Christina Patterson: Is this what they mean by care in the NHS?

How complicated can it be for a breast-care nurse to master the procedures of a clinic
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The Independent Online

So, on Monday, I go to Barts for the results of an MRI. Six and a half years after finding a lump in my breast, which proved to be malignant, and undergoing treatment the administration of which would have shamed an outpost of the former Soviet Union, the waiting time is short and, what's better, it's in a fancy new block with nice curtains and nice modern art.

The registrar's nice, too. He asks me how I am and I bore him with my aches and pains, and he then happens to mention that there are a couple of patches on my scan which are "suspicious". He talks about biopsies and ultrasounds and mammograms and appointments and when I emerge from the consulting room, reeling and, I have to admit, weeping, I am scooped up into a pair of sympathetic arms. OK, I think. If this has to happen again – please God may it not happen again – but if it has to happen again, this time it will be better.

The breast-care nurse is very nice and tells me she has pulled out all the stops and got me an appointment for the "one-stop" clinic on Thursday. I am duly grateful. On Wednesday, she phones me to tell me again that I will have an ultrasound, and a mammogram, and a needle aspiration, and, if necessary, a core biopsy, which she has already told me, but again I am grateful.

On Thursday, I go to the clinic, and I see a doctor, but there's nothing in the file. So I tell him that I'm there for an ultrasound, and a mammogram, and a needle aspiration, and maybe a biopsy, but no one, it turns out, has made an appointment for an ultrasound, or a mammogram, or a needle aspiration, or a biopsy, and anyway you can't, apparently, have a biopsy in a "one-stop" clinic, because it isn't part of the one stop.

But the doctor is very, very nice, and he makes me an appointment for an ultrasound, and a mammogram, and a needle aspiration, so I march upstairs and I put on my gown, and I try to follow the diagram about tying the green tags, but there aren't any green tags, and the white ones seem to be designed for maximum slippage and sudden exposure so that the doctor, when he finds me for a quick word in the waiting room, is embarrassed by the sudden appearance of a naked breast, but I'm not, because I have other things to worry about.

And I have my left breast pressed and squeezed and photographed, and think of Kate Moss as I lift my arm and thrust my shoulder forward (nothing tastes, I think, as good as alive feels) and then a woman puts some cold gel on my breast, and runs a roller over it, and stares at a screen and puts a needle in. In the middle of it all, the breast-care nurse bursts in and says "hello", and let's when this is finished, have a little chat.

So, we have a little chat, and she tells me that she's sorry that the mammogram and ultrasound and needle aspiration weren't booked, but that this was the result of a "misunderstanding", and she's sorry, but I can't have a biopsy today and this, too, is the result of a "misunderstanding". And suddenly the whole time-frame has changed, and everything she's telling me today about how things work is different to everything she was telling me yesterday and everything she was telling me on Monday.

And I'm wondering how complicated it can be for a breast-care nurse to master the standard procedures of a breast-care clinic, and I tell her that what I really need at the moment isn't a sympathetic shoulder, actually, though that's always nice, but tests, and results, and a time-frame, and someone who can manage the communication of this information without too much confusion. Which, I tell her politely, doesn't seem to be her.

I see the doctor, who tells me that I will have a biopsy next week, and I see a different breast-care nurse, who appears to be a lot less confused than the first one. In the middle of our conversation, and a little look at leaflets, another nurse bursts in and tells me that she has (somehow, miraculously, and entirely off her own bat) persuaded someone to do the biopsy. So I'm off upstairs again and then, in the waiting room, I am accosted. It's the woman who did my ultrasound. I think she's going to wish me luck, but no.

Instead, she shrieks – yes, she really does shriek, in front of the entire waiting room – that that's clearly how you get special treatment round here, by bullying and insulting her staff. I'm not quite sure how telling someone who has failed to book the appointments they've said they've booked, and, in the course of three conversations, given you three different accounts of standard procedure, that they haven't done a great job counts as bullying, but the nurse, apparently, is so upset, that she has been told to take the rest of the day off.

I, by the way, have just been told that I have cancer. Second time round isn't good. And this is Day One of my treatment on the NHS.

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