the corner. They both walk over to Darren and talk quietly to him and then come over to me. He looks desolate, she looks broken.
"He's gone," she says. "He was such a bonnie boy" Her husband takes her hand, "It's for the best."
"I'm so sorry," I say.
"You have been very kind," she says, "everybody has been so kind." I wonder what it was he had. He seemed so alive. And now he's gone, dead, just like that. He was only in his thirties, I am sure. How sad, how awful.
"They managed to get a priest to him before…" Her voice breaks.
"Aye, they did." Her husband says.
Not that that did him any good, I think.
In the afternoon, just before Heather came for a visit, poor John's bed space is taken by a newcomer, wheeled in by a porter and accompanied by a nurse. Another Scot, with a really strong accent, so strong I can hardly understand him. In his seventies I guess.
"I'm Ben," he told me, "Do you know how to work this telly? I want to watch the football." I take the remote off him and switch the TV on and show him how to change the channels, alter the volume etc.
"I was in the army," he suddenly says, "twenty-five years, went all over the place. Singapore, Gibralter, Germany, Canada – it was bleed'n cold there, I can tell you."
"Really?" "Oh, aye. But it's a good life, the army, aye, a good life."
A little later Heather arrives. "I've got good news," I tell her, "They are discharging me on Friday."
"Oh? That's good news?"
"Don't be cheeky!"
"How do you feel, I mean you know what happened last time."
"I feel fine."
"You said that last time."
Thursday 6th September
Early morning, Shivani is taking my blood pressure, temperature, etc. I ask her, "When the night shift hands over to the day shift the nurse who's handing over always gives a figure when she or he finishes describing my condition, like, ‘Gerald is one, or Gerald is one-and-a-half. What does that indicate?"
"You shouldn't talk while I'm taking your blood pressure, haven't I told you that before, Gerald?"
"Aren't you going to tell me, Shivani?"
"It's just a measurement of how your night went. Two not so good, one better." She removes the blood pressure cuffs, "How is it?" I ask.
"Are you sure? I mean, you being so close to me I thought it might be up a bit." I grin.
She looks at me and smiles, "If you are trying to flirt with me it isn't going to work."
"Are you married, Shivani?"
"Yes, and so are you."
"Oh – is that a reprimand?"
"Yes." I laugh as she packs her equipment up and wheels her cart away.
I had another shower this morning and washed my hair again. Things are getting back to normal. (‘have you opened your bowels, Gerald?' ‘Yes.') I went for another walk, ascended and descended a flight of stairs. Back in the enclave I walk over to Darren and sit and chat. He is a taxi driver, he tells me and has had bowel problems for years. After his recent surgery, he now has a stoma and the stoma nurse has been teaching him. He was philosophical about it. He shrugged his shoulders, "I'm getting used to it – it's better than the alternative." He hesitates for a second or two and then, "Have you…?"
"No," I say, and think how lucky I have been. Lucky Heather insists on me having check-ups and blood tests regularly; lucky this was diagnosed so early, lucky I live in the UK and we have the NHS…
I rang my sister, Stephanie, "How are you?" I ask.
"I'm okay, what's more important is how are you?"
"Good," I say. "Great," I say. "I'm feeling fine, I say."
Friday 7th September
A lot of paper work is involved in the discharge procedure but I am told it should be all sorted by the middle of the afternoon.
"Is your wife picking you up?" I am asked.
"Yes," I tell them, "I will ring her when you tell me it I am free."
They smile, say they will.
I am given leaflets on diet, an assortment of pills. I Text Heather, shower, dress. Chat to Darren.
I got my laptop out and look up a couple of statistics. There are around 16000 bowel cancer deaths in the UK every year (44 every day). It is the 2nd most common cause of cancer death in this country.
I think back to the 30th of April and my attending the surgery in Lingfield. Dr Richardson staring at the computer screen and looking up at me, "You are a little anaemic, Mr Thornhill, we must find out why." Well, we found out why. I am not trying to be dramatic and I know I am not exaggerating when I say my life has been saved. Thank you, Dr Richardson, thank you Mr Smith and all your team; thank you Shivani, Kunju, Mathew, and all of you working so hard in Copthorne Ward.