Day Surgery at St George’s: one person’s experience of the NHS

I have just undergone a second minor operation at the day surgery department of St George’s Hospital, Tooting in south west London. I want to share aspects of this experience and highlight blessings that are too easily taken for granted.

I was under the care of the Urology team, because an investigation to check for prostate cancer, leading to the all clear, had revealed a tumour in my bladder. This had been discovered by an MRI scan which, incidentally, is administered by a separate company contracted to the NHS, in a lorry in the car park outside the hospital. I had expected this to be a brief, silent, space age type experience, but in fact it lasted 30 minutes and sounded more like being in a noisy cement mixer.

The first bout of day surgery was, therefore, to have something called a TURBT (easy to remember because it is like a turbot) which is a cleaning out of the bladder by a very clever device inserted through the uretha, in my case under general anaesthetic. This is followed by analysis to see whether the tumour is of a relatively mild or serious, invasive nature. (Luckily, mine was a mild one.) The only time during this whole story when something went wrong was when the administrative organiser tried to fit me into an early appointment for my TURBT but failed to register the appointment on the system, so I turned up for my big day only to find that I was not expected. But note the response of the consultants: the consultant on duty came to apologise to me in person. He rang his colleague to see if he could fit me in to his surgery the next day. That colleague promised to try, and to ring me to let me know. He did ring and say that he could not fit me in that morning, but would work with his colleagues to find as early an alternative as possible. A day later, I received a phone call just as I was entering the cinema for an evening film; it was the second consultant, saying that he had found a gap for the next morning, and giving me personal instructions about preparing myself.

From that part of my experience I draw two conclusions: one, it underlines that the contribution of “administrative” or “backroom” NHS staff is absolutely crucial, and the politicians’ habit of talking as if they are “red tape”, far less important than doctors and nurses, is wide of the mark. Secondly, I was seriously impressed by the personal courtesy and conscientious commitment of the consultants. It may also seem a small thing that, in letters to my GP reporting on the results of their reviews of my case, it is their habit to refer to me as “this pleasant 68 year old gentleman”. It is not a small thing to me. I have never been called that before, and it sets the tone for the consistent respect and consideration with which they have communicated with me and with all the other patients I observed. Repeatedly, I have heard them talking openly, clearly, sensitively and honestly with every patient, with unfailing courtesy. Urological complaints are not very dignified, but each of those men is, in my experience, treated with complete dignity.

Arriving in the day surgery centre at 7.30 am, you are called one by one to go through a checklist of questions, change into throw-away blue paper shorts and a gown that gapes at the back, have your wedding ring taped and have two plastic bracelets attached saying who you are. You then meet the consultant and sign the consent form, and the anaesthetist. Yes, you do have to answer the same questions several times – so about five or six of them know I do not have any loose teeth – but hey, so what if they check, double and triple check so that they don’t give you the wrong operation or cause you to swallow a loose tooth under anaesthetic?

Once the day’s patients are prepared and changed, we shuffle off to the men’s waiting room, a motley procession indeed in our outsize, rustling paper shorts and flimsy gowns, some bandy kneed, one hobbling with a stick, one pretty tubby, a couple of younger men with vivid tatooes, sitting down to watch daytime TV and cracking jokes about who is going to be called to glory first and whether, since the day surgery shares the building with facial surgery, they might fix our faces at the same time as our bladders. One by one we are called, for a reprise of some of those questions and a bed to lie on for the operation. The anaesthetists also tell me exactly what is going to happen and engage me in chatting about holiday plans to help get through the slightly painful insertion of a drip into the wrist. Perhaps I should not admit it, but I quite enjoy the prospect of slipping into a deep sleep and waking up when it is all over in an orderly recovery section. As I come round a kindly nurse is calling me by name and offering me a glass of water. There is no sense of rush or pressure. When I feel wide awake, I am helped to ease myself gently off the bed and walk off to have a cup of tea and both Bourbon and squashed fly biscuits. The Consultant comes to tell me that the follow up inspection has shown everything in the bladder is all clear, subject to checking the result of a biopsy that will be through in a couple of weeks. He will then welcome me back for an annual check up next February.

I feel looked after, respected and lucky. Lucky, not least, to be in a country with a free health service that, despite all the pressures on it,  will look after the unspectacular, unedifying urological problems of many people (especially men of 60 and over) with such grace and skill. Don’t take it for granted. This pleasant 68 year old gentleman never will.

 

 

 

 

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