A Busy Month Part 4: The Home Straight

Not a great deal was achieved on the Sunday after I was admitted, although I did discover that the incompetent SHO had, when clerking me, written that I had discharged myself from the London hospital. Later in the week I got the opportunity to put him right on the matter, as a result of which I am sure that he will be very much more careful about the accuracy of what he writes in patient notes in the future.

On the Monday, I changed consultant from the one who had been on-call for the weekend to one of the cardiologists, although I was only to see him on the one day as he was attending a medical conference (golfing jolly) in Biarritz, and I was passed on to his fellow cardiologist (who was the one who told me that it was a golfing jolly).

I was also sent off to have the first of the radiological examinations, which in this case was an ultrasound. This showed that I had a small pleural effusion, which contradicted the X-ray, which showed a moderate amount. However, the radiologist explained that on X-ray, areas of collapsed lung can appear as an effusion. She also told me that the amount of effusion that was present was unlikely to be drainable.

The downside of everything that was going on was that I was regularly spiking pyrexias, making me feel really unwell. However, IV paracetamol is, in my opinion, the best thing since sliced bread.

One good thing was my visitors. m'Julie had tried to negotiate with my ex-wife that the children could visit me on the Sunday, but my ex had refused as there was some sort of churchy thing going on. However, she did agree to their visiting on the Monday for an hour, so from 4 to 5 I had the pleasure of Drew and Maggie visiting.

The evening and night was to prove much less agreeable. The ward where I was was supposed to be a male ward, however, the female ward was full and a certain amount of 'overflow' had found its way to the male ward, including a woman who I would say was in her fifties and had the definite look of someone who liked more than just the occasional drink, and who was opposite me.

Unfortunately, she chose that Monday to lose it completely, perhaps, a la Father Jack, all the alcohol had finally left her system. She became abusive to the staff and patients, made several attempts to escape, succeeding on one occasion and being brought back having collapsed outside A&E. Following the collapse, and her being brought back to the ward, there was then the debate about what should be done.

When I was a student and also first qualified and working on wards, patients could be sedated, even against their will, if the medical and nursing staff agreed that it was in the best interest of the patient concerned or the other patients in the ward with them. However, it now appears that no matter how mad the patient is, to sedate them may be a breach of their human rights, even if not to do so results in their physically or verbally attacking a fellow patient.

So I lay in bed listening to the various junior doctors, nurses and site practitioners debating what to do whilst the security guards kept an eye on the shouting madwoman who at this point was convinced that everybody, staff and patients, was plotting to kill her, and only her friend Emma, whom she, and she alone, could see further up the ward could save her, resulting in her screaming 'Emma, I'm here' at the top of her lungs.

The staff even tried oral medication. I did point out to them that I didn't think it would work, but they asked the madwoman if she would take some pills and she said yes. They gave her the pills and she threw them as far down the ward as she could, accusing the staff of trying to poison her. Surely I can't have been the only one that had seen this outcome.

Eventually the decision was made to sedate her, and there then followed the debate of who would actually inject her, as all seemed to be frightened that they may be putting their registration on the line by doing so. Just as I was about to say 'Give me the bloody syringe and I'll do it,' someone had the courage to inject her. But it didn't end there, as the madwoman made one last attempt to escape via the (very loudly alarmed) fire exit before finally settling down.

The following day, the madwoman had settled and I was sent for a CT Scan to confirm the location of the effusion. After the scan had been performed, the Radiographers came into the scan room and asked me about the surgery that I'd had, specifically whether I'd had abdominal as well as thoracic surgery. I knew where this was going and decided to have a bit of fun, and pointed out that I'd only had the thoracic surgery. When they asked if I'd had previous surgery I confirmed this, and added that if they were looking for my spleen, it had been removed 20 years ago. Cue sighs of relief all round, as they couldn't find it and were concerned that it may have ruptured, which was why I had the pain and they couldn't find it.

The CT Scan also showed that I did indeed have quite a small pleural effusion, and the decision was taken that it should be drained under radiological guidance.

That evening my eldest son visited, although he seemed to spend most of his time instructing the staff that they should give me a hard time. However, they apparently pointed out to him that they wouldn't do that as at some point I would be back at work, and would therefore be in a position to get my revenge.

Wednesday day passed off uneventfully, however, there was more entertainment in the evening. There had been a man admitted, in his fifties, who looked like a drinker, and whose legs were apparently completely paralysed.

Possibly years of experience helped, but watching this man's behaviour during the course of the evening, I knew what was going to happen. I even said to the staff that I thought that not only was he going to go loopy overnight, but I would bet them any money that he would re-discover the use of his paralysed legs.

Sure enough, by 11pm, this man was shouting about the fact that everybody was plotting to kill him (why is it that alcoholics become so paranoid and convinced that everyone wants to kill them when the alcohol wears off), and by the early hours, in an almost miraculous move, he had indeed re-discovered the use of his legs. Unfortunately, the on-call doctors did not have the courage of their colleagues from the Monday night and did not do anything, so the rest of the patients were subjected to this man's paranoid delusional shouting for the remainder of the night and much of the following day. In fact, the following day, his legs had recovered to such an extent that he could walk several yards before crashing to the floor. Again, the staff are not allowed to restrain patients, and other than telling this man to sit down, they could not prevent him from going walkabout and falling over, they could only fill out the incident reports afterwards.

On the Thursday, the decision was made to drain my effusion under radiological guidance, so I was off to the X-ray department, where a spinal needle, under ultrasound guidance, was inserted into the centre of the effusion and an attempt at drainage was made.

Sadly, the result was severe pain for me and approximately 1ml drained. It appeared that what had been an effusion was now a haematoma, and the only thing for it was to leave it to reabsorb on its own.

Back on the ward I was feeling very much better, even though only 1ml had been drained, but mainly because I hadn't spiked a temperature since the early hours of that morning.

However, the evening and night threatened to be a repeat of the previous evening and night with the madman. So, because I was so tired, as were the other patients, and prior to going to bed I informed the nurses and doctors that myself and the other patients were not prepared to tolerate another sleepless night, and that if they didn't have the balls to make the decision I was sure that I could find someone who did have, and if necessary I would be happy to personally administer any medication that was prescribed. This man was sedated and myself and the remainder of the patients got a good night's sleep.

The following morning, on the ward round, I was told that I could go home. Whilst this was the best news that I could have had, the downside was that m'Julie, Hannah, her friend and her friend's daughter had gone to Lincolnshire the previous day to a Pumpkin Festival, and they weren't coming home until the Saturday. However, m'Julie's mum agreed to be at the house until m'Julie got back.

Next was the question of transport home, and here I was very lucky, as one of the ward staff very kindly offered to give me a lift home.

So at 3pm, armed with a small pharmacy, I made my way out of the hospital to the car park and by 3.30 was sat on the sofa at home having a cup of coffee and catching up on the rest of the Sky+'d stuff.

m'Julie was home at 3.30pm on the Saturday, and I was able to settle in and concentrate on recovery, even if that did mean going to bed at 9pm, getting up at 6am, having an afternoon nap and generally behaving like a geriatric (remember, I moderate all comments!). At least I was home!