A Prayer for Contingency

A British AmbulanceLast October, my parents paid a visit to London. They spent the first few days of their holiday sampling the delights of the capital: they visited restaurants they enjoy, went to the theatre and did a bit of shopping. Then my father began to feel pain in his lower back; it became serious enough that he decided not to attend a performance of “Carmen” at the Royal Opera House. It was a very bad sign: early the next morning, he found he was in so much pain that he could not move.

The emergency services were called: after some pleading by my mother, an ambulance was dispatched. My father was taken to the nearest National Health Service hospital for examination; two of the attending doctors decided it was simply a muscle spasm. They prescribed him some painkillers and discharged him: he was literally wheeled out into the street. Yet, my father still could not move.

Fortunately, he had retained the services of a London doctor. Even more fortunately, he was due to see the doctor that morning; after a brief telephone call, the doctor told him to proceed immediately to his offices. A quick examination was sufficient to compel the physician to demand that my father be admitted to a nearby private clinic. A battery of tests were carried out with alacrity; it was suspected that my father had an infection of the spine. This diagnosis was later confirmed.

I don’t live in London; but as soon as I could, I made the trek into the city to see him. When I stepped into his room, it was a shock: my father is a hale and hearty man in his early sixties, who has taken pride in having maintained a rigorous fitness programme for many years. At that point, however, he was pale, sweating lightly due to a combination of the pain and the painkillers, and drifting in and out of consciousness. His dark eyes were sunk back into his head and had a glassy, almost tearful look in them. My sole consolation at being presented with this sight came when I took his hand in mine: at least the grip was still strong.

It took weeks for the doctors to come up with a detailed diagnosis. I took comfort from the fact that the clinic had tapped into the resources of University College London, one of the finest institutions in the country: a microbiologist was summoned as well as a team of doctors. The precise bacillus was identified. An ultra-strength antibiotic was administered. My father slowly began to improve.

It was important for him to maintain as much mobility as possible; the clinic provided a contraption called a “support walker”, which is generally given to patients recovering from surgery. It has four wheels and chest high arm rests: the patient pushes themselves along, letting the bulk of their weight settle on the rests. I accompanied my father on brief walks up and down the pastel peach coloured hall: he was sweating, grunting, working through the pain. This did not diminish his manners: he gave the nurses and support staff a grin and a friendly “hello” as we passed. All the while, he spoke about the future: I would complete my doctorate, Christmas was coming, there were trips we would take as a family in 2010, 2011 and 2012. He wanted to go to Paris, Istanbul, Rome. His eyes focused on me, then focused ahead, as if he was pushing himself towards the goals of which he spoke.

At long last, he recovered sufficiently that he was able to fly home. He received extended care in the United States; he ceased taking the massive doses of antibiotics in December. Unable to engage in the usual festivities, my sister and mother stuffed the Thanksgiving turkey. Stuck in Britain, I had additional impetus to pull myself together sufficiently to finish the doctorate; I successfully defended my thesis at the end of November. By the time I finally got to America a few days before Christmas, my father was able to walk with the assistance of a cane. He was pleased with the fact that he had lost thirty pounds, though neither he nor his American physician would recommend the method. The holidays echoed with his repetition of Barack Obama’s campaign slogan whenever he wanted to go anywhere: “Fired up and ready to go! Fired up and ready to go!” His recovery continues apace; he, and by extension, my family and I, are very lucky.

This tale is only a fortunate one because somewhere, somehow, a prayer for contingency was answered: note how the National Health Service fell down at the time of asking. This was not due to the service itself being uncaring or inattentive: my father had nothing but praise for the ambulance drivers in this instance. On a previous trip, he had come down with food poisoning and the NHS dealt with it efficiently. However, due to the government’s insistence on saving money rather than lives, there is an in-built bias in the system to discharge difficult cases. It was nothing short of a blessing that my father had sufficient connections and frankly, enough money, to be able to go an alternative route. His American doctor later told him that if he had merely followed the advice of the doctors at the NHS hospital, he might have ended up partially paralysed.

Both America and Britain are caught up in an ongoing debate about health care: what shape should the system take? Who pays? How should it be run? What are the values which will underpin the system? What balance is there going to be between efficiency and providing thorough care? The example of my father’s treatment suggests that contingency, i.e., some resilence within the system that provides an alternative means of achieving a proper result, needs to be more than prayer, it is a requirement. I am not confident that the politicians in Washington or London, absorbed as they are by bland statistics and the sweet nothings whispered by lobbyists, are fully aware of this need. Rather, they appear to be more interested in using health care as a political football, or more accurately, a bludgeon with which to beat each other. In light of my father’s experience, their behaviour is more than offensive, it’s disgusting: no doubt this sentiment is echoed on both sides of the Atlantic by people who have had similar experiences. Perhaps the politicians should stop for a moment in indulging their petty vanities or engaging in micro-Machiavellian tactics and think of a father and son pacing together down a long corridor and telling each other stories about the future intended to take away terrible pain. A spasm of mental clarity might occur: within that space, decency could triumph.

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