I know that having used that line from Tolkien, or at least the Peter Jackson version, I should then complete it by adding : One Of Nine. In this case though the number I had in mind when I came to the keyboard this morning was 170 as that was the number of patients waiting in the local A&E department the last time we had occasion to be there.
In the bearpit there, actually the waiting area of the ambulatory section of the department, there’s a monitor screen being continuously being updated with things like initial time to triage, time to being seen by a clinician and total number of patients waiting to be seen : even as I watched the screen the time to triage was going up and up – I saw it go past two hours which means that’s the first time someone clinical takes a first look at you.
Time spent in the ambulatory section of A&E department is deeply depressing and even it is the most normal part of the whole department : one time recently I had to be there myself and I was sat around for more than 28 hours before being admitted. As I remember it there were more than a dozen ambulances outside waiting for a slot to hand over their patients to the section of A&E i refer to as Majors and i’m told that when it’s really busy a patient can be in the back of an ambulance for more than 24 hours.
Sometime during the night I went for a wander while Jackie was hooked up to one bag of IV fluids and one of antibiotics and was trying to get a bit of sleep. One of the few places to sit – at least outside the department – are the comfy seats outside the bakery which is open around the clock and that does half decent coffee. In times past I would have had something sweet to eat as well but my no biscuit rule and one main meal was just about holding up.
When I got back from my late night latte and found a convenient corner to park in for a while I was joined by an ambulance crew depositing a very unhappy young woman in a wheelchair in the seat next to mine. She complained bitterly and at great length to the ambulance crew that deposited her there, her main moan being along the lines of why couldn’t they just send her home and then phone her with her blood results. It was so tempting to say that the reason they can’t and won’t do that is because they are run ragged actually treating people and it might be well to realize that she is just one of a number ; in this case not only of very low triage status but just one of the 170 odd other numbers in the department at the same time.
For a bit of context here, Jackie is having chemotherapy once per week for a form of Leukemia and the chemotherapy has basically trashed her immune system so when she gets poorly it happens very quickly and the CNS in the Haematology department tells her to come straight into A&E to be seen and have first line treatment. There’s actually an established protocol for this but one which is basically broken by the long triage time – luckily for her though they did put her straight into a single cubicle after initial triage.
It’s tempting to say that the people there waiting to be triaged and seen show us just how much the overall state of health has declined and is still declining. Patients seem to attend A&E with the expectation of being seen rather than trying to get an appointment with their own GP. Without the numbers to hand it’s hard to quantify what is going on but I can say that those numbers have only gone one way during the time that I was working there so that’s a 20 year view : at one time the department used to empty out a bit in the small hours but now it seems to be an endless flow of bodies waiting to be seen and many curled up in odd corners trying to sleep.
The numbers I wasn’t sure about but now am….
For months now iv’e been waiting for one particular number to pop up ; that number being in the form of a date and that date being my listing for a surgical revision of my failing knee replacement. On the same day that I did most of the work on this post we got a phone call from the hospital inviting me to come in and be seen by the surgeon in preparation for that surgery. The thing is that iv’e already seen the surgeon – that happened several months ago – and already been preoperatively assessed for surgery in the orthopaedic clinic. The return visit, apparently, is for the surgeon to make sure that i’m fir for surgery and for me to sign a consent form. Just after that phone call we had a second call inviting me to come in and be seen by the anaesthetist and of course it’s not on the same day as being seen by the surgeon.
The number, actually yet another date, that made us both laugh out loud, is the actual date for surgery which just happens to be on my partners birthday. The funny thing about that is that that’s also the date originally given for Jackie’s post treatment bone biopsy and she managed to change that to not being on her actual birthday but the day after. For me what it means is that my date for surgery is now just 2 months away and unless the hospital suddenly gets it’s act together 4 separate trips to the hospital ; having worked for the NHS for most of my working life I know just how disorganized and non joined up it can be but even so….
The numbers that failed :
The first number that failed this week was the number one ; my attempt at sticking to a one meal per day routine – which seems to have been working well until our second or third A&E visit of the week. When I finally drove home at stupid O clock what I really wanted was a thick slice of toast with jam….and that followed by biscuits. The next number that failed was 7500 ; which has been my usual target for steps walked each day. That failure was partially down to my dominant crutches wrist having gone weak and painful having over used it on the heavy gardening jobs this autumn.
The stranger numbers that failed, or perhaps just became an unreal number were 90 and 100. Ninety because that is the number I was hoping to see on the scales this month and is much less likely now. The stranger number, 100, is so because that’s the number of daily views my site statistics was telling me about. In fact that’s completely untrue and I should have been suspicious several weeks ago. It turns out that somewhere around half of my daily views are from Chinese Bot/hacker sites that routinely follow internet sites like mine looking for weaknesses to exploit.
According to the wordpress AI assistant it’s quite normal that anyone with a website like mine gets a lot of Bot views and, as I said above, that’s simply Chinese hacker sites looking for material that they can exploit – even worse if you have commercial site traffic – basically any actual cash going through the site, which I don’t. The outcome, weirdly, is that I feel a lot less like continuing with this site and as i’m near my one time stated goal of putting it all on hold at 1000 posts I may even pull the plug a bit early as the actual views and genuine engagement has mostly disappeared.
The big number that has failed this week though is the number 4 ; that’s how far Jackie is through her 8 weeks of chemotherapy – no choice there as she needs to be not sick in the way that she is to be medically safe to have her next dose of chemotherapy. As for me it’s now a case of being solidly back on the numbers as I absolutely want to get my weight into the 80’s prior to surgery and be in as well prepared a condition as possible
Best wishes Y’awl.
