Martin Newell’s Joy of Essex: We may moan but the NHS is there when we really need it
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The young eye doctor, having examined my right eye, tells me that he is just going to ask for a second opinion.
The senior surgeon arrives. “Put your chin here.” he says, gesturing at the apparatus in front of me. He sits down opposite me. “Look at my ear please.” I do so. The commands follow in quick succession: “Look down. Now look left. Left and up. Up. Right. Right and down. Okay. Sit back now.”
Very matter-of-factly he tells me. “The retina is detched. We’ll operate tomorrow. “
I’m in shock. I’m still dealing with the aftermath of the retina in my left eye, which detached two and a half years ago, necessitating three subsequent procedures, and much post-operative care. Now my right eye, the ‘good’ one, has detached too. “Will the operation be in London again?” I ask with sinking heart. “No. Here,” he replies. “No general anaesthetic?” I ask. “No. A local one,” he says. Relief.
“Okay then. What time?” I ask. He tells me to be at the operating theatre at 8am. My op is first up. “We have to save your sight” are his last words. I’ve been down this road before and know something of what may be involved.
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I stand outside the hospital in the rain. I hardly slept the night before. This is the point at which, if I’d still smoked, I might have lit up. Instead, I phone home. You could say that to have one retina detach itself is unfortunate, two seems like sheer carelessness.
It’s bad luck at any rate.
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My predicament although unusual, is not unheard-of. I know three men of similar age to whom double detachment has happened. Only a few decades ago many of the procedures for dealing with the condition didn’t exist. Fifty years ago, the success rate for retinal re-attachment was less than 40 per cent. Some people simply lost their sight.
Although at this juncture I feel apprehensive, I am also somewhat relieved. They’ve caught this one earlier than the last. And I’m in good hands. I feel lucky. I have just attended a first rate eye clinic and been seen by a well-respected surgeon. From time of diagnosis to time of surgery is 20 hours. Let no one say that I’m having less than first class service.
Actually, that’s the thing about the NHS. People may moan about queues, waiting lists and what-have-you. But when you are really, really in trouble, then nearly always their net will catch you before you fall.
It remains a kind of miracle.
The fact that the NHS is never far from the top of the political agenda, no matter who happens to be in government, means that the fact is acknowledged. This does not mean, however, as I am later reminded by a health professional, that the cracks in its structure are not appearing.
The night before my operation, I remember that the great baroque composers, Bach and Handel both suffered unsuccessful eye-surgery at about my age. Bach died of a stroke shortly aftewards. Handel survived a few years longer. Medical science has come a long way in the past three centuries. Eye surgery, which I’ve now experienced on four occasions, is by no means a picnic. But nor is it quite as fearsome or painful as you might think. It’s the after-care which is the difficult bit.
Last week, for instance, having been discharged two hours after surgery, I was instructed to spend the rest of that day and night sitting, head on pillow looking directly down, or else lying on my stomach face-down with my head on my arms. This procedure is referred to as ‘posturing’.
For the six days following, I was instructed instead to lie down, right cheek on my pillow, day and night, to help keep the re-attached retina in place. There were breaks. For 15 minutes each hour, I was permitted to walk gently around, and fit in any necessary light tasks I could do within the time allowed : shaving, making a cup of tea etc. No cycling and no heavy lifting. In addition, for a few weeks, there’s a daunting regime of eyedrops to be administered up to four times daily. There are antibiotic eyedrops, drops to help form good scar tissue, drops to keep the pupil dilated in order to facilitate healing and finally, drops to keep the ocular pressure at an acceptable level. These drops often have long names, which you may dilgently attempt to learn so that you can remind other medics which ones you’re taking. Later you’ll find that they call these same drops by a completely different name.
I learned to say, “Dexamethasone” for instance. Quite impressive I thought. The surgeon, however, always calls it “Maxidex.”a name which appears nowhere on the box.
Such mysteries apart, the follow-up regime is as important as the operation, as the nurses remind you. The nurses in NHS opthalmology departments, incidentally, are especially kindly and helpful. They know they are dealing with nervous, sometimes fearful people, many of whom may be of an age when eye ailments are more common.
In this country we are very lucky that such departments exist. They deserve to be cherished amd protected.