Barry

In my last post I described my seven hours in A&E with Chester and Barry. Chester came home to us after two days, diagnosis constipation. We kept expecting Barry 'home' for the last couple of days but when I got to work Friday Nadine called me into her office, sat me down and told me that Barry had died. She told me that Barry's brother, Maurice, had asked her to tell me on my own because he knew Barry and I were close.

I'm devastated, and disbelieving....

I can't understand how someone who can be well enough to be able to be discharged can suddenly just die. Barry was a great big bear of a man; a really good appetite (and these are two things that are very rare in care home residents); a good sense of humour; patient; very expressive, despite being unable to speak. Fair enough, this stroke he'd had previously comes with a fairly short life expectancy but he was just so...healthy and full of life. It's a tough time for all of us  - we all loved Barry. His brother and sister-in-law are ultra-supportive and this will destroy Maurice because he's lost his big brother. I'm going to offer to help them clear Barry's room, though it will be sad but I see it as doing him one last service.
Barry was 82 (which is no great age nowadays) and never married. He worked out in the open as a bricklayer for years then when the cold weather got to be too much for him he worked for the NHS here in Southampton, as a delivery man. His passions were ham radio, female singers of the 50s (Jo Stafford was a particular favourite) and old films. He was left unable to speak following his stroke and also couldn't move his right arm or leg. He could say 'yes' and this was his usual answer to any question, though his facial expression usually gave lie to that! It makes me happy to remember that Barry did actual speak, clearly and appropriately to me - once when I came back from two weeks holiday I went into his room to say hello and his face lit up. He said 'hello, how are you?'. I told Maurice about this (he would have LOVED Barry to speak to him one more time) but I was never 100% sure I hadn't imagined it. However the last time the vicar visited I took him along to Barry's room and Barry said, quite clearly, 'how are you?' so I guess he could do it after all.
Barry had a small fridge in his room where he kept his tins of cider (he liked a tipple at night) and he had a constant supply of sweets and chocolates. Because of this his teeth had almost all fallen out or gone bad and twice this year I accompanied him to the hospital to have extractions. Due to his size he needed the maximum amount of anaesthetic but he was so brave....I was the one secretly worrying - my nails left big marks in his hand where I'd been holding it so tight!When I think of Barry I think of Boxer, the brave, strong but ultimately doomed workhorse from Animal Farm.....don't know why. Sometimes I can't help but identify people I meet with characters from books or films. Is that crazy?

I'm glad that the last time I saw Barry, last Saturday at the hospital, I'd given him his dinner, held his hand, kissed him (yes, we do kiss our residents) and as he was being taken to the ward he was smiling and gave me the salute he always gave, in lieu of saying goodbye. Miss you already Barry xx

I'm not sure I can do this job.....

Seven Hours In A&E

This is in no way meant as a critique of the NHS which, as everyone knows, is a National Treasure - rather a description of what I saw during my Saturday at A&E.

Yesterday morning when I got to work at 10:00 there was an ambulance parked outside. One of our residents, Barry, who has had a stroke was in some difficulty and was being taken to hospital. My colleague Jackie told me that she thought a second resident, Chester, may also have to go to the General. To cut a long story short, I accompanied Chester to the hospital in the ambulance and it just so happened that he (and I) ended up in a bay next door to Barry. But only after 20 minutes in the gangway getting in everybody's way.

I had no money with me for a start, meaning I had to rely on the free water and juice provided, plus one cup of tea I managed to beg from an orderly. That was fine because I didn't expect to be fed and watered and it kept me sharper for my earwigging and general nosiness. Chester is 86 and Barry is 82 and during the whole time we were there Chester wasn't offered a drink - when I asked the orderly for one for him she told me that 'the nurse' said he wasn't allowed one. Barry was given a cup of tea though - sadly, due to his stroke he only has use of one arm and hand and couldn't get the cup from where it'd been left 3 feet away. From about 12:45 meals started to be brought to the department. I think the distribution must've been quite arbitrary because Chester was allocated food by the senior nurse (despite him being in obvious stomach pain from a twisted bowel) whilst Barry was given nothing. I was able to get permission to give Chester's meal to Barry - roast chicken with stuffing; roast spuds and some carrots that could have done double duty as small orange discuses - but I had to feed him since there was no way he could've balanced it on his stomach and eaten it with one hand, and there was no table available either. All I kept thinking was 'what would either of these guys have done if I hadn't been there?' Additionally, neither Chester nor Barry can speak coherently - Chester has dementia and Barry has had the stroke - so it would have been impossible to get any details from them had I not stuck around. There were plenty of staff members around; nurses, senior nurses, auxiliary types, even one or two doctors but nobody to just check folks were drinking or were able to eat the food that was being given out. Having said that, the nursing staff was constantly on the go - there was none of this standing around gassing about their personal life like you see in 'Casualty'. But then there was none of the chatting to patients and solving their problems like you see either...

Throughout the hours I spent darting between Barry and Chester there was a constant stream of people being brought in on stretchers, most of them elderly though some were middle-aged. The majority walked out again under their own steam, within a couple of hours - one even had the strength/energy/whatever to argue over whether his friend, who had followed him in in her car, should have to pay for the 3 hours of parking she'd bought. From what I could glean most people were, or had been, suffering from 'chest pains'...I'm guessing Saturday morning is a prime time for this. Or they had fainted. Nobody came in and had a crash team working on them or had masses of blood on them. There was no sense that anything emergency-like had happened. And everyone had friends, or family including small children, with them. I couldn't get over it because there is a perfectly good and really very efficient 'Walk-In Center' in the city. It's a sort of buffer between a doctor's surgery and the A&E Department - I've been twice recently with Red and would recommend it 100%.

So what are these people doing, clogging up the Health Service, and how much could be saved if they made their own way to the Walk-In Centre? They clearly have people who can drive them around, and they clearly are not really ill (as in not suffering from something critical necessitating emergency treatment)....is that called 'the worried well'? It got me wondering how different it would be if the people at A&E yesterday had been required to pay at source for their treatment, rather than pay through their National Insurance. I'm not advocating the kind of situation we read about in the US where uninsured patients are dumped on the street after receiving emergency treatment but there has to be some kind of check put on the use of our scarce resources. I really don't see that we can continue to spend the kind of money we are spending on health but the problem is that our NHS is such a sacred cow that to try to change it in any way is seen as completely awful and beyond the pale. I don't know what the solution is but before too many years go by I see the inhabitants of the UK having to be insured. Our NHS is good but it's not great, and I don't think we should expect it to be...we just don't pay enough for it. What do you all think?

Barry was admitted with a very nasty chest infection after four hours in A&E; Chester was admitted after six and a half hours in Bay 5, with the possibility of an operation on his bowel; and outside, on my way to get my lift home I passed a chunky girl and her boyfriend, both smoking furiously and arguing about walking home (her choice) versus getting a cab (his choice). She had been brought into A&E on a stretcher two hours earlier......