Thursday, 15 November 2018

A View from the Sheets



St Barts: FEBRUARY 2018
My wife Anne and I had a late lunch at Apuglia, an Italian restaurant behind London's St Bartholomew's Hospital. I had tagliatelle with porcini mushrooms and a glass of prosecco. There was a bicycle on the wall, for art not transport. I wasn't going to be travelling anywhere.
It was early evening by the time I had been 'processed' and taken to the pre-op ward. After Anne left for home I calmed my nerves by playing a Tibetan bowls recording through my earphones. I tried to meditate, but it was impossible.
In any case there were plenty of distractions; stethoscope on chest and back, blood tests and blood pressure checks and a visit from the anaesthetist. I was given two razors and asked to shave my chest, arms, legs and groin. It reminded me of plucking feathers from slaughtered chickens. Not a pleasant task but painless. The pain was to come later.
The next morning my chest was sawn open, my heart was stopped and blood flow was directed to a heart-lung machine. My body was cooled down and Anne tells me she was present in intensive care when they brought me back to consciousness by warming me up. She said that the nurse threw a switch and I started to twitch like Frankestein's monster. My eyes, she said, looked like the 'living dead' and she was afraid that I was about to sit up and pull out the many tubes and wires inserted into my body.
During the three-hour operation my aortic valve was replaced with cow tissue, leaving me ever grateful to my reluctant and gentle-grazing posthumous donor.
Of course I have no memories of my time under anaesthetic except to confirm these words from Diogenes: 'Where there is life there is no death. Where there is death there is no life.'
All I can remember from my time in intensive care is the button I was told to press when I needed a morphine shot to ease the pain.
Two days later and in the High Dependency Unit I was now conscious and taking note of my surroundings. Not very pleasant as I seemed to be connected to multiple monitors as well as tubes inserted into my stomach, neck and groin and with wires connected to my heart.
I spent two nights in HDU and it was exhausting. Any attempts to sleep were stopped by the constant checks; temperature, blood pressure, blood sampling and medication administered, as I remember, through the tube in my neck At one point the patient beside me went into a cardiac crisis and with great speed the 'crash' team arrived. I wasn't in a fit state to count precisely, but was told later that there would have been fifteen in attendance. Strangely comforting to witness such positive pandemonium in the service of one continued life.
I can remember telling a nurse I hadn't had a pee for ages. She laughed and invited me to look below my pyjama trousers. My God, there was a tube inserted into my penis. I remembered a friend of mine who had once suffered terrible pain when this was removed after an operation who told me, ''My cock never gave me so much pleasure as it gave me pain when the catheter was removed.'
I decided I wouldn't rush this procedure.
After five days on the post-op ward I was ready to go home, but the final task was to remove two 'pacing' wires wrapped around my ventricles and connected to a monitor I had to carry around with me. I had thought that the two plasters on my stomach were stitches, but a nurse told me they were the entry points for these wires and that I must remain in hospital for twelve hours after their removal. If pulled out incorrectly I could die.
Brian Piniera works in stem cell research at the hospital but, from time to time, turned up on his old ward to help out as a volunteer. He is well known and well liked throughout the hospital. He was visiting me when I was given this information and offered to undertake the procedure. I was happy to have him do this tricky task.
It wasn't painful, but it was frightening as I watched him start to draw them out. They were each 20 cm in length and have to be removed slowly and with a steady hand. Brian is an incessant talker, but I urged him into silence and shut my eyes.
He is Filipino as are many NHS workers. My heart surgeon was Egyptian. Four years earlier when I had had brain surgery my surgeon was Nigerian, assisted by Italians, Spaniards and Brits of multiple ethnicities.
Here I am writing this. Still alive and conscious that every breath I take is a gift of life and time. My cow and the skills of my surgical team have given me ten to fifteen years, before I might need this operation again, but I have been told one of my two carotid arteries is 50% furred up. So who knows what I have left to me.
It's quality I must go for now. A friend of mine helps run an organisation called The 'Long Now'. They have constructed a clock which ticks once every 100 years. I used to be cynical about the project, but now I understand that perspective much better.
Whatever life is left to me I owe it to myself, to my loved ones and family, to not let it go to waste. I will try to put back together my dysfunctional family. I will write more. Much will be about the struggles we all face to save the NHS, a health system based in Aneurin Bevan's words on the principle that, 'No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.'
I am lucky to be a citizen of a country that can still offer me free medical procedures that have kept me alive. I was very aware of this after this operation and what needs to be done to save our medical services from the privatising predators who are creeping in through the cracks inour defences
As recently as five months before I was admitted, Barts were responsible for their own catering. Brian told me what pride he took in serving food to his patients and how this was a central part of nursing care. Today this has been handed to Serco, (company logo "We Care'). As well as hospital contracts for food, cleaning and porterage, they run our prisons and military centres. Their annual revenue from healthcare alone is over £1.4 billion. 
I love the idea that the military is listed alongside healthcare and 'other citizen services'. Also nice to know that the inmates of Wormwood Scrubs receive the same food services as we get in this hospital. I wonder if they have the same problem – a shortage of small spoons. In the Scrubs they may be being put to use tunnelling their escapes and probably don't ask why there is a shortage. There was no answer to me when I asked this question.
Breakfast was tepid tea or coffee, cereal or porridge and toast. As I bit into the cold, spongy “toast” I could imagine Serco executives meeting to discuss how to cut back their costs to increase their profits. 'Let's start with breakfast'.
On my ward I got to know my fellow patients. Barry had already had three heart operations when he arrived at Barts for his fourth. His operation lasted 28 hours and they 'lost' him three times. He told me of his out of body experiences which had traumatised him and made him scared of going to sleep.
He had been born in Jamaica and next to him was Erroll, a Trinidadian bus driver from West London. They would chat about youthful memories of their island homes and their love of the calabash tree, its soft brown bark home to multi-coloured orchids. They told me that these trees, pollinated by bats, grow on hillside pastures, along roadsides and wherever there are human beings. The tree has many medicinal qualities. The NHS is our calabash tree.
What memories do I take away from the time I spent at Barts? Not the operation and its after-effects of pain and worry, but the nursing care I received with such commitment and humour. The nurse pushing my bed down a corridor who I got chatting to. On hearing I was a writer, he brought my bed to a halt and, with a wonderful smile, quoted verbatim from Gabriel Garcia Matquez's 'Love in the Time of Cholera. 'Age has no reality except in the physical world. The essence of a human being is resistant to the passage of time. Our inner lives are eternal, which is to say that our spirits remain as youthful and vigorous as when we were in full bloom. Think of love as a state of grace, not the means to anything, but the alpha and omega. An end in itself.'
Then there was the nurse replacing my chest bandage who wanted me to breath in deeply. 'Puff out your chest', she said, 'like a Robin Redbreast.'
I wrote this poem soon after the operation. It is dedicated to Dr Wael Awad, his surgical team, anaesthetist and all nursing / ancillary staff at Barts Hospital in respect for their care and skills.
My blood pump was stopped
while a machine took over
the job my heart had done
for almost 73 years.
A cow's pericardium replaced
my narrowed, furred valve
that no longer moved like
a sea anemone's fronds.
This valve was given without
agreement or consent
so I made a vow to my dead donor
to never eat beef again.
Last time it was a subdural haematoma.
I escaped with my brain intact.
That involved an earlier pact,
made with myself, to act wisely
with attention to my herd.
My plan of action now
begins with breaking through the fence
to arrive, together, in greener pastures




St Barts: SEPTEMBER 2018
I am back in Barts, seven months after my operation. I have had a stroke caused by an infection which is attacking my new heart valve. This time I am going to write a hospital diary.

. Barts Hospital is a microcosm of UK society today. It embodies all the best and the worst. The NHS staff, from the doctors, surgeons, nurses and laboratory workers, to the caterers, cleaners and porters, work with love and commitment to the patients. They are of all nationalities, from across the EU, and from Ghana to the Phillipines.

.... The new Barts King George V building, where I will now be a patient for many weeks, is alive with all this and I have come to love and respect all those who work in the NHS.

. The reason the senior nurse on the ward is called 'sister' is because hospitals were first opened in convents and priories. St Bartholomew's Hospital is no exception. Situated between St Paul's Cathedral and Smithfield meat market, the area has been a place of butchery and healing for hundreds of years. The Scottish rebel, William Wallace, was hung drawn and quartered here – just a gentle reminder of how cruel things can get with our rulers.

. When Native Americans visit a friend, they symbolically place any troubles they have in a willow box at the door so they don't bring them into another's life. I mention this because hospitals are suprisingly cheerful places if you ignore the illness and suffering that accompany the lives of many patients.
The reason for this is that the people who make up the NHS—the consultants, doctors, nurses, cleaners and caterers—all have their own troubles, but they are experts at leaving them “in the willow box” as they enter the hospital.
From my bed I look out on The Old Bailey and to its left are the offices of Merrill Lynch. I would like to move that banks bosses to stand trial a short distance away at the Central Criminal Court.

. Hospitals have a lot in common with prisons. The attention to numbers – the counting of days. One difference. A prisoner can mark off the days to his/her release, but in hospital there is, as in my case, no end date so I count forward – today 25 days completed. The slow passing of time allows for reflection and thought. And time to write these blogs.

. When you have been in hospital for a long time you learn a lot about the other patients and about the NHS staff. Here are some examples. The nurse who is always smiling, always ready with a joke and comforting words. When I comment on this I learn that her husband died when he returned to their African home to get work and rebuild a future for his wife and two sons to return to.
The low paid Serco worker who gives me an early morning cup of tea, whose half-day is seven and a half hours and full day is eleven and a half. The nurse who wakes me every morning to do the daily ECG. She is always singing and when I ask her why she is so cheerful answers, 'what choice do we have?' The doctor who is part of the Consultant's morning visit team who sees I am upset by the news I am given and who returns to my bedside after they have moved on to offer me reassurance. The patient who, uninvited, sits beside me to tell me about his army days in Malaya. I can't stand his Empire memories, but when he turns to his love of gardening he becomes human again. Mohammed who keeps me awake all night with his involuntary dream-screams. The next morning he apologises and we go together to the nurses desk to ask for a solution to help both of us.
He is moved to his own room. A dear man and I hope he recovers because he has been so ill.

We all deal with our hospital depressions and fears in different ways and we all have mechanisms to combat them. I am fortunate because I have my wife, Anne, who is my rock and my island. I also have other family and many friends who visit me.
Others are less fortunate and seem to be entirely alone in the middle of their illness and the worries that accompany it. They are entirely dependent on the willow box.

. During both my stays in hospital this year I have not been short of visitors and have been sent cards and messages of support from across the world.
Both lapsed and active Catholics have lit candles in churches, atheist 'Muslims' have attended mosques and offered 'dua' for me, distance healers have healed me from south west UK to south west USA, Jews have played Leonard Cohen's 'Halleluja', Buddhists have meditated on my behalf and musician friends have brought me guitars and played for me.

. One of my first questions to visitors is to ask about the weather. It's hard to tell from the inside of these glazed windows. Yesterday was apparently very warm and and I was told it was 'too warm', 'unusual weather' and so on. Here I am outside these experiences, looking out at them, but not a part of them.
This curious situation brings me to another 'reflection'. More than ever before this hospital stay has made me acutely aware that I am observing something quite troubling out there. The advance of barbarism. Brought close to me in the comments and conversation from my visitors. Yesterday a friend telling me she was heading off from here to Notting Hill for a Grenfell march and that the surrounds of the massacred building are full of toxins, as found at Ground Zero in NYC. Other topics passing through my hospital room range from the impending struggle over the decline in social security payments to the twelve, or is it thirteen, years we have left to save our world from global warming.
And have you heard that the 1% who are responsible for this are buying up property in New Zealand? I am sure you have your own concerns which you can add to this list.

. I was once a member of the International Socialists – today's SWP. In my time I have been an anarchist, Trotskyist, syndicalist, Nihilist and today a Desperatist. Anyway, their leading cadre was Yigael Gluckstein, an Israeli revolutionary who changed his name to Tony Cliff. He would often open his talks with this. 'Comrades, we are all on a train. The rich are eating caviar and sipping champagne in the restaurant car. The middle class are asleep in their couchettes. The working class are crammed into the corridors. But we are all on the same train. And it is heading to barbarism.' I used to think his view was extreme. Surely we had plenty of time to stop the train. Today I think he was thinking along the right tracks.

. I have to be connected to the computer and carry around a bulky console. Taking a shower with it is impossible and the toilet even more so. They have recently offered us ‘carriers’ and, after a short self-training exercise, sorted out my own system. This involved cutting away 50% of the carrier straps to make it useable. I must check who got the contract for this piece of 19th-century technology. Must be a US company because it's like a pistol-holder.

. Today I woke up without a fever. This increases the chances that I will not have to face a new operation. (My consultant leans heavily in the direction of this option). And the sun is shining! If things are getting better for me it is largely due to the NHS staff here.

 …. I don’t get much sleep, with new drips, blood pressure and ECG’ arriving too regularly, but all delivered to me with humour.

. If this country closes down who will replace the Nigerian surgeon who did my brain operation, the Egyptian my heart valve replacement, the Sudanese checking my blood cells, the nurse who gets me a cup of tea after taking my ECG. Who?

..Yesterday I was fitted with a Power Picc, which allows for blood tests and samples without the need for renewing catheters in arm and / or wrist. Progress of sorts.

. You don't have to be in hospital for long to realise it is the dedication, long hours and humour of NHS staff which keeps it all going. I watched Jeremy Corbyn speech at LP conference. What the f—k are we waiting for?

. I woke up at 3 am this morning and tried to go to the toilet for a pee. Impossible. My pyjama trouser's one remaining snap-on had now joined the others on the pyjama top and could not be snapped on or off. I tried to make it to the ward loo, one hand clutched to my trousers, the other to the electronic monitor.. My alarm went off and I sat back on the bed and waited for the nurse. She told me it had been set it off because my heart rate was too high. She then got me new pyjamas and reset the monitor. Now I have a urine bottle. We are supposed to keep mobile and be self-caring, but electronic alarms and 'snap-neither-on-nor-off' pyjamas conspire to keep us immobile and set off alarms.

. Just had my Serco breakfast and wonder if anyone can tell me who has the privatised contract for NHS pyjamas? I will never write about this or any other hospital without praising all hands-on NHS staff followed by my curse against this bankster government.

. I need a scapegoat and in my case it is the goat. The microbiology lab here at Barts hospital has concluded that the bug which got into my heart valve – the bovine (cow) valve which was fitted here in February, is of the Equine Streptococcal strain. So we have cows, horses and now, my theory albeit unbacked by evidence – goats. I spent a month last summer with my Bosnian family at their home outside Mostar. After I met my wife Anne on the Croatian island of Mljet I picked up a virus which lasted until my stroke five weeks ago. There were no horses on the island but the lab has said that other animals share 99% of their DNA.
There are goats in the area, some of them once owned by the family we stay with, but that was some years ago and the goats have long since taken themselves up into the surrounding woods and hills.
But back in Mostar there are goats-a-plenty. They are on the hillside at the end of Oha and Masa Maslo's garden where I stay when I am there. Twice a day a goat-herder walks his animals slowly across my eyes. I hear their bells before I see them emerge from the trees onto the sage-covered rocks. Even when I can't see them I hear their bells as I sit on the terrace which faces onto a garden full of cherry, pomegranate, figs and walnut trees.
Wildflowers in the nearby field attract Cleopatra butterflies, Plain Tigers and a profusion of Simple Whites. Bees from Masa's hives buzz in and out from the sage bushes the goats feed from. The hill rises up to Mount Velez and we seem to be at the base of a bowl, in a hidden valley which induces a feeling of remoteness, peace and isolation.
Of course this is all an illusion. The herder is a refugee from central Bosnia, eking out a subsistence living with the help of his animals. The hillside is still peppered with mines. The wildflowers in that field are there because the family who owned the land fled when the area was under bombardment.
I see and hear the goats, but's that's it. But the two Maslo dogs are free-range and spend time on the hillside. For sure they must tread through goat detritus. Lovely dogs, they jump up to greet me whenever possible and it is possible that they brought me the streptococcal.
But are the goats to blame for my hospital stay? Of course not. I am to blame for not building up my immune system after the open-heart surgery.
I won't make the same mistake again. I have been told that the Russian military developed Neuropeptide Bioregulators that are great as immune builders. So I will move east of the Balkans and seek help from the Russians. Then it will be back to sitting on the Maslo terrace, waiting for the goats.

After three weeks in hospital and with the likelihood of at least the same again I have plenty of time in the company of my own thoughts. Plenty of time to observe the goings on in my ward and the lives of other patients. There are some here who are having a much worse time of it than me, medically and personally. I feel for those who do not have family or friends to visit them. The patient whose wife is disabled and housebound for example. Those without friends or whose family and friends live far away.
I am lucky. My wife is, for the third time in almost as many years, my life-saving presence and working hard to challenge my weight-loss with her supply of burittos. She is there on ward rounds to ask the questions I never thought to ask. Waits with me while I have the endless checks and scans.
Then my visitors. My family and friends who cheer me up and supply me with foods, drinks and other treats. Books of course. I start reading one when my attention is distracted by the next arrival. Of course pride of place, an ex-neighbour's collection of her poems which nearly rolled me onto the floor in laughter. Then those who give me distance healing and their prayers. My son who put together a music programme for me. My Bosnian 'son' who suggests music to get better with. Finally the staff here whose care and humour I have already written about.
And not allowed to escape without mention. The Barts nurse who became a friend when I was here for the operation in February and who regularly visits me and answers the questions I still need answers to!

. Olivia Ellor-Freeman and Lydia Kortey are the Serco caterers on my ward. These two, along with their cleaning colleagues, always uplift the patients, if not with Serco food, with their presence. I love the way Lydia ignores our illnesses and, if someone is asleep when she is taking lunch orders, demands that they be woken up.

. I can see the end of this tunnel now and hope to be home in two weeks. I have now been in hospital for 6 weeks and such a long stay has an interesting effect on you. You become ‘institutionalised’. By that I mean you construct ways of getting through the days and weeks. In my case I walk 30 ward rounds each day, a corridor that encircles all the rooms on my ward. 150 paces, so I divide it into three blocks of ten. 10 early in the morning, 10 in the afternoon and 10 in the evening. I plan the first at soon after 7am which means I walk past Lydia as she is preparing her breakfast trolley. This means I get given an extra early morning cup of tea! It also means I get known for this activity with the result that the doctors have stopped insisting I have the anti-coagulant injection at 5 pm. A sharp stab in the stomach which I hated.

. Of course the hospital have their routines. Drip-feed drugs fed to my arm feed every four hours, night and day. Blood pressure and temperature every 4 hours, Cardiogram at 6 am every morning - and so on. Then there are the unexpected. The orderly turning up to take me to X-ray, cardiac tests I hadn’t been told about and so on. Of course I get to know all the staff well and we laugh and joke quite a bit. Visits from medical students etc.
Then my visitors. Most days I have friends / relatives visit me. My wife and they bring me real food as the stuff they give you here would put you in hospital if you weren’t here already! When left alone I read - at the moment a great book on the Spanish civil war, listen to music and chat with my neighbour - right now an Angolan geologist. But since I am long-term, they come and go and I am like the older relative, inducting them into useful secrets, e.g. how to get an early morning cup of tea. Of course my ‘bed-blogs’ - my stories on life in hospital which. Finally regular physio exercises. My stroke weaknesses are getting better, but my left hand is still numb and weak and I cannot play guitar. I have one here. This is the one late-in-life talent I am most proud of so my objective is that I will play it again, just not yet.
Damage to my left hand means that I can't grip the strings to make the chords and individual notes. If I was a professional musician this would be a catastrophe, but for me it is just sad. I came to the guitar late in life, even after spending much of my working life with music and musicians. Firstly with War Child and then at the Pavarotti Music Centre. I was enjoying being the oldest student of Deicola Neves and Dil Sandhu. They and all those at Camden Guitars have become my London Pavarotti Centre. So I will return there, will take more classes, will treat my guitar as central to my recovery. Will, hopefully before long, once again start each day with Autumn Leaves and Here Comes the Sun.

.... I am going home in three days after being at Barts for seven weeks. I have been told that Jeremy Corbyn is going to visit me. His office has let me know the date and time. I am amazed, but delighted that he is coming. He is my MP and I have known him for twenty years. When I was Press Officer at the Stop the War Coalition we would meet regularly, but I didn't count myself as being close to him and felt embarrassed that he was making this effort to see me. A friend told me that a haidresser in Notting Hill received a phone call from David Cameron's office. He wanted a haircut. This was after he had resigned as PM. Half an hour before he was booked in three burly gentlemen entered the premises and, without a word, started opening drawers and cupboards.
This didn't happen in my hospital ward. The door opened and there was Jeremy, hotly pursued by surprised and delighted ward staff. I had been careful not to le anyone know about his visit. Olivia and Lydia posed for selfies with him and he happily obliged.
I had a mental list of things I wanted to discuss with him - how was he coping with all the pressure, the Press hostility, the vicious attacks from the right wing of his own party, the false accusations of racism and anti-semitism. Not a chance. He wanted to talk about the Spanish civil war book on my side table and what had brought me into hospital. When, after an hour, he and his partner Laura said they were going home he asked Anne if she would like to join them on the bus . They live in Finsbury Park not far from our home in Holloway.
No burly men, no security detail, no driver. He is an exceptional man and quite unlike what we have come to expect of politicians. I hope he stays safe and and that we all work hard to ensure he becomes our next Prime Minister. JC4PM

 

Thursday, 8 November 2018

Jeremy Corbyn visits Barts Hospital









heart of the NHS




Olivia Ellor-Freeman and Lydia Kortey are the Serco caterers on my ward. These two, along with their cleaning colleagues, are lovely and always uplift the patients, if not with Serco food, with their presence. I love the way Lydia ignores our illnesses and, if someone is asleep when she is taking lunch orders, demands that they be woken up. My message to their grossly overpaid Serco CEO - 'Their wages, hours and conditions are shocking. How do you sleep at night?'

Tuesday, 30 October 2018

The end of the tunnel






A friend in Spain asked me to describe my life in hospital. You might find it interesting. You might not!
I can see the end of this tunnel now and hope to be home in ten days / two weeks. I have now been in hospital for 6 weeks and such a long stay has an interesting effect on you. You become ‘institutionalised’. By that I mean you construct ways of getting through the days and weeks. In my case I walk 30 ward rounds each day, a corridor that encircles all the rooms on my ward. 150 paces, so I divide it into three blocks of ten. 10 early in the morning, 10 in the afternoon and 10 in the evening. I plan the first at soon after 7am which means I walk past the breakfast caterer as she is preparing her trolley. This means I get given an extra early morning cup of tea! It also means I get known for this activity with the result that the doctors have stopped insisting I have the anti-coagulant injection at 5 pm. A sharp stab in the stomach which I hated. Of course the hospital have their routines. Drip-feed drugs fed to my arm feed every four hours, night and day. Blood pressure and temperature every 4 hours, Echocardiogram at 6 am every morning - and so on. Then there are the unexpected. The orderly turning up to take me to X-ray, cardiac tests I hadn’t been told about and so on. Of course I get to know all the staff well and we laugh and joke quite a bit. Visits from medical students etc. Then my visitors. Most days I have friends / relatives visit me and Anne Aylor most days. She and they bring me real food as the stuff they give you here would put you in hospital if you weren’t here already! When left alone I read - at the moment a great book on the Spanish civil war, listen to music and chat with my neighbour - right now an Angolan geologist. But since I am long-term, they come and go and I am like the older relative, inducting them into useful secrets, e.g. how to get an early morning cup of tea. Of course my ‘bed-blogs’ - my stories on life in hospital which are all on my website - one or two now published on internet sites. Finally regular physio exercises. My stroke weaknesses are getting better, but my left hand is still numb and weak and I cannot play guitar. I have one here. This is the one late-in-life talent I am most proud of so my objective is that I WILL play it again, just not yet.

song. Dire Straits Tunnel of Love 

Friday, 26 October 2018

Getting Better


When you have been in hospital for a month you learn a lot about the other patients and about the NHS staff. Here are some examples. The nurse who is always smiling, always ready with a joke and comforting words. When I comment on this I learn that her husband died when he returned to their African home to get work and rebuild a future for his wife and two sons to return to. The low paid Serco worker who gives me an early morning cup of tea, whose half-day is seven and a half hours and full day is eleven and a half. The nurse who wakes me every morning to do the daily ECG. She is always singing and when I ask her why she is so cheerful answers, 'what choice do we have?' The doctor who is part of the Consultant morning visit team who sees I am upset by the news I am given and who returns to my bedside after they have moved on to offer me reassurance. The patient who, uninvited, sits beside me to tell me about his army days in Malaya. Can't stand his Empire memories, but when he turns to his love of gardening he becomes human again. Mohammed who keeps me awake all night with his involuntary dream-screams. The next morning he apologises and we go together to the nurses desk to ask for a solution to help both of us. He is moved to his own room. A dear man and I hope he recovers because he has been too ill. As for me I'm now getting better


Thursday, 25 October 2018

Throw away food



A friend attended a lecture at The Welcome Institute last week and was told that Serco hospital food (see my earlier blog) is cooked in Wales, is then frozen and transported across the country to the company’s franchises. The food is then reheated and ’served’. The culinary destinations include not just hospitals, but the military, prisons, asylum-seeker holding centres and not forgetting the Flyingdales early warning facility. A third to a half of all this food is thrown away. The bread today was clearly toasted in Cardiff. No aspersions on Serco staff who are kind, caring and doing their best on their poverty wages. The Serco CEO on his £850,000 annual salary is doing best of all. 


song: Food glorious food

Wednesday, 24 October 2018

hot water bottles & fans




A new, low-carbon combined cooling, heating and power solution has been created for St Bartholomew’s Hospital in London as part of the first fully-financed PFI deal of its kind.
Delivered by Skanska, the project is part of Sustainable Development Capital‘s (SDCL) Powering Health collaboration with GE, Clarke Energy and the NHS Confederation.
Under the deal SDCL has provided finance for Skanska to deliver a low-carbon combined chilling/heating and power (CCHP) solution at the hospital. The £2.5m investment will be made by the UK Energy Efficiency Investments Fund, which has launched a £50m fund supported by the Green Investment Bank.”
Sounds great. I have been a patient at Barts hospital for a month and was a patient here in February, and neither the heating nor the air-conditioning have worked. My bed faces the west and on sunny days gets very hot. And it's autumn. A nurse told me that during the long hot summer this year the temperature on south and west-facing sides was 'unbearable' for both patients and staff. In winter, she said, it was so cold at night, they were handing out 4/5 blankets to each patient.
How can a medical institution of such excellence, with such a dedicated staff, all of whom I now admire and adore, mess things up when it comes to the simple problems of temperature and nutrition?
Answers from Skanska and Serco please. I am ill and cannot continue this struggle. Maybe others can.
Meanwhile these two photos show my solution for this hospital over the coming years.
I'm afraid I feel very depressed about all this right now so here is another Leonard Cohen to help you join me.



Friday, 19 October 2018

Scapegoats



"When a goat likes a book, the whole book is gone.”

I need a scapegoat and in my case it is the goat. The microbiology lab here at Barts hospital has concluded that the bug which got into my heart valve – the bovine (cow) valve which was fitted here in February, is of the Equine Streptococcal strain. So we have cows, horses and now, my theory albeit unbacked by evidence – goats. I spent a month last summer with my Bosnian family at their home outside Mostar. After I met Anne on the Croatian island of Mljet I picked up a virus which lasted until my stroke five weeks ago. There were no horses on the island but the lab has said that other animals share 99% of their DNA.
There are goats in the area, some of them once owned by the family we stay with. See Anne Aylor's film about their goats here,  (at 4.10 mins) But that was some years ago and the goats have long since taken themselves up into the surrounding woods and hills. 
But back in Mostar there are goats-a-plenty. They are on the hillside at the end of Oha and Masa Maslo's garden where I stay when I am there. (Oha is Director of Mostar Rock School) Twice a day a goat-herder walks his animals slowly across my eyes. I hear their bells before I see them emerge from the trees onto the sage-covered rocks. Even when I can't see them I hear their bells as I sit on the terrace which faces onto a garden full of cherry, pomegranate, figs and walnut trees. Wildflowers in the nearby field attract Cleopatra butterflies, Plain Tigers and a profusion of Simple Whites. Bees from Masa's hives buzz in and out from the sage bushes the goats feed from. The hill rises up to Mount Velez and we seem to be at the base of a bowl, in a hidden valley which induces a feeling of remoteness, peace and isolation.
Of course this is all an illusion. The herder is a refugee from central Bosnia, eking out a subsistence living with the help of his animals. The hillside is still peppered with mines. The wildflowers in that field are there because the family who owned the land fled when the area was under bombardment.
I see and hear the goats, but's that's it. But the two Maslo dogs are free-range and spend time on the hillside. For sure they must tread through goat detritus. Lovely dogs, they jump up to greet me whenever possible and it is possible that they brought me the streptococcal. 
But are the goats to blame for my hospital stay? Of course not. I am to blame for not building up my immune system after the February operation. I won't make the same mistake again. I have been told that the Russian military developed Neuropeptide Bioregulators that are great as immune builders. So I will move east of the Balkans and seek help from the Russians. Then it will be back to sitting on the Maslo terrace, waiting for the goats.

Here's a goat refusing to be a scapegoat

Thursday, 18 October 2018

Every Step You Take

I am now very aware that every step we take is precious. I am fortunate to be at Barts where steps matter and every morning I am receiving amazing physio treatment from a team, who like everyone here, are helping me. As a result I will recover my steps and my guitar playing – lost for the moment. My eldest son has spent his whole life struggling with his steps and my present predicament has heightened my awareness of his strength and inner will to overcome his life obstacles. These have included his PLP victory against this criminal government. I have to recover fully because Anne and I live on a top floor flat which, when reached, is itself on three levels. So when you leave home today enjoy every step you take.

Tuesday, 16 October 2018

Sisters of Mercy



The reason the senior nurse on my ward is called 'sister' is because hospitals were first opened in convents and priories. St Bartholomew's Hospital is no exception as you can discover if you watch this short film. Situated between St Paul's Cathedral and Smithfield's meat market, the area has been a place of butchery and healing for hundreds of years. The Scottish rebel, William Wallace, was hung drawn and quartered here – just a gentle reminder of how cruel things can get with our rulers. I live behind the Holloway Road, a few miles north of here. Why Holloway? The cattle drovers arriving in London on the way from the North to Smithfield came along that road. It would get clogged up with animal shit and had to be hollowed out from time to time. End of history lesson. Watch the film and here is Leonard Cohen with 'Sisters of Mercy'. A great singer and poet.

Oh the sisters of mercy, they are not departed or gone.
They were waiting for me when I thought that I just can’t go on.
And they brought me their comfort and later they brought me this song.
Oh I hope you run into them, you who’ve been travelling so long.

Yes you who must leave everything that you cannot control.
It begins with your family, but soon it comes around to your soul.
Well I’ve been where you’re hanging, I think I can see how you’re pinned:
When you’re not feeling holy, your loneliness says that you’ve sinned.

Well they lay down beside me, I made my confession to them.
They touched both my eyes and I touched the dew on their hem.
If your life is a leaf that the seasons tear off and condemn
they will bind you with love that is graceful and green as a stem.

When I left they were sleeping, I hope you run into them soon.
Don’t turn on the lights, you can read their address by the moon.
And you won’t make me jealous if I hear that they sweetened your night:
We weren’t lovers like that and besides it would still be all right,
We weren’t lovers like that and besides it would still be all right.

Sunday, 14 October 2018

The cliff




Hospitals have things in common with prisons and it's not just the Serco 'food'. There's also the attention to numbers – the counting of days. One difference. A prisoner can mark off the days to his/her release, but here there is no end date so I count forward – today 25 days completed . Of course any other comparisons end there. Prisons are places for containment and punishment. Oh and of course now profit. I read that Serco are to be given the power of arrest soon! But there is one other comparison – the slow passing of time which allows for reflection and thought. And time to write these blogs. One of my first questions to visitors is to ask about the weather. It's hard to tell from the inside of these frosted windows. Yesterday was apparently very warm for mid-October and I was told it was 'too warm', 'unusual weather' and so on. Here I am outside these experiences, looking out at them, but not a part of. And this curious situation brings me to another 'reflection'. More than ever before this hospital stay has made me acutely aware that I am observing something quite troubling out there. The advance of barbarism. Brought close to me courtesy of Serco of course, but also in the comments and conversation from my visitors. Yesterday a friend telling me she was heading off from here to Notting Hill for a Grenfell march and that the surrounds of the massacred building are full of toxins, as found at Ground Zero in NYC. Other topics passing through my hospital room range from the impending struggle over the decline in social security payments to the twelve, or is it thirteen, years we have left to save our world from global warming. And have you heard that the 1% who are responsible for this are buying up property in New Zealand? I am sure you have your own concerns which you can add to this list. So now to this train and the cliff. I was once a member of the International Socialists – today's SWP. In my time I have been an anarchist, Trotskyist, syndicalist, nihilist and today's desperatist. Anyway, their leading cadre was Yigael Gluckstein, an Israeli revolutionary who changed his name to Tony Cliff. He would often open his talks with this. “Comrades, we are all on the same train. The rich are eating caviar and sipping champagne in the restaurant car. The middle class are asleep in their couchettes. The working class are crammed into the corridors. But we are all on the same train. And it is heading to barbarism.” I used to think his view was extreme. Surely we had plenty of time to stop the train. Today I think he was thinking along the right tracks. Visit me, tell me about the weather and let me know what you think. Help me pass the time as we head towards that cliff.

Friday, 12 October 2018

In The Living Years





After three weeks in hospital and with the likelihood of at least the same again I have plenty of time in the company of my own thoughts. Plenty of time to observe the goings on in my ward and the lives of other patients. There are some here who are having a much worse time of it than me, medically and personally. I feel for those who do not have family or friends to visit them. The patient whose wife is disabled and housebound for example. Those without friends or whose family and friends live far away. I am lucky. My wife is, for the third time in almost as many years, my life-saving presence and working hard to challenge my weight-loss with her supply of burittos. She is there on ward rounds to ask the questions I never thought to ask. Waits with me while I have the endless checks and scans. Then my visitors. My family and friends who cheer me up and supply me with foods, drinks and other treats. Books of course. I start reading one when my attention is distracted by the next arrival. Of course pride of place, an ex-neighbour's collection of her poems which nearly rolled me onto the floor in laughter. Then those who give me distance healing and their prayers. My son who put together a music programme for me. My Bosnian 'son' who suggests music to get better with. Finally the staff here whose care and humour I have already written about. And not allowed to escape without mention. The Barts nurse, now working here in research, who became a friend when I was here for the operation in February and who regularly visits me and answers the questions I still need answers to! I am not going to claim all is perfect in my life. There are those once close to me who remain distant. This song says it all and is dedicated to all those in this and other hospitals who have or are experiencing sadness and loss

Tuesday, 9 October 2018

NHS Pirates, reposted. SERCO is only part of our problem



Illness is neither an indulgence for which people have to pay, nor an offence for which they should be penalised, but a misfortune, the cost of which should be shared by the community” Aneurin Bevan 

Capitalism is the astounding belief that the most wicked of men will do the most wicked of things for the greatest good of everyone.” JM Keynes



Virgin Care leads the way in negating the founding principles of the NHS whilst claiming to promote the greatest good. So I will start with them.
Over the past seven years they have been awarded NHS contracts worth over £2 billion. By this year, they were running over 400 NHS services. 
Virgin Care has two arms to its business in the NHS: primary care services, including GP services and community-based NHS services.
In January 2018 Virgin Care Private was launched, opening its first health and wellbeing centre in Birmingham.This centre provides GP services, specialist consultations, diagnostics and tests on a pay-as-you-go service.
The company targets large contracts containing numerous services in the area of community health and social care. Since 2012 they have won these contracts in over seven UK regions.
When Virgin Care has failed to win contacts it has resorted to legal action. The full amount paid to date to Virgin by you and me as taxpayers could be as high as £2.6 million.
Labour MP Paula Sherriff, revealed that when she worked for Virgin Care the company insisted on “extra consultations before surgery, boosting their profits at the expense of the taxpayer and patient safety”.
The parent company, Virgin Group Holdings Ltd, is registered in the British Virgin Islands. Richard Branson and his family hold a £2.7 billion stake in this offshore, tax-free, tax-haven company.
Virgin is just the tip of the scalpel.
NHS Support Federation, reveals that profit-driven companies such as Bupa, Virgin Care and Care UK have in the last four years won more than 130 NHS service contracts worth £2.6bn to provide NHS services. Dr Mark Porter, of the British Medical Association, said: “These figures show the extent of privatisation in the NHS following the pushing through of the Health and Social Care Act. An act that the government denied loud and long would lead to privatisation, has done exactly that. Enforcing competition has not only fragmented services and compromised the delivery of high-quality care, but it is also diverting vital funding away from frontline services to costly, complicated tendering processes, highlighting just how counterproductive the reorganisation has been.”
At the beginning of 2017 private-sector companies had been invited to bid for 14% more NHS contracts than a year previously. According to the Department of Health accounts, the private sector delivered a total of £8.7bn of NHS services for 2015/16, or around 7.6 per cent of the total NHS budget. These figures exclude GP services, dentistry and community pharmacy.
David Hare, chief executive of the Partners Network, which represents private sector providers, has said there was a slow “evolutionary trajectory” of greater private sector involvement in the NHS.

So who, alongside Richard Branson and his family, are a part of this trajectory? These are the 'privateers' I have discovered. There are others. 32 to date and counting.
Alliance / Lodestone - Diagnostics for the NHS and independent sector
BDO - Commissioning services for the NHS
BMI - You can now choose to have your NHS treatment at a BMI Healthcare hospital
BUPA - The biggest private healthcare company which takes your money and then depends on the NHS to carry out expensive treatments.
Capio - Free family practice services if registered with them.
Capita - IT, patient engagement, HR, payroll, commissioning services.
Cap Gemine – NHS programme management and technical expertise.
Care UK - Day care and homes for elderly. GP services, diagnostics, treatment centres, mental health services learning disability services.
Centene - IT, digital technologies for NHS.
Circle UK - Large community care contracts and is the first private company to run an NHS hospital – Hinchingbrooke in Cambridgeshire.
Classic Care - homecare services.
Diaverum UK Ltd - kidney services in partnership with the NHS.
Exel Europe Ltd - consumer procurables acquired for NHS.
Facilities First LLP - pathology services to NHS Foundation Trusts.
Gemini - IT support for NHS
General Healthcare - a private specialist in fertility treatment.
HCA International - Through US companies Tenet Healthcare and Aspen Healthcare provide “opportunities to work with and support the NHS.
IBM - Electronic staff records services to NHS, payroll, pensions and other human resources functions.
InHealth Group - diagnostics for NHS throughout the UK.
McKesson - IT support
Mouchel - Commissioning services.
Nector Primecare - Home care, care homes, mental health services, children’s services, out-of-hours, dentistry and primary care.
Netcare - Clinics set up iby South African company, which works under contract to the NHS.
Optimum - part of of US United Health Group which works with the NHS to provide services such as contract negotiations and medication management.
Partnership in Care – Working with NHS as provider of secure mental health facilities across the UK. Working with the NHS.
Pathology First LLP - pathology services to NHS Foundation Trusts.
The Practice - 75% owned by US company Centene, providing primary care services and specialist clinical services to GPs.
Priory Group - Provider of acute mental health care, complex care and neuro-rehabilitation services, fostering and care homes.
Ramsay UK - 22 hospitals in the UK delivering both private treatment and care under contract to the NHS 

Serco with an annual turnover in excess of £3 bn, it operates prisons and immigration detention centres, provides support to the military and manages healthcare facilities.

Spite Classic - Second largest private healthcare hospital group in the UK with 37 hospitals; NHS admissions accounting for 25% of its business.
Totally PLC - Working with the NHS including physiotherapy, podiatry, dermatology, referral management services and clinical health coaching.
United Health/Optum - Health needs assessment, GP Commissioning, performance & contract management, Medicines management.

An historical note on pirates: Richard Branson has a home on Necker Island, part of the British Virgin Isles. In the 17th century these islands were a centre of piracy. Yes I know peg-legged, one-eyed, walk-the-plank buccaneers. The truth is the 'pirates' were often escaped black slaves who set up a Pirate's Republic in the area. The Jack Sparrow / Jonny Depp characterisation is myth which has become reality in our times with the arrival of the real Jack Sparrow in the form of Richard Branson.

Redemption Song

Sunday, 7 October 2018

Let Them Eat Serco


Now for the dark side of hospitals, creeping – no galloping - privatisation of our NHS and what it means in reality. As I have already reported Serco, 'serves many community services, including hospitals, the military and prisons.' Oh and controls the Flyingdales early warning system in Yorkshire. It also runs Yarls Wood women's immigration detenton centre. The company was referred to the Serious Fraud Office for overcharging the Ministry of Justice for the electronic tagging of prisoners there and in other 'holding' facilities. When the women went on hunger strike in March 2018 their supporters left decaying food on the steps of Serco's London HQ as an act of solidarity.
The company has since struggled to win new work while losing a series of contracts including a deal to manage the Docklands Light Railway in London and run a New Zealand prison amid allegations that staff were running “fight clubs”.
Meanwhile Serco food here at Barts is, well, a mess of mash. I have started chosing sandwiches as an option; today's tuna lunch, shrouded in white chemical bread. It would not cut much into Winston Churchill's grandson and Cerco CEO, Rupert Soames' £850,000 annual salary to use a half-way decent roll.
Serco employees at Barts are excluded from the limited protection of NHS pay agreements and receive less than £10 per hour. Serco should be thrown out of our hospitals and food should, once again, be treated as central to health and getting better. It must not be a means to enrichment for Soames and his wealthy cronies.
Qustion for Serco's CEO. What did you eat for lunch today Mr Soames?

song: Money