Thursday, 27 August 2009


A fun day of sorts today – I had an appointment at the local rheumatology department. I have a sneaky suspicion that it’s not actually run by the NHS and is in fact an offshoot of First Great Western railway. I come to this conclusion because last year I never caught a FGW train that was on time and I’ve never had an appointment at rheumatology that started on time.

Today was no different; I was there at 9.15 for an appointment at 9.30 and actually seen at 10.40. It does give an opportunity to study what goes on.

At the entrance to the outpatient area there is a device that delivers antibacterial hand gel and a sign that says please use before entering this area. This time a few more people used it – probably motivated by the swine flu, mostly I’m the only person that touches the stuff. I guess everyone thinks it’s mindless bureaucracy but actually rheumatologists use some drugs that depress the immune system – Methotrexate for instance, so people in the patient area could be at greater risk of infection, and hand hygiene is an important protection

They always take my blood pressure and it’s always about 15 points lower than it was in cardiology. I’ve told them each time I come and they always tell me that their machine is more accurate. Is that likely? Would the hospital put a more accurate machine in rheumatology than in cardiology? Today there was a woman sitting next to me who’s been to cardiology as well. Her blood pressure is also 15 points lower in rheumatology than it is in cardiology. I told them about it again but I’d be prepared to bet nothing will have changed next time I go.

There’s another feature of sitting in that queue – the booping alarm. I call it that because I know the sound so well. I have no idea what it is but it goes off every time I’m sitting on those chairs at the end of the corridor. If you time it for several minutes you get six boops in 62 seconds, once every 10.333333333333333333 seconds, you can tell how long I’ve been listening. There is something of a contradiction in that alarm. It’s obviously important to someone, otherwise why have an alarm on it, but it’s not so important that anyone bothers to turn it off. It’s obviously like the hand gel – it matters to someone but no one knows who.

There is something about communication in that place. The last time I went the doctor I saw suggested I see the hand surgeon. OK by me, my arthritis can get me down and gradually joints in my fingers are fusing together. Sooner or later I’m going to have solid sticks protruding from my palms, so I thought seeing the hand surgeon would be a good idea. Three months later I saw him.

‘Why have you come?’ he said.

‘The rheumatologist sent me.’

‘Well there’s nothing I can do for you – the kind of arthritis you have is going to go on all around the joints even if I put in a new one.’

We did eventually agree that if my fingers go stiff pointing in a really useless direction the surgeon can at least make them move a bit and point somewhere more useful. They will still hurt.

Did I need to wait three months and spend two hour at the hospital to tell me that? The hand surgeon is sitting in the same clinic and the same desk as the rheumatologist who set me off on this unnecessary visit. Even if they can’t bring themselves to talk to each other they could stick notes on the desk. Some communication must be possible.

Would it be an awful pun about the rheumatology department to say it was disjointed? I promise I’ll get back to the novel, so long as my fingers keep pointing the right way.

1 comment:

  1. I fear the answer is that a patient who does not pay at point of service (because God knows we all pay for the NHS) will not be treated as a valued customer. Go private, and the experience is quite different; you will not be kept waiting, and you will be listened to.

    I'm sorry to hear about your fingers.