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The battle of Alan's foot

One woman's experience at the hands of the NHS has divided the nation. After years of good health while observing the political scene, Alan Watkins recently had to undergo a spell in hospital. Here he offers some reflections on his own dealings with the service

Sunday 06 March 2005 01:00 GMT
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On the whole I have enjoyed undeservedly good health, though lately there have been a few troubles. One of them was that I developed Dupuytren's Contracture. This is what it is called when a finger bends into the palm and cannot be straightened. It is quite a distinguished condition, having afflicted Graham Greene, Margaret Thatcher (who, it may be remembered, had an operation for it) and, I am told, the former rugby commentator Bill McLaren. I have it in the little finger of my right hand. Luckily, I am left-handed. It is not life-threatening and is more a nuisance than anything else.

On the whole I have enjoyed undeservedly good health, though lately there have been a few troubles. One of them was that I developed Dupuytren's Contracture. This is what it is called when a finger bends into the palm and cannot be straightened. It is quite a distinguished condition, having afflicted Graham Greene, Margaret Thatcher (who, it may be remembered, had an operation for it) and, I am told, the former rugby commentator Bill McLaren. I have it in the little finger of my right hand. Luckily, I am left-handed. It is not life-threatening and is more a nuisance than anything else.

Nevertheless, I resolved to emulate Lady Thatcher and to get something done about it. To this end, I consulted my GP, who made an appointment with a specialist at a London teaching hospital. This took some months. The surgeon said he (or maybe someone else) would perform the operation at the Royal Free Hospital, Hampstead. More months elapsed, until I received a summons to attend the Royal Free, for an examination rather than an operation. In November 2003 I saw a surgeon different from the one I had seen originally.

At this point we come to my other trouble. For two years I had suffered from what I called blisters and the doctors called ulcers. They were on the feet and seemed to come about through warm baths. I had them dressed either at the GP's group practice or at the podiatry department of the Whittington Hospital, Archway, where the woman podiatrist was greatly impressed by my acquaintance with Mr Andrew Marr.

In September 2003 I was on holiday in France; a dressing came off; I did not replace it; and the blister, or ulcer, became infected. I felt rotten. Returned to London, I decided to deal solely with the Whittington simply to secure a consistency of approach. There followed several months of antibiotic capsules or tablets. In November, when I saw the hand-surgeon at the Royal Free, the infection had still not cleared up. There was "no way", he said, in which he was going to perform an operation on my hand when I had an infection of my foot.

He spoke truer than he knew, or else he had foreseen the course of events. Towards the end of November 2003 the foot became swollen, I was in considerable pain - not as bad as toothache or gout, but bad enough - and the toes were inflamed, a burnished red. The podiatrist at the Whittington (not the one who so much admired Mr Marr, but a man) advised me to try applying a packet of frozen peas. I gave my considered medical opinion that my condition went far beyond anything that could be remedied by a packet of peas.

On my next visit, a few days later, he called in a young doctor. She took one look at my foot and said I must come into the Whittington next day for a course of intravenous antibiotics and "bed rest". I explained I could not come in then because I was due to have a pre-Christmas lunch with the editor and the rest of the political staff of this paper. We compromised on the day after that.

Knowing little about hospitals and their ways, I thought that, together with a good friend who was accompanying me, I would be shown briskly to a bed in a ward. Not a bit of it. From morning to evening I was in Accident and Emergency. I received an X-ray, an electrocardiograph and, doubtless, other tests as well.

Then I was told I must wait for a bed to become available. People in various states of disarray or distress - a man without shoes or socks, a girl holding a dressing to her cheek - sat as if they knew their flight was delayed yet again. Eventually my friend told a presiding nurse that, unless I was accommodated by seven, I intended to go home. This seemed to do the trick, and soon she was helping me unpack my sparse belongings.

According to the invaluable Professor John Yudkin, who was in charge, the infection was even worse than had originally been supposed. He prescribed more and stronger antibiotics and a stay of weeks rather than days. He said I could carry on writing a column. I did not feel like it, because the conditions for writing were inauspicious. For the first time in 40 years, I missed a column or, rather, several of them. Instead I worked on the proofs of the reissued edition of my Brief Lives and read Roy Jenkins's Churchill.

I subsisted on a diet of Marks & Spencer sandwiches, cheese, biscuits, fruit and occasional delicacies, brought in by my nearest and dearest, who went beyond any call of duty. I drank fizzy water supplied by them and machine-made tea without milk or sugar provided by the hospital.

One of my fellow patients acquired a great liking for my mineral water. He was called Cyril, had the shakes and was, I think, Greek. He stopped by my bed and, pointing to the bottle, said: " 'ighland Spring." I offered him a plastic cup of the stuff, which he drank with every appearance of appreciation. He took to turning up at the foot of my bed with increasing frequency. The water was going down at an alarming rate. He held out his palsied hand yet again.

"Look," I said, "just bugger off."

This he proceeded to do, shuffling down the ward towards his own bed in his orange hospital-issue pyjamas (which did not then have the sinister overtones which they were subsequently to acquire) and giving no appearance of ill-will. Subsequently I was told he had been transferred to a psychiatric ward.

The younger doctors were impressed by my abstemious regimen. They clearly thought they were dealing with a fully paid-up dipsomaniac. One of them said:

"There isn't any medical reason at all why you shouldn't have the occasional drink if you feel like it. Just tell us and we can arrange it."

I thanked him for his consideration but declined, saying I was not in the mood for strong drink. What I did not add was that I thought, from my skimpy medical knowledge, that he was wrong - that drink would have a deleterious or, at least, a neutralising effect on the antibiotics which were being administered by drip in such generous quantities.

When Churchill, the proofs and the daily papers palled, I would turn to the nurses' notes in a folder in a rack at the foot of the bed. By some quirky interpretation of freedom of information, these could be read by the patient, whereas doctors' notes were not so available. "Keeps himself clean," one nurse wrote - and I should hope so too, though, as in a barrack-room, about two out of three of the washbasins had no plugs. Another note went: "Needs no assistance," which was nice to know. And another was: "Very active around the ward." This was the first and remains the only time I have been described as "very active" by anybody, whether in a ward or anywhere else.

The nurses from South-east Asia were superb, the nurses from Ireland even better. The numerous Irish patients were likewise a cut above the rest. They were invariably good-humoured, some of them were witty, they were always courteous to the nurses and they took an interest in life or, at any rate, in horse-racing.

My only complaint, apart from the one about the initial wait, was that telephone calls, run by some parasitic organisation outside the NHS, were exorbitantly expensive. I have not had any more foot-trouble since leaving the Whittington over a year ago. But I am still waiting to hear from the Royal Free about my hand.

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