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| Should I resort to Culpepper? |
They got worse.
Some ten days ago, my neck and shoulder became so painful that I was interspersing paracetamol with ibuprofen every couple of hours. It was like extreme toothache - the pain you get when you have an abscess, only relocated elsewhere. I did a lot of night time reading but very little sleeping.
Worried, I phoned my medical practice. The best they could offer me was a telephone appointment with a nurse practitioner in a couple of days time. I took it, carried on taking the pills, and then had a brief chat with her. I pointed out the crack on the head and wondered if I needed an X-Ray. She suggested that because the pain was so acute, I should go to A & E. I waited an hour to see the triage nurse.
'We can't help you,' she said.
I'm not blaming her. She was under strict orders. 'Nothing to do with the bump on the head. It was too long ago. You've probably turned the wrong way in bed.' I was close to tears by this point, between the weeks of pain, the worry and the lack of sleep, so she went out to speak to a doctor and came back within seconds. 'He says it's nothing to do with the bump on the head. It's not your fault. You shouldn't have been sent here. You need to go home and phone your GP again. They have emergency appointments.'
This was about 10.30 in the morning. There were six people in the waiting room. 'It would be six hours before you could see a doctor anyway' she said, briskly. On the way out, a stressed elderly woman grabbed my arm and said 'it's a disgrace, that's what it is.'
I should probably point out here that I have never, not once, been into A & E on my own behalf before. Only with my mum when she had terminal cancer. I tend to ignore problems and assume they will go away. On the way home, I tried to call the GP several times but it was always engaged.
Fortunately my husband was driving. And even more fortunately, there was a traffic jam which meant that we took a detour and stopped at a village pharmacy where a kindly pharmacist listened to me with sympathy. 'It sounds like a trapped nerve and it can be excruciating,' she said. She suspected that it might indeed have to do with the bump on the head, since it had gradually been building ever since. She had several useful suggestions. She gave me more painkillers, suggested that very gentle yoga exercises might be a good thing, and thought I might try Tiger Balm. She also suggested that I should persevere in trying to see a GP, but that if it did turn out to be nerve compression, an osteopath might be the answer. Tiger Balm, surprisingly, helped. Ibuprofen helped too, but I had to stop taking it after a day or two because it was upsetting my stomach,
I followed her suggestions as far as possible, and the acute pain abated just enough for me to sleep, with the aid of Nytol. That was more than a week ago. The pain has now mutated into something a little more bearable but just as unpleasant. Like a series of intense, exceedingly weird electric shocks through my neck and head as well as very painful and tender skin, with no evidence of any inflammation on the surface. The 'shocks' come and go throughout the day. It's wearing me down.
Last week, I got through to the GP practice, but was told that it would be a couple of weeks before I could see one of the four GPs face to face. By dint of polite pleading, I got a phone appointment with an actual doctor for next Tuesday.
On the same day, with desperation setting in, I contacted a private clinic recommended by a friend and now I have an appointment with a fully qualified osteopath on Monday afternoon. When I told them the history of this injury, they too suspected that the bump on the side of the head might well have something to do with it, and the pain and other symptoms sounded like nerve compression.
We'll see. It's going to cost me money we can ill afford, but I can't go on like this, and the NHS has - so far - been no help at all.
Throughout my adult life, I've been lucky enough to be reasonably fit, and seldom needed to visit a GP, so I don't think I had realised just how poor the service had become, although I had heard similar or infinitely worse tales from friends.
I'm old enough to remember when you could go to your doctor's surgery and wait to be seen. The doctor knew you, your family, your situation, your medical history. Unless you could get there early, you might have to wait a couple of hours. but he would see everyone in the surgery. It was hard cheese if you needed to get to work, but it was a valid excuse. If somebody arrived in acute pain, or obviously very ill, they would jump the queue. If you were too ill to come to the surgery, the doctor would visit you at home later or - as a last resort - call an ambulance for you himself. The last doctor to do this in our town retired when our son was very young - more than thirty years ago. For a while the new health centre with its appointment system worked reasonably well. Until it didn't.
'Gradually then suddenly,' to quote Hemingway.
I don't know exactly what has gone wrong. Who does? 13 years of Tories? Money? Staffing? Brexit? Some deadly combination of all these things? Too many patients and too few doctors? I've just checked on the practice website. There are four doctors, two advanced nurse practitioners, a practice nurse, a staff nurse, a 'health care assistant', a practice manager and eight medical administrators.
There are two practices in this smallish town.
But knowing just how much of my own time is taken up with the demands of the (cue hollow laugh) 'paper free office' in which admin for a house and two micro-businesses, my own and my husband's, seems to take a million times longer than it ever did in the olden days - I sometimes wonder if the systems have just got completely out of hand and overriden considerations of patient care. In much the same way, with less disastrous consequences, as the Scottish Book Trust now seems to have more than 70 staff members to 'support Scotland's writers' while Creative Scotland has roughly the same number. All doing what? Admin? Create a space and the demands of bureaucracy will expand to fill it, like cavity wall insulation.
And you know what the worst of it is? It's everything. All this admin doesn't work. None of it really works. Nothing including the NHS, education, the Post Office, the police, the water companies, transport, local government, banking - nothing works the way it should.
If we paid a small sum to see a GP as people do in many EU countries, would it make a difference? Or would it just compound the problems? I have no answers to these questions. When I do, very occasionally, get to see a GP, I find them as helpful, as kind, as my old GP ever was. So that isn't where the problem lies. But as far as access to resources go, we compare very badly with our European neighbours.
All I know is that, sadly, the elderly NHS, 75 years old, is showing her age. She has grown confused and forgetful, weary and uncommunicative, and those of us who love her are finding her increasingly difficult to access when we badly need her help and advice. She is, in short, falling apart at the seams, and we're falling apart with her. Whether she is now beyond saving is up for debate but the alternative is too hideous for all but the wealthy to contemplate.
PS
I've now seen an (excellent) osteopath and in a few days I'll be seeing an (also excellent, caring) doctor. The condition hasn't gone away, but it's improving a little. It's clear that the problem doesn't lie with the health professionals. It lies, sadly, with the systems surrounding them. The professionals are like those musicians, valiantly playing on, while the Titanic is sinking around them.
