|Brilliant cartoon by Michael Leunig who has been my hero for thirty years.|
In my delicate mental state I probably shouldn’t really be watching television shows like BBC2’s The Trap since it confirms what I have always suspected – that the world is actually being run by an evil mathematician from somewhere near to the earth’s core and that people who look powerful to us like Bill Gates and Rupert Murdoch, are really only munchkins in Armani, (or in the case of Bill Gates – vintage Man at C&A). The mathematician is responsible for the prevailing world view that if the greediest half dozen people in the world are allowed to hoover up ninety per cent of its wealth with no constraints whatever, it will be good for everyone. Would it be impertinent to suggest that this theory wasn't all that thoroughly thought through?
Last Sunday’s programme, the second of three, explored the mathematical foundation for the promotion of unbridled capitalism in the west since the Second World War. Using Game Theory, economists reduced human interaction to a series of selfish strategies motivated by individual ambition. As you know, I am not all that kindly disposed to the world at large, but even I have noticed that parents don’t immediately put their newborn babies up for sale on eBay despite the obvious financial potential created by the strong demand from Morgan Stanley high flyers who were so busy making moolah they clean forgot to make whoopee while their own biological window was still open. Despite its sixty year longevity, the theory seems flawed because – and this is quite a thing for me to say – most people aren’t selfish, money grabbing cunts – the media just makes it look that way.
But this economic theory has had a potent effect on western governments as politicians like nothing better than to have people reduced to numbers and New Labour have jumped on the algebra express with Keynesian keenness, resulting in the reduction of every aspect of public service to a series of Glengarry Glen Ross type impossible targets. It’s obviously a stretch to imagine Gordon ‘Scrooge McDuck’ Brown in the Alec Baldwin role, although Alec is looking a bit doughty and doughy himself of late, but the deal is pretty much the same – deliver the ‘outcomes’, as they like to call the heinous things they do to us, or hand in your BlackBerry.
The NHS was particularly hard hit by the target-driven approach to social order. The disinclination of humans to run their health as if it were the 7.42 from Bishops Stortford certainly sprinkled liberal quantities of the wrong kind of leaves on the tracks of Health Trusts’ journey plans. The Trap disclosed how ingenious hospital managers became at devising innovative schemes to reduce waiting lists without actually seeing the patients that were parked on them, presumably for good reason. One hospital wrote to all its waiting list patients to ask them when their holidays were and promptly scheduled their hip replacements while they were being wheel-chaired around Broadstairs. Short, easy operations like the removal of bunions were prioritised over brain surgery and you could no longer make an appointment with your GP for more than two days ahead, even if it would be more convenient for you.
But I was going to talk about the person who occupied the next bed for the four days I was on the gastro ward at the Homerton University (???) Hospital where they didn’t actually have any medicated or antiseptic cleaning products. Spew, shit and worse was mopped up with J-cloths whether it be on you, the floor, your beside table or Maeve Blinchy novel that you were given by the mobile library because that was the only book they had that wasn’t Mills & Boon. Holly (not her real name obviously), was a heroin user. I did not know this because of my superior powers of deduction and diagnosis, although I am beginning to think that I could cut it on CSI or ER as I certainly managed to work this out before any of the doctors and nurses had twigged.
Holly arrived an hour or two after I’d been moved to the ward at around ten in the evening with no notice at all and a misunderstanding with the porter in which he interpreted the question ‘why am I being moved?’ as an indolent refusal to co operate resulting in a bad-tempered oratory lasting the interminable journey, punctuated by occasionally body-jarring collisions with corners and parked life-support machines worth millions of pounds. After screaming in pain for an hour and being completely ignored by the night nurses who had all gathered to discuss the latest episode of Scrubs and flog gallstones on eBay, Holly made a phone call. Shortly thereafter she arose from her bed, got clobbered-up and announced that she was going for ‘a smoke’.
Some hours later Holly returned and I was woken by the sound of her chomping on fistfuls of crisps. The next morning, the sound of her groaning rewoke me. She called for the nurses. One of those ridiculous throw-away sick pots was produced into which she threw up the night before’s crisp feast and then clenched her stomach in pain. Nurses offered painkillers but Holly wouldn’t have any tablets because of the nausea (duh!). Eventually she was offered a morphine shot. She even enquired about the dose without raising an eyebrow – how many milligrams? 'No, I need more.'
Whereas a middle-aged lady like Pants, with all her own teeth and zero hospital admissions, was treated like a criminal for asking for painkillers at all, (I was even informed by a nurse barely out of training bras that morphine is ‘addictive’ – well yes, I suppose you could get addicted to the idea of not feeling like someone was attacking you with a fucking ice pick), Holly seemed able to write her own prescription.
The pattern continued over the four days we were neighbours. Holly would wake in the morning retching after her midnight feast and refuse to eat. She would call her large family, many of whom would be on the scene within the hour. Her staunch matriarch of a mother would pace and peruse Holly’s chart harrumphing knowingly ‘Morphine? Why they giving you that then? That’s for dead people’. Well, I guess she was in the ball park, sort of. The family would beseech the doctors to ‘find out what’s wrong with her’ to which the doctors would promise to do ‘the very best possible’. Holly would mercifully then sleep for the rest of the day, only waking to retch, yell and refuse food for long enough to achieve an injection of morphine.
Come the changeover to the languid night staff, Holly would again get herself kitted up and would be gone for hours for ‘a smoke’. Once she even brought ‘the man’, back for a little party. I knew it wasn’t her husband because I’d seen him – timid, damaged and confused, not having the vaguest idea of what to say or do. After that night, the incoming nurses found Holly’s bedside table littered with crisp packets and soft drink bottles and a mysterious brown liquid on the floor which they circled for a long time before finally identifying as ‘chocolate’. The overturned carton nearby was the giveaway clue. A great deal of deliberation was necessary to work out how to deal with this situation as there are no actual cleaning products and no one knows where the cleaners keep their mop and bucket. It was finally decided that a bath towel was the appropriate, or perhaps only, solution and one of the nurses duly tossed one over the brown mess.
Holly is a daily heroin user. I know this because she told one of the doctors who was on the ball enough to ask a couple of obvious questions.
Do you use heroin?
Do you use it every day?
Do you inject or smoke it?
But then the doctor completely blew it by explaining that because Holly used heroin, it might mean that other painkillers did not work so well on her. They didn’t find anything wrong with Holly. She had a non-specific pain that she could not describe. She was using other medications as well. In addition to her night-time connections, she was popping her own anti-depressants quite openly. What is going on here, I asked myself.
Holly is of mixed race. I know this because I saw her white mother and black father visit. I started to wonder if narrow, phobic targets and fear of being accused of cultural stereotyping might be playing a part in the reluctance of healthcare staff to recognise that Holly had a very specific health problem that they should be able to address without worrying about triggering headlines in the Daily Mail. Both of us, in our own very different ways, were numbers that didn’t add up. It’s time for a new theory about how we look after each other…