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: