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Archive for October, 2007

University College Hospital: Professor Spiro, Professor of Whitewash.

October 30th, 2007 No comments

Last week when my Consultant, Richard Cohen, was away on holiday the ward manager Martin Bruce came and saw me. We had a discussion for about twenty minutes. He explained that their job was to get me out of hospital. He made no bones about it: success had nothing to do with my health or otherwise: it was all about “moving me through the system”. His plan was that when Cohen returned there would be a meeting with the ward sister who best knows my case, Mr Cohen and a representative from the team responsible for my psychotherapy. The purpose of the meeting would be to get me out of his bed.

During the week another senior consultant who had first referred me to Mr Cohen was due to visit. She never arrived.

When Mr Cohen returned yesterday he came and saw me in the morning. He explained that this consultant had about-turned on her decision to see me. She had written to him by email and said that she had “been advised by a senior colleague not to come”. She is the medical director of the hospital she works at.

Mr Cohen explained that there was nothing more the hospital could do to help me. He was clearly trying to move me towards discharge without any such meeting. I protested that it was not safe for me to be moved home, that despite Mr Cohen doing his honest best the hospital as a whole had not done so, that it was inappropriate that so many of the people he had tried to refer me to had refused to see me, that there was no understanding of what is wrong with me and that I was not happy to be sent home. I explained that I want to be moved to a rehabilitation unit or to another hospital that would try and understand what is wrong with me.

Mr Cohen said he would try and get the medical director of the hospital to come and see me. This morning he returned and explained that Professor Stephen Spiro would be coming to see me at lunch time and asked me to be here from 11am until 2pm to be sure I didn’t miss him. Spiro, a former medical director of the hospital, had been asked “not to look at my notes” before meeting me and arrived at arout 20 minutes before 1pm. After about ten minutes of questioning he conducted a two or three minute physical examination with me on my bed. Professor Spiro did not ask me to get off of my bed and did not watch me walk.

He appeared friendly, understanding and helpful. He’s a pretty good actor.

As he left I asked him if he had reached a conclusion. “No”, he said, “I am going to read your notes and then let Mr Cohen know my thoughts”. My notes are in a folder nearly two inches thick. They contain around 100 pages of material and reports from this hospital and elsewhere. He walked over to the nursing station, sat there for one minute and wrote the following in my notes:

“Very complex Psychiatric/Psychological situation. Whatever the patients muscular problems are there is no need for admission. Fit for discharge.” – I am allowed to read my notes in the presence of a nurse and did so the minute Spiro left.

This took him about thirty seconds. He certainly did not even attempt to read my notes. He then left the ward, met Martin Bruce, the ward manager in the lobby and exchanged a few words with him. I couldn’t hear the conversation. Martin Bruce looked happy smiled and waved Professor Spiro off. Clearly Bruce was happy that Spiro had rubber stamped my discharge such that the hospital can pour whitewash over the whole incident of my being here.

As Spiro got into the outer lobby he was already on his mobile telephone to Mr Cohen to tell him the good news that despite having no understanding of what is wrong with me (”Whatever the patients muscular problems are”) he had happily written me up for discharge. Within the hour Mr Cohen had arrived with his new puppy-dog Senior Registrar, James Arbuckle, and was telling me I would be discharged by the end of this week to my home. No understanding of what is wrong, no care plan, no treatment plan, no rehabilitation plan. However this is of course a great success for the hospital. After all I will have “left their bed” and be “off their plate”.

Nice medicine. I think University College can be very proud of itself. The smell of whitewash however is rather overwhelming.

On the subject of things white … this building is a complete white elephant. It cost twice what it should, nothing works properly, the staff hate it and complain about it constantly. The lifts fail. They were put in on the cheap as the trust had overspent and what’s more, they even designed and built it complete with a trunk:

University College Hopital Building - A white Elephant

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University College Hospital: A Pain In The Neck.

October 23rd, 2007 No comments

The report on the X-rays of my neck has been missing from my file for three weeks despite repeated requests for it to be put on file. Last Friday it was noted in my notes that my “muscle spasms are improving”. This is utterly untrue. I was put on Gabapentin to control the muscle spasms ten days ago and quite quickly suffered severe reactions. Last Monday I was advised to stop taking it. I requested another Neurological consult immediately for a replacement as the Diazepam I have been on for two years is no longer doing the job and is effectively dissolving the muscles that do not work and it is therefore urgent a suitable replacement is found.

On Tuesday morning I again politely requested a Neurological consult for the same purpose. No one came. On Wednesday morning I again politely requested a Neurological consult for the same purpose. No one came. On Thursday morning I again politely requested a Neurological consult for the same purpose. No one came. On Friday morning I again politely requested a Neurological consult for the same purpose. No one came. I was making these requests because the muscle spasms were worsening dangerously and causing further destabilisation in my already very damaged neck.

At 4pm on Friday afternoon I gave up asking politely and went to see the ward Manager. “Martin”, I said, “I have been politely asking for a Neurological consult for the last five days. it is 4pm and it’s Friday. You have got one hour before all the doctors go home for the weekend and I am left inincreasing pain and danger. If that happens I am going to kick off. You don’t want me to kick off”.

“I’ll deal with it”, he said. And he was indeed good to his word. Half an hour later a very helpful Neurologist turned up. Unfortunately, misinformed by the records about the nature of my condition, she prescribed Amitiptyline – usually prescribed as an anti-depressant but also used as a pain control drug for Neuropathic pain. I didn’t need a drug to control the pain I needed one to control the spasms – and in particular one that was not going to weaken the failed, atrophied and damaged muscles that are leading others to spasm.

Gabapentin had done very well on this score but also and lead to a nasty itchy rash developing up my legs within 48 hours and stabbing chest pains 20 minutes after I took it. Amitriptyline is doing no good whatsoever because it is known not to have muscle relaxant and anti-spasmodic properties. The spasms are getting worse quickly, reducing further the mobility of my neck and causing ever increasing damage. This is why it worries me that such misleading statements as “muscle spasms are improving” are appearing on my notes.

It appears to fit the pattern of the hospital trying to “appear to do their best” – as opposed to “trying to do their best” – two very different things.

Here are the X-rays of which the report is missing:

Neck  X-ray

Neck  X-ray

Neck  X-ray

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University College London Hospitals Trust Chairman: Peter Dixon – A Challenge: Put Your Money Where Your Mouth Is.

October 21st, 2007 No comments

A very nicely branded University College London Hospitals Annual Review of 2006/7 was today left open on my bed by one of the nursing staff I presume. I think the nursing staff are becoming aware that something very odd is going on.

After all I will have been an inpatient here for eight weeks on Tuesday, my health is failing fast, there has been a failure to undertake appropriate tests and a repetition of pointless ones. Doctors have refused to see me – though the consultant I am under admits it is not me that is at fault here but the cock-ups that have happened elsewhere and are being used as an excuse to deny me the care I need. Tests which would have proven useful have been denied on spurious grounds.

Reports are missing from my file and I have been asking for them for three weeks. The hospital sat on my old scans for five weeks before loading them into their PACS system. They then sent back my EBT scans saying the images could not be read. Which was odd because when I shoved the disk in my laptop it fired up and read every image without fail. And when I showed the 3D renditions of my cervical spine to a Neurologist last week he said that needed further clarification before running out the door backwards saying he could no longer support me staying in hospital as the hospital is “not helping” me – the one point we agreed on.

The Annual Review was left open on my bed on the page “Our commitment to you”. On that page was a highlighted statement from Peter Dixon the Trust Chairman – who has been in receipt of a “stongly worded” fax from my MP for the last six weeks of my “hotelisation” here.

That statement reads:

“It’s a matter of treating others as we would wish to be treated ourselves. It may sound easy, but making it happen is going to require attention to detail and routinely going that extra mile.” – Trust Chairman, Peter Dixon.

It’s time to pay attention to detail, go the extra mile and stop trying to look like you are doing your best and do your best, Mr Dixon. That is my challenge to you. There is no excuse for my human right to health to be stamped on, whomever may be pushing you to do so. Far from treating me as you would wish to be treated yourself the overall treatment I have received here is worse than you would allow for your dog. It’s shape up time.

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University College Hospital: Can’t Help or Won’t Help? – Does It Matter?

October 19th, 2007 Comments off

Two very revealing conversations have taken place this week here at university College Hospital.

On Wednesday Dr Anton Emmanuel finally turned up after two weeks of waiting. He had agreed to “put to one side” his prejudices – as had I – and have a conversation aimed at understanding what I understand to be wrong with me. This conversation was a farce.

At the beginning of the session I showed Dr Emmanuel the 3D rendition of the scans of my neck which clearly indicate the misalignment of my cervical vertebrae and that some of the spinous processes have grown at an angle of around 10 degrees from the straight line they should inhabit. This is important as it is proof positive that my body grew under abnormal muscular strains and imbalance significant enough to mean my bones are the wrong shape. He said he needed to establish the significance of this.

I went on to start describing what is wrong with me. Dr Emmanuel – far from trying to understand what I was explaining – argued every tiny point with me. His favourite phrase was “you can’t prove that”. The whole two hours was frankly a waste of time. I listed the scientific medical proofs of the failure of my Pelvic musculature, namely: thinned and scarred internal sphincter, descended pelvic floor, internal rectal prolapse, urinary incontinence and that my bladder rolls forward on filling. “You can’t prove that”, said he. Yet unfortunately for him those things are already proven though he decided to deny them.

The time was a waste except for the discovery that Dr Emmanuel also works at the Royal National Orthopaedic Hospital, home to the manipulative and disgusting Dr Joseph Cowan who kept me out of his rehab unit on spurious grounds for a year – such as “your attitude must improve” – then broke the GMC guidelines writing to other doctors asking them not to see me as I had complained.

As Emmanuel backed out of the door, having wasted two hours of his and my time arguing instead of trying to understand, he said “I can’t support you remaining in hospital any longer. It’s ridiculous – we’re not helping you”. On the last point I can agree with him wholeheartedly as this hospital is not helping me – and aside from the excellent colo-rectal consultant under whom I am admitted – this is largely because the hospital is not trying to help me.

They have refused to do certain tests which would show major problems on rather spurious grounds, chosen to dismiss out of hand both the psychological reports and physical reports of other healthcare professionals, repeated a bunch of tests already known not to be helpful and to show negative results, and, to quote the colo-rectal consultant some of the doctors I need to see have “refused to see me” as I am perceived as trouble – although he personally agreed it is not me that is trouble but the people and events around me.

When I enquired at the RNOH in Stanmore under the freedom of information act what the maximum and average times were for admission to Dr Joseph “I am the ultimate bastard” Cowan’s unit, the call to inform me of the information came from a lovely lady called Kim Harris. “I don’t know why they have asked me to telephone you”, said Kim, “I am the complaints manager. But the information you requested is that the maximum time to admission to Joseph Cowan’s unit is twenty one weeks. Eighteen weeks from GP referral to an appointment with the team and three weeks from that appointment to admission”. This was at a point in time when I had been under Cowan’s (lack of) care for a year and he had made excuses about having an extended waiting time for admissions and started interfering in my care under other doctors. So even though Ms Harris did not understand why “they” had asked her to call them it was pretty plain to me.

This is a prime example of exactly the kind of “trouble” I am. I want my right to health upheld and it is extremely inconvenient and troublesome to some doctors that I want this. Many doctors have truly forgotten that the “do no harm” bit of the Hippocratic oath is meant to refer to their patients: they think it refers principally to others in their profession. Yet more are so hyper-aware of the career realities of Doctoring in the UK that they are easily swayed by pressure not to do the right thing: if they cross the line and stand by an inconvenient truth such as myself they know it may be held against them. This is the nature of the closed shop and is the main reason the NHS is only 18th best health system in the world when measuring outcomes in the World Health Organisations analysis.

The other conversation this week that was informative was the one with my colo-rectal consultant. He tried once again to start discharging me from hospital. I have been here six and a half weeks and he has failed, despite his genuine and best efforts, to get the Multi-disciplinary team my healthcare requires in place. After all if the doctors he asks to see me refuse then how can a MDT be put in place? It can’t. He said during this conversation that the hospital “can’t” help me. I pointed out that only last week he had admitted that people he asked to see me wouldn’t come and drove home the point that it is that the hospital won’t help me.

Perhaps this has something to do with the fact that the Medical Director of this hospital serves on the Board of the Royal College of Surgeons with Professor Williams – aka “the Lying Surgeon” – who not only has acted abysmally towards me, lied to my MP and interfered with investigations elsewhere but has recently scared off a journalist who was writing up my medical history with “cleverly worded, evil but veiled threats”.

That Doctors employed to serve us by a state organisation we pay for with our taxes can act in such unethical and self-serving ways and with total impunity and no fear of being held to account is proof positive of the danger of the closed shop.

It is no wonder one of the nurses here said to me “You couldn’t pay me enough to be a doctor in this country – doctoring is completely messed up”.

Since the day I arrived this hospital has done it’s best to appear to have done it’s best – It has not done it’s best nor tried to so. There is a big and important difference between the two.

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www.vipassanaforum.net Makes A Good Start

October 9th, 2007 No comments

The meditators forum I recently launched, http://www.vipassanaforum.net/ with a good spiritual friend from America called Joe and inspired by another good spiritual friend from Sweden called Anders is making a good start.

We want a sane space in which as meditators we can delve into the issues we meet on the path and find others who can shine a light for us. We want a slowly growing Sangha which is happening already.

Five days after launch we have 20 members and today hit our 100th collective post. We have asked and answered questions from the need for retreats to being a meditator who smokes and how meditation affects sleep.

We have started building our library and resources collection with links to online meeditation texts, audio Dhamma talks and embedded youtube videos of teachings and meditation instruction.

We’re not even listed on google yet and did not exist at all one week ago yet in the last two days we have enjoyed visits from in excess of 100 individuals each day and growing. Today 27 of the 139 visitors were repeat visits and visitors loaded an average of 4 pages each when removing the site staff activities from the log which is not bad going for a new forum with relatively little content right now.

My appologies for being busy “over there” … I promise I will return here soon and write something really interesting or funny or clever.

No I can’t promise that … not everything I write meets one of those criteria. But I will write something substantial here soon.

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