Counting the hours in the twilight zone

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The Independent Culture
I SPENT most of last week with my baby in the paediatric ward of our local hospital, the Whittington, in north London. He'd been admitted with a spectacularly high temperature, and a heartbeat that my GP said was too fast to measure. When we arrived in casualty, he was almost limp, and I was muttering to myself, in the manner of a madwoman, "Be calm, calm, calm."

I am, in many ways, a natural pessimist, and as we sat waiting to see a doctor, I rem- embered all the lurid horror stories that I'd read about the decaying NHS: we'd probably have to stand for hours in a cold, damp corridor, only to see an inept junior doctor who'd been on duty for 48 hours and had drunk so much black coffee (or worse) that he couldn't see straight.

In fact, our very efficient GP had rung the hospital and told them to expect us and we were rushed out of casualty in less than 10 minutes and taken straight to the ward. There, a brisk young woman examined him and sent him off for an X-ray in case he had pneumonia (he didn't), and told us he would have to stay in hospital until his temperature came down. A needle was inserted into his hand, and blood tests were swiftly taken, along with throat swabs and urine samples; he was, in short, given prompt and thorough medical care by responsible people who did not behave as though they were in a bad medical soap opera.

Once I'd stopped worrying that he was going to die, the rhythms of the hospital became curiously soothing: the hourly measuring of his pulse and temperature; the regal morning visit of the consultant with a retinue of admiring medical students; the regular arrival of the food trolley at 8am, 12 noon and 6pm precisely. At night, although it was almost impossible to sleep (I dreamt, briefly, that I was in a Californian hotel full of caterwauling rock stars), at least I knew that I was not alone in my wakefulness. Phones rang and machines beeped and nurses patrolled the ward; even the birds outside the windows sang, in the false dawn and the bright hospital lights. After a couple of days, it felt as though I had been there for ever. I knew the names of the other children on the ward, and what their ailments were, and when they were due to go home. I'd agreed with their parents that yes, there was a lot of it about; I'd overcome my fear of sitting on hospital lavatories (you never know, you might catch something nasty); I'd admired an architect's designs for the new fracture clinic, displayed outside the hospital canteen (mud-coloured "tarragon" tweed for the chair covers, sludge-coloured "Navahoe" fabric for the cubicle curtains).

By the time we left the hospital, I was positively brimming with thanks for the doctors and nurses who had cared for Tom. But I was also feeling more than usually venomous towards Virginia Bottomley and her slimy cohorts. Forget interior-designed fracture clinics - what about some extra staff? On one lunchtime trip to the canteen, I sat opposite a harassed junior doctor with a nervous tic who wolfed down his food in a couple of minutes, while constantly checking his watch as if it might rear up and bite him. Everyone around him looked equally fraught, as though they'd been up for days, and had another endless shift ahead of them.

On the paediatric ward itself, there were occasions when the nurses were clearly overwhelmed by their workload. They had just enough time to deal with their patients' medical needs - but rarely could they sit down and coax a sick child to eat something (let alone make a quick cup of tea for themselves). One of them explained to me that the ward was chronically understaffed, because of a lack of trained paediatric nurses. What happened, I wondered, when the ward was suddenly swamped: with asthma cases, for example, when the pollution levels rose in London, as they so often do? "We never stop," she said, "not even for a minute."

Her comments were echoed by a friend of mine, a former paediatric nurse in a prestigious London teaching hospital. "The ward got by on a skeleton staff," she said. "The minimum of staff did the maximum of work. People worked ridiculously long hours - 96 hours a week, sometimes. It was sheer hell. Why else do you think I left?"

I thought then of the chairman of British Telecom's remark last month that he would prefer a job as a junior doctor, because it would be more relaxing than his own onerous duties. According to a recent survey, more than half of junior doctors work over 73 hours a week on pay as low as £12,500. At that rate, the BT chairman's salary (£663,000) would pay for 55 doctors, or 66 newly-qualified paediatric nurses. I know that Virginia Bottomley cannot be blamed for the fact that the BT chairman earns an obscene amount of money, but as I lay awake in the hospital ward, doubtless irrational from lack of sleep, I wondered who else but her was responsible for the closure of the accident and emergency department at Bart's: the reduction of hospital staffing levels; the sinking morale in the NHS?

When I came home with my baby (who turned out to have had some nameless virus), a neighbour across the road was setting off for the hospital with her three-year-old son, who had a severe attack of asthma. He stayed the night, nursed by the same people who had looked after my child; people who had been on their feet all day, and the day before that, simply doing their job - the most important job in the world, when it is your child that is sick. They continue to work in gruelling conditions, for not very much money, presumably because they care about their patients. For that, we should be most grateful, though I fail to see why gratitude alone should be deemed sufficient reward for their labours. !

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